Unraveling the Pathophysiology of Restless Legs Syndrome from Multimodal MRI Techniques: A Systematic Review

[MrCrow]

link to the paper: sciencedirect.com/science/a...

Notable excerpts:

“patients with primary RLS have structural and metabolite alterations, changes in multiple white matter tract architectures, and disrupted functional connectivity within multiple brain areas.”

”3.3.2. DTI

First, many “association pathways” mediating “intra-hemispheric” cortico-cortical connectivity were found to be affected; these include the (a) uncinate fascicle (UF; frontal and temporal connectivity) [51]; (b) cingulum (CG; cingulate gyrus and entorhinal cortex) [49], [51]; (c) superior longitudinal fasciculus (SLF; occipito-frontal connectivity) [51]; (d) inferior longitudinal fasciculus (ILF, occipito-temporal connectivity) [51] and (e) inferior fronto-occipital fasciculus (IFOF, temporal-frontal connection) [49], [51]. Next, weakened “inter-hemispheric” connectivity was evident from an altered integrity of “commissural pathways”; for example, corpus callosum (CC) [54]. Finally, (a) thalamo-cortical pathways, i.e., anterior and posterior thalamic radiations (ATR and PTR) [49], [50], [51] (b) projection fibers (cortex to the spinal cord), i.e., cortico-spinal tract (CST) [49], [51], internal capsule (IC) [43], and (c) brainstem-cerebellar tracts, i.e., superior cerebellar peduncles (SCP) [50] and corona radiata (CR) [50], also demonstrated integrity alterations (see references in Table 4).”

“3.3.3. fMRI

In addition to alterations in the “default mode network” (DMN) [60], [62], altered connectivity patterns were noted in the salience network [63], sensorimotor network [61], brainstem network [61], sensory thalamic network [56], [57], [59], [61], basal ganglia-thalamic network [61], dorsal and ventral attention networks [61], cingulate network [61], executive network [63], and cerebellar networks [63].”

“3.3.4. Iron-imaging MRI

A lower thalamic iron content in two datasets [66], [67] contrasts with the unchanged values noted by others [70]. The cerebellar dentate demonstrated either low [66] or unaltered levels [67], [70]. An increase [70], a decrease [69], or no alterations [40], [66], [67], [68] in red nucleus iron content were noted. Similar conflicting results were noted with regard to the iron contents of the basal ganglia and its sub-divisions. The majority of studies found an unchanged iron content of the caudate, pallidum, and substantia nigra and decreased/unchanged putaminal iron levels. Others, however, noted that the test results are driven by technical factors [69] (Table 5).”

“3.3.5. MRS

All the datasets analyzed thalamic metabolite alterations and found a significant increase in glutamatergic activity coexisting with unaltered GABA-ergic signaling [36], [71], [72], [75]. An increased level of NAA in the ACC has been noted [71].”

Also read the discussion section. Too long to list the content here.

[Eryl]

Not all RLS arises from brain malfunctions, some RLS arises from neuroinflammation in the nerves of other parts of the body. I've eliminated my RLS by driving down the systemic inflammation caused by foods.

[WideBody]

That is excellent find. Thank you. I can't seem to get access to the full study. When I do, I will attempt to read it. Give me about a year... wow.

[SueJohnson in reply to WideBody]

My laugh for the day - Give me about a year 🤣🤣🤣

[MrCrow in reply to SueJohnson]

what do you think? is there hope for the future? by future i mean 10 - 20 years?

[SueJohnson in reply to MrCrow]

Haven't read it - too much in your excerpts I have no idea what it means.

[MrCrow in reply to SueJohnson]

I mean in general. From all that you have read so far. Not just this article. Do you see any hope for better treatments in the future?

[SueJohnson in reply to MrCrow]

No idea but there is always hope.