不宁腿综合征中脑干结构的超声异常

Sonographic abnormalities of brainstem structures in restless legs syndrome.

作者信息

Godau Jana, Wevers Anne-Kathrin, Gaenslen Alexandra, Di Santo Adriana, Liepelt Inga, Gasser Thomas, Berg Daniela

机构信息

Hertie Institute for Clinical Brain Research and Center of Neurology, Department of Neurodegeneration, Hoppe-Seyler-Str. 3, University of Tuebingen, 72076 Tuebingen, Germany.

出版信息

Sleep Med. 2008 Oct;9(7):782-9. doi: 10.1016/j.sleep.2007.09.001. Epub 2007 Nov 19.

DOI:10.1016/j.sleep.2007.09.001

PMID:18024170

Abstract

BACKGROUND AND PURPOSE

Using transcranial B-mode sonography (TCS), the first morphological marker for restless legs syndrome (RLS), hypoechogenicity of the substantia nigra (SN) has been found. The aim of this study was to validate SN hypoechogenicity as a morphological marker for RLS in a large patient cohort and to investigate further RLS-associated brain abnormalities using TCS.

METHODS

One hundred forty-three RLS patients (37 with symptomatic RLS) and 45 controls, matched for age and gender, underwent TCS by an experienced and independent rater who was blinded to clinical data.

RESULTS

The basal ganglia, ventricular system and cerebral lobes showed no RLS-specific abnormalities. SN hypoechogenicity correlated with a family history of RLS (p<0.001) and showed good sensitivity (82%), specificity (83%) and positive predictive value (94%). Red nucleus hyperechogenicity and brainstem raphe (BR) hypoechogenicity were more prevalent in RLS than in controls (both p<0.001) and correlated with reported periodic limb movements and depression, respectively (both p<0.001). Seventy-six percent of the patients (7% of controls) showed a co-occurrence of two or more sonographical abnormalities; 60% of symptomatic RLS patients showed the same sonographic features as the majority of RLS patients.

CONCLUSIONS

TCS is a useful additional tool for diagnosing RLS and RLS-related disorders that demonstrate various brainstem abnormalities.

摘要

背景与目的

使用经颅B型超声（TCS），已发现不宁腿综合征（RLS）的首个形态学标志物——黑质（SN）回声减低。本研究的目的是在一个大型患者队列中验证SN回声减低作为RLS的形态学标志物，并使用TCS进一步研究与RLS相关的脑异常。

方法

143例RLS患者（37例有症状性RLS）和45例年龄及性别匹配的对照者，由一位对临床数据不知情的经验丰富且独立的评估者进行TCS检查。

结果

基底神经节、脑室系统和脑叶未显示出RLS特异性异常。SN回声减低与RLS家族史相关（p<0.001），并显示出良好的敏感性（82%）、特异性（83%）和阳性预测值（94%）。红核回声增强和脑干中缝（BR）回声减低在RLS患者中比在对照者中更常见（均p<0.001），且分别与报告的周期性肢体运动和抑郁相关（均p<0.001）。76%的患者（7%的对照者）出现两种或更多种超声异常；60%的有症状性RLS患者表现出与大多数RLS患者相同的超声特征。