Department of Neurology, Kunshan Hospital of Traditional Chinese Medicine, Kunshan, China.
Department of Central Laboratory, Affiliated Yancheng Hospital, School of Medicine, Southeast University, Yancheng, China.
J Sleep Res. 2021 Oct;30(5):e13298. doi: 10.1111/jsr.13298. Epub 2021 Feb 8.
Brain structural abnormalities in idiopathic restless legs syndrome have long been debated. Voxel-based morphometry is an objective structural magnetic resonance imaging technique to investigate regional grey matter volume or density differences between groups. In the last decade, voxel-based morphometry studies have exhibited inconsistent and conflicting findings regarding the presence and localization of brain grey matter alterations in restless legs syndrome. We therefore conducted a coordinate-based meta-analysis to quantitatively examine whether there were consistent grey matter findings in restless legs syndrome using the latest algorithms, seed-based d mapping with permutation of subject images. We included 12 voxel-based morphometry studies (13 datasets, 375 patients and 385 healthy controls). Our coordinate-based meta-analysis did not identify evidence of consistent grey matter alterations in restless legs syndrome. Grey matter alterations via voxel-based morphometry analysis are not therefore recommended to be used as a reliable surrogate neuroimaging marker for restless legs syndrome. This lack of consistency may be attributed to differences in sample size, genetics, gender distribution and age at onset, clinical heterogeneity (clinical course, anatomical distribution of symptoms, disease severity, disease duration, abnormal sensory profiles and comorbidity), and variations in imaging acquisition, data processing and statistical strategies. Longitudinal studies with multimodal neuroimaging techniques are needed to determine whether structural changes are dynamic and secondary to functional abnormalities.
特发性不宁腿综合征的脑结构异常一直存在争议。体素形态计量学是一种客观的磁共振成像技术，用于研究组间灰质体积或密度的差异。在过去的十年中，体素形态计量学研究对于不宁腿综合征中脑灰质改变的存在和定位表现出不一致和相互矛盾的发现。因此，我们使用最新的算法，即基于种子的弥散张量成像配准与受试者图像置换，进行了基于坐标的荟萃分析，以定量检查不宁腿综合征是否存在一致的灰质发现。我们纳入了 12 项基于体素的形态计量学研究（13 个数据集，375 例患者和 385 例健康对照者）。我们的基于坐标的荟萃分析并未发现不宁腿综合征存在一致的灰质改变的证据。因此，不建议通过体素形态计量学分析来改变灰质，将其作为不宁腿综合征可靠的神经影像学替代标志物。这种不一致可能归因于样本量、遗传学、性别分布和发病年龄、临床异质性（临床病程、症状解剖分布、疾病严重程度、疾病持续时间、异常感觉特征和合并症）以及成像采集、数据处理和统计策略的差异。需要进行多模态神经影像学技术的纵向研究，以确定结构变化是否具有动态性，是否继发于功能异常。
