White matter hyperintensities on brain magnetic resonance imaging: comparison of early-onset and late-onset restless legs syndrome |
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| Affiliation: | 1. Department of Neurology, Dongsan Medical Center, Keimyung University School of Medicine, Daegu, Republic of Korea;2. Department of Radiology, Dongsan Medical Center, Keimyung University School of Medicine, Daegu, Republic of Korea;3. Department of Biomedical Engineering, Keimyung University School of Medicine, Daegu, Republic of Korea;4. Department of Psychiatry, Yale University, School of Medicine, New Haven, CT, USA;1. Hospital Moinhos de Vento (HMV), Porto Alegre, Rio Grande do Sul, Brazil;2. Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS), Brain Institute (InsCer), Porto Alegre, RS, Brazil;1. Division of Pulmonary, Critical Care, and Sleep Medicine, University Hospitals Case Medical Center, Cleveland, OH, USA;2. California Pacific Medical Center Research Institute, San Francisco, CA, USA;3. Electrophysiology Section, University of Colorado Anschutz Medical Campus, Denver, CO, USA;4. VA Eastern Colorado Health Care System, Denver, CO, USA;5. Colorado Cardiovascular Outcomes Research (CCOR) Group, Denver, CO, USA;6. Division of Sleep Medicine, Brigham and Women''s Hospital and Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA;7. Department of Neurology, Yale School of Medicine, New Haven, CT, USA;8. Neurologic Institute, Cleveland Clinic Lerner College of Medicine of Case Western Reserve University, Cleveland, OH, USA;1. Neurology Service, Hospital Clínic de Barcelona, IDIBAPS, Barcelona, Spain;2. CIBERNED, Barcelona, Spain;1. Neurology Department, Hospital Universitario Son Espases, Illes Balears, Spain;2. Pneumology Department, Sleep Unit, Hospital Universitario Son Espases, Illes Balears, Spain;3. Instituto de Investigación Hospital Universitario de la Princesa (IISP), Universidad Autónoma de Madrid, Madrid, Spain |
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| Abstract: | ObjectivePrevious studies have suggested that early-onset RLS (EOR) and late-onset RLS (LOR) might have different etiopathophysiologies. Few previous studies have examined accumulation of cerebrovascular ischemic changes as a potential cause of LOR.MethodsWe recruited 39 RLS subjects (LOR: defined as age of RLS onset ≥45, n = 18 and EOR: age of onset <45; n = 21); and 39 healthy control subjects matched on age and sex. Structural magnetic resonance imaging (MRI) of the brain was performed for each subject, and images were graded for severity of periventricular white matter hyperintensities (PVH) and deep white matter hyperintensities (DWMH) independently by trained raters according to standardized methods.ResultsInterrater reliabilities were 0.861 (p <0.001) for PVH and 0.900 (p <0.001) for DWMH. LOR subjects had a significantly higher grade of DWMH than the EOR subjects (p = 0.043) and age- and sex-matched controls (p = 0.015). In contrast, there was no difference in DWMH severity rating between the EOR group and the EC group or in PVH severity between the LOR or EOR groups and their age-matched controls.ConclusionOur findings suggest that the presence and severity of DWMH is associated with LOR, but not with EOR. Further examination of the contribution of cerebrovascular disease to the etiopathogenesis of LOR is warranted. |
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