Astrakas L G, Konitsiotis S, Margariti P, Tsouli S, Tzarouhi L, Argyropoulou M I
Department of Radiology, Medical School University of Ioannina, Greece.
Neurology. 2008 Sep 16;71(12):911-6. doi: 10.1212/01.wnl.0000325914.50764.a2.
To assess in patients with late-onset idiopathic restless legs syndrome (RLS) the brain iron content with magnetic resonance relaxometry, and brain activation during dorsiflexion and plantar flexion of both feet, using fMRI.
The study was approved by the institutional review board, and informed consent was obtained. Twenty-five RLS patients (14 women, 11 men; age range 55-82 years; mean 66.5 +/- 8.9 years; disease duration 6.5 +/- 4.5 years) and 12 sex- and age-matched controls were studied. A T1-weighted high-resolution three-dimensional spoiled gradient echo sequence was used for structural imaging, a multislice spin echo Tau2-weighted sequence was used for T2 relaxometry, and a single-shot multislice gradient echo planar sequence was used for fMRI. The motor paradigm consisted of alternating periods of rest and movement, each 40 seconds in duration. Region of interest analysis was used on the T2 relaxometry maps. Statistical parametric mapping software was used for analysis of the functional data.
T2 relaxation time was significantly higher in patients than in controls in the substantia nigra pars compacta. Within-group analysis showed that both patients and controls activated the primary motor cortex, the primary somatosensory cortex, the somatosensory association cortex, and the middle cerebellar peduncles. Patients also activated the thalamus, putamen, middle frontal gyrus, and cingulate gyrus. Between-group analysis showed that patients had higher activation of the dorsolateral prefrontal cortex.
Late-onset restless legs syndrome is associated with low iron content of the basal ganglia and increased activity of the dorsolateral prefrontal cortex.
采用磁共振弛豫测量法评估迟发性特发性不宁腿综合征（RLS）患者的脑铁含量，并使用功能磁共振成像（fMRI）评估双脚背屈和跖屈时的脑激活情况。
本研究经机构审查委员会批准，并获得了知情同意。对25例RLS患者（14例女性，11例男性；年龄范围55 - 82岁；平均66.5±8.9岁；病程6.5±4.5年）和12例性别及年龄匹配的对照者进行了研究。使用T1加权高分辨率三维扰相梯度回波序列进行结构成像，使用多层自旋回波Tau2加权序列进行T2弛豫测量，使用单次激发多层梯度回波平面序列进行fMRI。运动范式包括交替的休息和运动期，每个周期持续40秒。在T2弛豫测量图上进行感兴趣区域分析。使用统计参数映射软件对功能数据进行分析。
在黑质致密部，患者的T2弛豫时间显著高于对照者。组内分析显示，患者和对照者均激活了初级运动皮层、初级躯体感觉皮层、躯体感觉联合皮层和小脑中脚。患者还激活了丘脑、壳核、额中回和扣带回。组间分析显示，患者背外侧前额叶皮层的激活程度更高。
迟发性不宁腿综合征与基底节铁含量降低及背外侧前额叶皮层活动增加有关。
