title: DTI and VBM reveal white matter changes without associated gray matter changes in patients with idiopathic restless legs syndrome.
abstract: OBJECTIVE
  We evaluated cerebral white and gray matter changes in patients with iRLS in order to shed light on the pathophysiology of this disease.
  
  
  METHODS
  Twelve patients with iRLS were compared to 12 age- and sex-matched controls using whole-head diffusion tensor imaging (DTI) and voxel-based morphometry (VBM) techniques. Evaluation of the DTI scans included the voxelwise analysis of the fractional anisotropy (FA), radial diffusivity (RD), and axial diffusivity (AD).
  
  
  RESULTS
  Diffusion tensor imaging revealed areas of altered FA in subcortical white matter bilaterally, mainly in temporal regions as well as in the right internal capsule, the pons, and the right cerebellum. These changes overlapped with changes in RD. Voxel-based morphometry did not reveal any gray matter alterations.
  
  
  CONCLUSIONS
  We showed altered diffusion properties in several white matter regions in patients with iRLS. White matter changes could mainly be attributed to changes in RD, a parameter thought to reflect altered myelination. Areas with altered white matter microstructure included areas in the internal capsule which include the corticospinal tract to the lower limbs, thereby supporting studies that suggest changes in sensorimotor pathways associated with RLS.
authors.affiliation: Department of Neurology, Philipps-University Marburg Baldingerstrasse, Marburg, 35043, Germany.
authors.forename: Marcus
authors.initials: M
authors.lastname: Belke
authors.affiliation: Department of Diagnostic Radiology, Philipps-University Marburg Baldingerstrasse, Marburg, 35043, Germany.
authors.forename: Johannes T
authors.initials: JT
authors.lastname: Heverhagen
authors.affiliation: Department of Diagnostic Radiology, Philipps-University Marburg Baldingerstrasse, Marburg, 35043, Germany.
authors.forename: Boris
authors.initials: B
authors.lastname: Keil
authors.affiliation: Department of Neurology, Philipps-University Marburg Baldingerstrasse, Marburg, 35043, Germany ; Epilepsy Center Franfurt Rhein-Main, Department of Neurology, Johann Wolfgang Goethe University Frankfurt am Main, Germany.
authors.forename: Felix
authors.initials: F
authors.lastname: Rosenow
authors.affiliation: Department of Neurology, Philipps-University Marburg Baldingerstrasse, Marburg, 35043, Germany.
authors.forename: Wolfgang H
authors.initials: WH
authors.lastname: Oertel
authors.affiliation: Department of Neurology, Philipps-University Marburg Baldingerstrasse, Marburg, 35043, Germany ; Somnomar, Institute for Medical Research and Sleep Medicine Marburg Marburger Strasse 9a, Marburg, 35043, Germany.
authors.forename: Karin
authors.initials: K
authors.lastname: Stiasny-Kolster
authors.affiliation: Department of Neurology, Philipps-University Marburg Baldingerstrasse, Marburg, 35043, Germany.
authors.forename: Susanne
authors.initials: S
authors.lastname: Knake
authors.affiliation: Department of Neurology, Philipps-University Marburg Baldingerstrasse, Marburg, 35043, Germany.
authors.forename: Katja
authors.initials: K
authors.lastname: Menzler
mesh_terms: D016022:Case-Control Studies; D056324:Diffusion Tensor Imaging / Q000379:methods; D005260:Female; D066128:Gray Matter / Q000473:pathology* / Q000503:physiopathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D059906:Neuroimaging / Q000379:methods; D012148:Restless Legs Syndrome / Q000473:pathology* / Q000503:physiopathology; D066127:White Matter / Q000473:pathology* / Q000503:physiopathology
keywords: Diffusion tensor imaging; gray matter changes; restless legs syndrome; voxel-based morphometry; white matter changes