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Magnetic resonance imaging of the restless Legs Syndrome

Final Activity Report Summary - MRI OF RLS (Magnetic Resonance Imaging of the Restless Legs Syndrome)

Restless legs syndrome (RLS) is a sensorimotor disorder characterised by a distressing urge to move the legs, and sometimes other parts of the body as well, usually accompanied by a marked sense of discomfort or pain in the leg or other affected body parts. Although frequently under-diagnosed, several epidemiological studies have estimated its prevalence in western countries at 4 to 10 % of the general population. Despite of the growing body of literature on the RLS during the last few years, the underlying causes of the disorder remain unclear. RLS increasingly appears to be a complex disorder, probably influenced by a variety of genetic factors and other causes that may work through a variety of biochemical systems as well as a number of prominent environmental factors.

In this project, RLS patients and controls were recruited to explore RLS-related metabolic and neuropathological mechanisms using magnetic resonance imaging. Relaxometry studies confirmed decreased concentration of iron in substancia nigra pars compacta, a significant element of brain motor circuitry. For the first time functional studies revealed the implication of frontal brain areas. Iron deposition was not correlated with brain function.

These findings opened new lines of research and rose important questions towards the ultimate goal of understanding the RLS syndrome. They supported the hypothesis that increased frontal activity was associated with RLS, consistent with a proposed role for the circuit frontal cortex-basal ganglia in the pathogenesis of this disorder. Future research would need to further specify the significance of increased activity in these structures in relation to RLS symptoms.