From the Department of Radiology (B.-Y.L.), University of Minnesota, Minneapolis; Biomedical Engineering (J.K.), Duke University, Durham, NC; Departments of Neurosurgery (J.R.C.), Neurology (G.D.P.), and Radiology, Neurosurgery, and Bioengineering (Q.X.Y.), Pennsylvania State Hershey Medical Center; and Department of Radiological Science (Y.R.), Gachon University, South Korea.
Neurology. 2018 May 22;90(21):e1834-e1841. doi: 10.1212/WNL.0000000000005562. Epub 2018 Apr 25.
To investigate morphologic changes in the somatosensory cortex and the thickness of the corpus callosum subdivisions that provide interhemispheric connections between the 2 somatosensory cortical areas.
Twenty-eight patients with severe restless legs syndrome (RLS) symptoms and 51 age-matched healthy controls were examined with high-resolution MRI at 3.0 tesla. The vertex-wise analysis in conjunction with a novel cortical surface classification method was performed to assess the cortical thickness across the whole-brain structures. In addition, the thickness of the midbody of the corpus callosum that links postcentral gyri in the 2 hemispheres was measured.
We demonstrated that a morphologic change occurred in the brain somatosensory system in patients with RLS compared to controls. Patients with RLS exhibited a 7.5% decrease in average cortical thickness in the bilateral postcentral gyrus ( < 0.0001). Accordingly, there was a substantial decrease in the corpus callosum posterior midbody ( < 0.008) wherein the callosal fibers are connected to the postcentral gyrus, suggesting altered white matter properties in the somatosensory pathway.
Our results provide in vivo evidence of morphologic changes in the primary somatosensory system, which could be responsible for the sensory functional symptoms of RLS. These results provide a better understanding of the pathophysiology underlying the RLS sensory symptoms and could lead to a potential imaging marker for RLS.
研究体感皮层形态变化和胼胝体各亚区厚度的改变，这些改变提供了 2 个体感皮质区之间的半球间连接。
在 3.0T 磁共振上对 28 例严重不宁腿综合征（RLS）患者和 51 例年龄匹配的健康对照者进行高分辨率 MRI 检查。采用顶点分析结合新的皮质表面分类方法，评估全脑结构的皮质厚度。此外，还测量了连接 2 个半球中央后回的胼胝体体部的厚度。
与对照组相比，RLS 患者的大脑体感系统存在形态学改变。RLS 患者双侧中央后回的平均皮质厚度下降了 7.5%（<0.0001）。相应地，胼胝体后体部（<0.008）显著变薄，其中胼胝体纤维与中央后回相连，提示体感通路上的白质性质发生了改变。
我们的研究结果提供了体感系统形态变化的活体证据，这可能是 RLS 感觉症状的原因。这些结果为 RLS 感觉症状的病理生理学提供了更好的理解，并可能导致 RLS 的潜在影像学标志物。
