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 Med. 2023 Dec;112:256-261. doi: 10.1016/j.sleep.2023.10.030. Epub 2023 Nov 2.
We aimed to investigate alterations in cerebellar volume and the intrinsic cerebellar network in patients with restless legs syndrome (RLS).
We recruited 69 patients with RLS and 50 healthy controls who underwent brain magnetic resonance imaging (MRI), including three-dimensional T1-weighted imaging. The total cerebellar volume and cerebellar volume subdivisions were analyzed through automatic cerebellum anatomical parcellation using U-Net with locally constrained optimization program. The intrinsic cerebellar network was calculated through brain analysis using a graph theory program based on the cerebellar volume subdivisions. The cerebellar volumes and intrinsic cerebellar networks were compared between patients with RLS and healthy controls.
The cerebellar volume and subdivisions in patients with RLS did not show significant differences compared to those in healthy controls. However, significant alterations were observed in the intrinsic cerebellar network of patients with RLS. Increased mean clustering coefficient (0.185 vs. 0.114; p = 0.047) and small-worldness index (0.927 vs. 0.800; p = 0.047) were observed in patients with RLS. Additionally, total cerebellar volume was negatively correlated with the Pittsburgh Sleep Quality Index (r = -0.398; p = 0.020) and Insomnia Severity Index (ISI; r = -0.396; p = 0.011). Negative correlations were additionally observed between the right X lobule volume and the International Restless Legs Syndrome Severity Scale (r = -0.425; p = 0.008) and between the vermis VIII volume and ISI score (r = -0.399; p = 0.011).
We demonstrated alterations in the intrinsic cerebellar network in patients with RLS compared with healthy controls, showing increased connectivity with increased segregation in patients with RLS. This suggests a potential role of the cerebellum in RLS pathophysiology.
本研究旨在探讨不安腿综合征（RLS）患者小脑体积和内在小脑网络的变化。
我们招募了 69 例 RLS 患者和 50 例健康对照者，他们均接受了脑部磁共振成像（MRI）检查，包括三维 T1 加权成像。采用 U-Net 结合局部约束优化程序对小脑进行自动解剖分区，分析总小脑体积和小脑体积分区。基于小脑体积分区，通过脑分析使用基于图论的程序计算内在小脑网络。比较 RLS 患者与健康对照组的小脑体积和内在小脑网络。
与健康对照组相比，RLS 患者的小脑体积和小脑体积分区无显著差异。然而，RLS 患者的内在小脑网络存在显著改变。RLS 患者的平均聚类系数（0.185 比 0.114；p=0.047）和小世界指数（0.927 比 0.800；p=0.047）升高。此外，总小脑体积与匹兹堡睡眠质量指数（r=-0.398；p=0.020）和失眠严重程度指数（ISI；r=-0.396；p=0.011）呈负相关。右侧 X 小叶体积与国际不安腿综合征严重程度量表（r=-0.425；p=0.008）和蚓部 VIII 体积与 ISI 评分（r=-0.399；p=0.011）之间也存在负相关。
与健康对照组相比，RLS 患者的内在小脑网络存在改变，表现为 RLS 患者的连接性增加，分离度增加。这表明小脑在 RLS 病理生理学中可能发挥作用。
