Silent Cerebral Small Vessel Disease in Restless Legs Syndrome.
Growing literature suggests that patients with restless legs syndrome (RLS) may be at increased risk for hypertension, heart disease, and stroke. Cerebral small vessel disease (SVD) is a known risk factor for clinical stroke. This study evaluated silent cerebral SVD by MRI in patients with RLS, in the absence of a history of previous clinical stroke or known stroke risk factors and taking into account disease duration.



Fifty-three patients with RLS < 10 y were prospectively recruited along with 44 with RLS > 10 y and 74 normal controls. A magnetic resonance imaging study was obtained from all subjects and scans were analyzed for area and volume of SVD.



There was a significant increase in SVD area in the entire group of RLS patients compared to controls (P = 0.036); this was almost entirely driven by the group with RLS > 10 y. SVD area and volume were significantly increased in patients with RLS > 10 y with respect to both controls (P < 0.0001 and P < 0.0014, respectively) and RLS < 10 y (P < 0.00022 and P < 0.003, respectively). Age, duration of RLS, and the interaction of age and duration of RLS were independent predictors of SVD disease. Duration of RLS was an independent predictor of the burden of cerebral SVD (area P < 0.00012 and volume P < 0.0025), whereas sex and insomnia were not.



RLS duration should be taken into account when analyzing the association between RLS and cerebrovascular disease; our data support the hypothesis that a long-lasting RLS and its accompanying periodic limb movements in sleep are a risk factor for silent SVD and perhaps for the development of clinical stroke.
Department of Neurology I.C., Oasi Research Institute, Troina (EN), Italy.
Raffaele
R
Ferri
Department of Neurology I.C., Oasi Research Institute, Troina (EN), Italy.
Filomena I I
FI
Cosentino
Capital Regional Medical Center, Trenton, NJ.
Michael
M
Moussouttas
Department of Neurology I.C., Oasi Research Institute, Troina (EN), Italy.
Bartolo
B
Lanuzza
Department of Neurology I.C., Oasi Research Institute, Troina (EN), Italy.
Debora
D
Aricò
Vanderbilt University School of Medicine, Nashville, TN.
Kanika
K
Bagai
Vanderbilt University School of Medicine, Nashville, TN.
Lily
L
Wang
Vanderbilt University School of Medicine, Nashville, TN.
BethAnn
B
McLaughlin
Vanderbilt University School of Medicine, Nashville, TN.
Arthur S
AS
Walters
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016022:Case-Control Studies; D059345:Cerebral Small Vessel Diseases / Q000000981:diagnostic imaging / Q000209:etiology*; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012148:Restless Legs Syndrome / Q000150:complications*; D012307:Risk Factors; D013997:Time Factors
MRI; Willis-Ekbom disease; cerebral small vessel disease; restless legs syndrome; stroke