Restless legs syndrome (RLS) is a sensorimotor disorder characterized by a distressing urge to move the legs and sometimes also other parts of the body, usually accompanied by a marked sense of discomfort or pain in the leg or other affected body part. Epidemiological studies in the white population suggest that RLS prevalence in adults' ranges between 5 and 15%. Despite the recent advances in the epidemiology, clinical definition and therapeutic management of the disorder, nowadays RLS still remains a misdiagnosed and poorly treated disorder.
The goal of our proposal is to elucidate pathophysiological mechanisms of the RLS, which still remain unclear, using magnetic resonance imaging. Our hypothesis is that presence of a subcortical dopaminergic dysfunction and regional brain iron insufficiency play a major role in RLS pathophysiology. To achieve our goal and test our hypothesis, we will use functional magnetic resonance imaging (fMRI) to investigate cerebral generators involved in the pathogenesis of RLS. Additionally we will measure iron concentration using T2 relaxometry. We will apply automatic segmentation tools to calculate brain activation and iron content in areas of the central dopaminergic system, particularly the striatonigral system and other areas like the red nucleus, the thalami, the mamillary bodies, the dentate nucleus, the tuber cinereum, the pituitary gland and the pineal gland.
Healthy volunteers and idiopathic RLS patients will participate before and after medication. fMRI studies will b e performed at night when RLS symptoms are most pronounced. Statistical and fMRI analysis will evaluate differences between groups and pharmacological effects and will correlate imaging data with standard neurological indices. We anticipate this study to lead to the development of a new protocol for optimal MR neuroimaging of RLS patients and provide new information into RLS pathophysiology yielding unique prospective information for RLS management.
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