Center for Brain Imaging, School of Life Science and Technology, Xidian University, Xi'an, 710126, People's Republic of China.
Engineering Research Center of Molecular and Neuro Imaging, Ministry of Education, Xi'an, 710126, People's Republic of China.
Brain Imaging Behav. 2020 Feb;14(1):42-50. doi: 10.1007/s11682-018-9968-z.
Restless legs syndrome (RLS) is common in the end-stage renal disease (ESRD) population; however, their interrelationship remains largely unclear. In the current study, we aimed to investigate the brain structure variation in ESRD patients with RLS (ERSD-RLS) and its potential relation with the severity of RLS. Diffusion tensor imaging and T1-weighted imaging were obtained from 64 ERSD-RLS and 64 matched healthy controls. Voxel-based morphometry (VBM) analysis and tractography atlas-based analysis (TABS) were used to detect the alteration of gray matter (GM) volume and white matter (WM) microstructural characterization. The corticospinal tract (CST), which is a main motor-pathway, was selected as a fiber bundle of interest in the TABS analysis. The severity of RLS was evaluated by using the International RLS Study Group scale. Lastly, a correlation analysis was performed to explore the interrelationship between RLS rating scores and brain structure measurements. For the results, ERSD-RLS showed abnormal GM volume of motor-related brain regions located in the bilateral superior frontal gyri, precentral gyrus, and putamen. Significant differences in the diffusion properties were found at the posterior limb of the internal capsule. Furthermore, the severity of RLS was only significantly associated with the diffusion properties, which was not found in the motor-related regions of GM. Our results suggest that the motor-related brain structure was altered in ERSD-RLS. The abnormal WM microstructure of the CST may serve as an imaging marker correlated with the severity of motor dysfunction in ERSD-RLS, indicating that WM neuroprotection should be considered when improving motor function in ERSD-RLS.
不宁腿综合征（RLS）在终末期肾病（ESRD）人群中很常见；然而，它们之间的相互关系在很大程度上仍不清楚。在目前的研究中，我们旨在研究 RLS 合并终末期肾病（ESRD-RLS）患者的大脑结构变化及其与 RLS 严重程度的潜在关系。从 64 例 ESRD-RLS 患者和 64 例匹配的健康对照组中获得弥散张量成像和 T1 加权成像。采用基于体素的形态测量学（VBM）分析和基于束追踪图谱分析（TABS）检测灰质（GM）体积和白质（WM）微观结构特征的改变。作为主要运动通路的皮质脊髓束（CST）被选为 TABS 分析中感兴趣的纤维束。采用国际 RLS 研究组量表评估 RLS 的严重程度。最后，进行相关性分析，以探讨 RLS 评分与脑结构测量之间的相互关系。结果显示，ESRD-RLS 患者双侧额上回、中央前回和壳核等与运动相关的脑区 GM 体积异常。内囊后肢的扩散特性存在显著差异。此外，RLS 的严重程度仅与 WM 微观结构显著相关，而与 GM 中的运动相关区域无关。我们的结果表明，ESRD-RLS 患者的运动相关脑结构发生改变。CST 的异常 WM 微观结构可能作为与 ESRD-RLS 运动功能障碍严重程度相关的影像学标志物，提示在改善 ESRD-RLS 运动功能时应考虑 WM 神经保护。
