Department of Internal Medicine, Haeundae Paik Hospital, Inje University College of Medicine, Busan, Korea.
Department of Internal Medicine, BMS Hanseo Hospital, Busan, Korea.
Sleep Breath. 2024 May;28(2):673-681. doi: 10.1007/s11325-023-02943-9. Epub 2023 Oct 27.
The purpose of this study was to examine differences in functional connectivity between patients with end-stage renal disease (ESRD) with and without restless legs syndrome (RLS). In addition, the study aimed to identify any potential associations between RLS severity and functional connectivity.
We enrolled patients with ESRD who had been undergoing hemodialysis. Patients with and without RLS were separated into two groups. Using functional near-infrared spectroscopy (fNIRS) and a graph theory approach, we determined the functional connectivity of patients with ESRD. The data were collected during a 300-s resting state evaluation performed in the dialysis room prior to dialysis.
Eighteen of 48 patients with ESRD were diagnosed with RLS, whereas 30 patients did not exhibit RLS symptoms. Notably, functional connectivity metrics differed significantly between patients with and without RLS. Specifically, patients with ESRD and RLS displayed higher values for mean clustering coefficient (0.474 vs. 0.352, p = 0.001), global efficiency (0.520 vs. 0.414, p = 0.001), strength (6.538 vs. 4.783, p = 0.001), and transitivity (0.714 vs. 0.521, p = 0.001), while values for diameter (5.451 vs. 7.338, p = 0.002), eccentricity (4.598 vs. 5.985, p = 0.004), and characteristic path length (2.520 vs. 3.271, p = 0.002) were lower in patients with ESRD and RLS compared to those without RLS. In addition, there were correlations between the RLS severity score and the assortative coefficient (r = 0.479, p = 0.044), the small-worldness index (r = -0.475, p = 0.046), and transitivity (r = 0.500, p = 0.034).
We demonstrated differences in functional connectivity between patients with ESRD with and without RLS, which may shed light on the pathophysiology of RLS. Notably, a number of functional connectivity metrics demonstrated strong associations with RLS severity. Our study also confirmed the applicability of fNIRS as a tool for investigating functional connectivity in patients with RLS.
本研究旨在探讨终末期肾病（ESRD）伴与不伴不安腿综合征（RLS）患者之间功能连接的差异。此外，本研究旨在确定 RLS 严重程度与功能连接之间的任何潜在关联。
我们招募了正在接受血液透析的 ESRD 患者。将伴或不伴 RLS 的患者分为两组。使用功能近红外光谱（fNIRS）和图论方法，我们确定了 ESRD 患者的功能连接。数据是在透析前在透析室进行的 300 秒静息状态评估期间收集的。
48 名 ESRD 患者中有 18 名被诊断为 RLS，而 30 名患者没有 RLS 症状。值得注意的是，伴或不伴 RLS 的患者的功能连接指标存在显著差异。具体而言，ESRD 伴 RLS 患者的平均聚类系数（0.474 比 0.352，p=0.001）、全局效率（0.520 比 0.414，p=0.001）、强度（6.538 比 4.783，p=0.001）和传递性（0.714 比 0.521，p=0.001）较高，而直径（5.451 比 7.338，p=0.002）、偏心度（4.598 比 5.985，p=0.004）和特征路径长度（2.520 比 3.271，p=0.002）较低。此外，RLS 严重程度评分与聚类系数（r=0.479，p=0.044）、小世界指数（r=-0.475，p=0.046）和传递性（r=0.500，p=0.034）之间存在相关性。
我们证明了 ESRD 伴与不伴 RLS 患者之间的功能连接存在差异，这可能为 RLS 的病理生理学提供了线索。值得注意的是，一些功能连接指标与 RLS 严重程度有很强的关联。我们的研究还证实了 fNIRS 作为一种研究 RLS 患者功能连接的工具的适用性。
