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Cerebral generators involved in the pathogenesis of the restless legs syndrome
Author(s) -
Bucher Stefan F.,
Seelos Klaus C.,
Oertel Wolfgang H.,
Reiser Maximilian,
Trenkwalder Claudia
Publication year - 1997
Publication title -
annals of neurology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 4.764
H-Index - 296
eISSN - 1531-8249
pISSN - 0364-5134
DOI - 10.1002/ana.410410513
Subject(s) - thalamus , brainstem , sensory system , functional magnetic resonance imaging , cerebellum , globus pallidus , medicine , neuroscience , psychology , cerebral cortex , restless legs syndrome , magnetic resonance imaging , basal ganglia , anatomy , central nervous system , neurology , radiology
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.