Department of Neurology, Haeundae Paik Hospital, Inje University College of Medicine, Busan, South Korea.
Department of Neurology, Keimyung University School of Medicine, Daegu, South Korea.
Sleep. 2022 Jul 11;45(7). doi: 10.1093/sleep/zsac099.
To evaluate alterations of global and local structural brain connectivity in patients with restless legs syndrome (RLS).
Patients with primary RLS and healthy controls were recruited at a sleep center where they underwent diffusion tensor imaging (DTI) of the brain. We calculated the network measures of global and local structural brain connectivity based on the DTI in both groups using DSI studio program and a graph theory.
A total of 69 patients with primary RLS and 51 healthy controls were included in the study. We found a significant difference in the global structural connectivity between the groups. The transitivity in the patients with RLS was lower than that in healthy controls (0.031 vs. 0.033, p = 0.035). Additionally, there were significant differences in the local structural connectivity between the groups. The characteristic path length (r = 0.283, p = 0.018), radius of graph (r = 0.260, p = 0.030), and diameter of graph (r = 0.280, p = 0.019) were all positively correlated with RLS severity, whereas the mean clustering coefficient (r = -0.327, p = 0.006), global efficiency (r = -0.272, p = 0.023), small-worldness index (r = -0.325, p = 0.006), and transitivity (r = -0.351, p = 0.003) were negatively correlated with RLS severity.
We identified changes in the global structural connectivity of patients with RLS using graph theory based on DTI, which showed decreased segregation in the brain network compared to healthy controls. These changes are well correlated with RLS severity. We also found changes in local structural connectivity, especially in regions involved in sensorimotor function, which suggests that these areas play a pivotal role in RLS. These findings contribute to a better understanding of the pathophysiology of RLS symptoms.
评估不安腿综合征（RLS）患者的全脑和局部结构连接的变化。
在睡眠中心招募原发性 RLS 患者和健康对照者，他们接受了大脑弥散张量成像（DTI）检查。我们使用 DSI studio 程序和图论，在两组中基于 DTI 计算了全脑和局部结构脑连接的网络度量。
共纳入 69 例原发性 RLS 患者和 51 例健康对照者。我们发现两组之间的全脑结构连接存在显著差异。RLS 患者的转导性低于健康对照组（0.031 比 0.033，p=0.035）。此外，两组之间的局部结构连接也存在显著差异。特征路径长度（r=0.283，p=0.018）、图半径（r=0.260，p=0.030）和图直径（r=0.280，p=0.019）均与 RLS 严重程度呈正相关，而平均聚类系数（r=-0.327，p=0.006）、全局效率（r=-0.272，p=0.023）、小世界指数（r=-0.325，p=0.006）和转导性（r=-0.351，p=0.003）与 RLS 严重程度呈负相关。
我们使用基于 DTI 的图论识别出 RLS 患者的全脑结构连接变化，与健康对照组相比，这些患者的大脑网络的分离度降低。这些变化与 RLS 的严重程度密切相关。我们还发现局部结构连接的变化，特别是在与感觉运动功能相关的区域，这表明这些区域在 RLS 中起着关键作用。这些发现有助于更好地理解 RLS 症状的病理生理学。
