Winkelman John W, Schoerning Laura, Platt Sam, Jensen J Eric
Department of Psychiatry, Harvard Medical School, Boston, MA, USA; Departments of Psychiatry and Neurology, Sleep Disorders Clinical Research Program, Massachusetts General Hospital, Boston, MA, USA.
Departments of Psychiatry and Neurology, Sleep Disorders Clinical Research Program, Massachusetts General Hospital, Boston, MA, USA.
Sleep Med. 2014 Oct;15(10):1225-30. doi: 10.1016/j.sleep.2014.05.019. Epub 2014 Jun 12.
Previous research has demonstrated abnormalities in glutamate and N-acetyl aspartate (NAA) in the thalamus in individuals with restless legs syndrome (RLS) compared with healthy matched controls. However, levels of these transmitters in other RLS-related brain areas and levels of the most common inhibitory neurotransmitter, gamma-aminobutyric acid (GABA), have not been assessed.
This study examined GABA, glutamate, and NAA levels in the dorsal anterior cingulate cortex (ACC), thalamus and cerebellum with the use of proton magnetic resonance spectroscopy ((1)H-MRS) at 4 tesla (4 T) and Megapress difference-editing in 18 subjects with RLS and a matched control group without RLS. Actigraphy was performed on the nights before scans to assess periodic limb movements of sleep (PLMS).
Levels of GABA, glutamate, and NAA were no different between RLS and control subjects in any of the three voxels of interest. However, GABA levels were positively correlated with both PLM indices and RLS severity in the thalamus and negatively with both of these measures in the cerebellum in RLS subjects. In addition, NAA levels were higher in the ACC in RLS than in controls.
Our preliminary data suggest that known cerebellar-thalamic interactions may modulate the intensity of RLS sensory and motor symptoms. In addition, anterior cingulate cortex may be associated with the affective components of the painful symptoms in this disorder.
先前的研究表明，与健康对照者相比，不宁腿综合征（RLS）患者丘脑谷氨酸和N-乙酰天门冬氨酸（NAA）存在异常。然而，这些神经递质在其他与RLS相关脑区的水平以及最常见的抑制性神经递质γ-氨基丁酸（GABA）的水平尚未得到评估。
本研究使用4特斯拉（4T）的质子磁共振波谱（（1）H-MRS）和Megapress差异编辑技术，检测了18例RLS患者及匹配的无RLS对照组受试者背侧前扣带回皮质（ACC）、丘脑和小脑的GABA、谷氨酸和NAA水平。在扫描前一晚进行活动记录仪监测，以评估睡眠期周期性肢体运动（PLMS）。
在三个感兴趣的体素中，RLS患者和对照者的GABA、谷氨酸和NAA水平均无差异。然而，在RLS患者中，丘脑GABA水平与PLM指数和RLS严重程度均呈正相关，而小脑GABA水平与这两项指标均呈负相关。此外，RLS患者ACC中的NAA水平高于对照组。
我们的初步数据表明，已知的小脑-丘脑相互作用可能调节RLS感觉和运动症状的强度。此外，前扣带回皮质可能与该疾病疼痛症状的情感成分有关。
