Ultrasound Results Suggest Possible Etiology for Restless Legs Syndrome
Medscape Nov 18 2005 - Hypoechogenicity of the substantia nigra in patients with restless legs syndrome suggests nigral iron deficiency as a possible etiology for the condition, according to a report in the October Annals of Neurology.
Deficient iron transport in substantia nigra neurons has recently been described in postmortem studies of patients with restless legs syndrome, the authors explain.
Dr. Werner Poewe and colleagues from Innsbruck Medical University, Innsbruck, Austria investigated whether transcranial ultrasound could detect differences in midbrain echogenicity between 20 patients with restless legs syndrome, 20 patients with idiopathic Parkinson disease, and 20 age-matched normal control subjects.
Patients with restless legs syndrome had a significantly smaller area of hyperechogenicity of the substantia nigra region (0.001 square centimeter) compared with both the control (0.08 square centimeter) and Parkinson disease (0.18 square centimeter) groups, the authors report.
Half of the restless legs syndrome patients had no hyperechogenic signal of the substantia nigra on either side, the report indicates, compared with only 1 control subject and no Parkinson disease patients.
Previous research has shown correlations between transcranial ultrasound echogenicity and tissue iron concentration in the substantia nigra, the investigators note.
"If, indeed, nigral echogenicity is determined by tissue iron concentrations," the researchers suggest, "these findings appear to lend further support to nigral iron deficiency as a pathogenetic factor in restless legs syndrome."
"Although it remains unsettled what exactly causes substantia nigra hyperechogenicity in Parkinson disease and hypoechogenicity in restless legs syndrome, our findings fit well with current concepts of opposite change of nigral iron content in both disorders," the authors conclude.
"Further studies of transcranial ultrasound of patients with restless legs syndrome are warranted and should be extended to patients with comorbid restless legs syndrome and Parkinson disease to further clarify the relation between these two disorders."
Source: Ann Neurol 2005;58:630-634.
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Brain Bank Tissue Collection
Because the answers to many questions about neurological disorders have come from the postmortem examinati-on of brain tissue, the RLS Foundation has es-tablished a private col-lection at the Harvard Brain Tissue Resource
Center. This collection is available only to re-sidents of the conti-nental USA. Through your efforts and that of the RLS Foundation and Harvard Brain Tissue Resource Center com-bined efforts, many re-searchers around the world have been able to search for the answers to the cause of and cure for restless legs.
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