Cerebral generators involved in the pathogenesis of the restless legs syndrome
Cerebral generators involved in the pathogenesis of the restless legs syndrome
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DOI：
10.1002/ana.410410513
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发表时间：
1997-05-01
影响因子：
11.2
通讯作者：
Trenkwalder, C
中科院分区：
文献类型：
--
作者：
Bucher, SF;Seelos, KC;Trenkwalder, C
不宁腿综合征的周期性肢体运动和感觉性腿部不适的病理生理学尚不清楚。通过高分辨率功能磁共振成像，我们首次定位了19例不宁腿综合征患者与感觉腿不适和周期性肢体运动相关的大脑发生器。在感觉腿部不适，主要是双侧激活小脑和对侧激活丘脑。在合并周期性肢体运动和感觉腿部不适的情况下，患者的小脑和丘脑也显示出活动。与单独的感觉腿不适条件相反，组合条件与靠近网状结构的红核和脑干中的额外激活相关。患者和对照组自愿模仿周期性肢体运动与脑干活动无关，但与苍白球和运动皮层的额外激活有关。这些发现表明，小脑和丘脑激活可能是由于感觉腿不适，红核和脑干参与不宁腿综合征患者周期性肢体运动的产生。
The pathophysiology of periodic limb movements and sensory leg discomfort in the restless legs syndrome is unknown. With high-resolution functional magnetic resonance imaging, we localized for the first time cerebral generators associated with sensory leg discomfort and periodic limb movements in 19 patients with restless legs syndrome. During sensory leg discomfort there was mainly bilateral activation of the cerebellum and contralateral activation of the thalamus. During the combined periodic limb movement and sensory leg discomfort conditions, patients also showed activity in the cerebellum and thalamus. In contrast to the sensory leg discomfort condition alone, the combined condition was associated with additional activation in the red nuclei and brainstem close to the reticular formation. Voluntary imitation of periodic limb movements by patients and control subjects was not associated with brainstem activity, but with additional activation in the globus pallidus and motor cortex. These findings indicate that cerebellar and thalamic activation may occur because of sensory leg discomfort and that the red nucleus and brainstem are involved in the generation of periodic limb movements in patients with restless legs syndrome.