Moreau Augustin, Namer Izzie Jacques, Tatu Laurent, Wolff Valérie, Bourgin Patrice, Ruppert Elisabeth
CIRCSom (International Research Center for ChronoSomnology) & Sleep Disorder Center, Strasbourg University Hospital, 1 Place de L'Hôpital, 67000 Strasbourg, France.
Department of Biophysics and Nuclear Medicine, Strasbourg University Hospital, Strasbourg, France.
Sleep Biol Rhythms. 2024 Jun 17;22(4):531-534. doi: 10.1007/s41105-024-00534-z. eCollection 2024 Oct.
Stroke-related restless legs syndrome (sRLS) is an emerging clinical entity, with a clear relationship between stroke and the occurrence of restless legs syndrome (RLS). Dopamine dysregulation has been observed in sRLS of the lenticulostriate region with increased dopamine precursor and decreased dopamine transporter. The aim of this work is to explore an original case of regressive RLS following stroke. Anatomical (MRI) and functional (F-FDG PET; F- FDOPA PET; I-FP-CIT SPECT) brain imaging was performed in our patient. A 63 year-old woman experienced complete resolution of longstanding restless legs syndrome (RLS) after a right middle cerebral artery stroke (left faciobrachial sensorimotor deficit), efficiently treated with intravenous thrombolysis. Having had RLS for 14 years, she reported complete symptom relief within four days post-stroke. 2 year follow-up confirmed sustained improvement. In our patient, functional dopaminergic imaging revealed an overall normal dopaminergic tone. This case contradicts the more commonly reported scenario of sRLS where stroke leads to the onset or worsening of RLS. The pathophysiology of RLS remains unclear and in the absence of clear biomarkers for RLS, small lesion models in humans can provide valuable insights to a better understanding of this disease.
卒中相关性不安腿综合征（sRLS）是一种新出现的临床实体，卒中与不安腿综合征（RLS）的发生之间存在明确关联。在豆状核纹状体区域的sRLS中观察到多巴胺调节异常，多巴胺前体增加而多巴胺转运体减少。这项工作的目的是探讨一例卒中后退行性RLS的原始病例。对我们的患者进行了脑部解剖学（MRI）和功能成像（F-FDG PET；F-FDOPA PET；I-FP-CIT SPECT）。一名63岁女性在右侧大脑中动脉卒中（左侧面臂感觉运动功能缺损）后，长期存在的不安腿综合征（RLS）完全缓解，经静脉溶栓有效治疗。她患有RLS 14年，报告称卒中后四天内症状完全缓解。两年随访证实病情持续改善。在我们的患者中，功能性多巴胺能成像显示多巴胺能张力总体正常。该病例与更常见的sRLS情况相反，即卒中导致RLS发作或恶化。RLS的病理生理学仍不清楚且缺乏明确的RLS生物标志物，人类的小病变模型可为更好地理解这种疾病提供有价值的见解。
