Sensory-motor network of restless legs
Syndrome (RLS): Electrophysiology and Imaging
Dr. Richard Allen (United States)
Conference given at the 2018 Vancouver World Sleep Congress
Summary
In recent years, there is more progress in the pathophysiology of restless legs syndrome (RLS), especially electrophysiological and neuroimaging investigations in sensory-motor disorder of RLS.
Novel imaging techniques such as functional magnetic resonance imaging and diffusion tractography images have demonstrated activation or connectivity changes in the sensory-motor network.
The cortex, basal ganglia, cerebellum, thalamus, and connections appear to play a key role in sensory-motor processing abnormalities in RLS.
Furthermore, patients with RLS exhibit increased excitability of the sensorimotor cortex, a marked abnormality in early control of somatosensory activation, and an attenuated interneuron inhibitory network.
But in vivo excitability studies in motor and sensory axons provide evidence that increased excitability of peripheral motor neurons but not sensory axons contribute to the pathophysiology of RLS. Movement disorders are modulated by internal and external sensory signals, and such abnormal sensorimotor integration can disrupt normal motor control.
It has been shown in patients with RLS that Transcranial Magnetic Stimulation (TMS) can reduce short-latency afferent inhibition, a marker for sensorimotor integration.
In addition, the low frequency rTMS in S1-M1 connectivity alleviates sensory-motor complaints
of patients with RLS modulating cortical excitability and inducing synaptic plasticity in the short term.
This symposium will provide electrophysiology and imaging tests of sensory-motor network abnormality to gain new insight into the mechanism pathophysiology of RLS to better guide treatment.