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Park KM, Kim KT, Lee DA, Cho YW. Alterations in functional brain connectivity following treatment for restless legs syndrome: The role of symptom improvement in restoring functional connectivity. J Sleep Res 2024:e14303. [PMID: 39098007 DOI: 10.1111/jsr.14303] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2024] [Revised: 06/30/2024] [Accepted: 07/22/2024] [Indexed: 08/06/2024]
Abstract
The pathophysiology of restless legs syndrome (RLS) remains incompletely understood. Although several studies have investigated the alterations of brain connectivity as one of the pathophysiological mechanisms of RLS, there are only few reports on functional connectivity changes after RLS treatment. Forty-nine patients with newly diagnosed RLS and 50 healthy controls were prospectively enrolled. The patients underwent resting-state functional magnetic resonance imaging (rs-fMRI) at baseline, and 39 patients underwent follow-up rs-fMRI, 3 months after treatment with pramipexole or pregabalin. Patients were divided into good or poor medication response groups. Functional brain connectivity was analysed using rs-fMRI and graph theoretical analysis. Significant differences in functional connectivity were observed between the RLS patients and healthy controls. The average path length, clustering coefficient, transitivity, and local efficiency were lower (2.02 vs. 2.30, p < 0.001; 0.45 vs. 0.56, p < 0.001; 3.08 vs. 4.21, p < 0.001; and 0.71 vs. 0.76, p < 0.001, respectively) and the global efficiency was higher (0.53 vs. 0.50, p < 0.001) in patients with RLS than in healthy controls. Differences in functional connectivity at the global level were also observed between post- and pre-treatment RLS patients who showed a good medication response. Transitivity in the post-treatment group was higher than that in the pre-treatment group (3.22 vs. 3.04, p = 0.007). Global efficiency was positively correlated with RLS severity (r = 0.377, p = 0.007). This study demonstrates that RLS is associated with distinct alterations in brain connectivity, which can be partially normalised following symptom management. These findings suggest that therapeutic interventions for RLS modulate brain function, emphasising the importance of symptom-focussed treatment in managing RLS.
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Affiliation(s)
- Kang Min Park
- Department of Neurology, Haeundae Paik Hospital, Inje University College of Medicine, Busan, South Korea
| | - Keun Tae Kim
- Department of Neurology, Keimyung University School of Medicine, Daegu, South Korea
| | - Dong Ah Lee
- Department of Neurology, Haeundae Paik Hospital, Inje University College of Medicine, Busan, South Korea
| | - Yong Won Cho
- Department of Neurology, Keimyung University School of Medicine, Daegu, South Korea
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Antelmi E, Mogavero MP, Lanza G, Cartella SM, Ferini-Strambi L, Plazzi G, Ferri R, Tinazzi M. Sensory aspects of restless legs syndrome: Clinical, neurophysiological and neuroimaging prospectives. Sleep Med Rev 2024; 76:101949. [PMID: 38749362 DOI: 10.1016/j.smrv.2024.101949] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2023] [Revised: 11/20/2023] [Accepted: 04/29/2024] [Indexed: 07/26/2024]
Abstract
Restless Legs Syndrome (RLS) is a complex sensorimotor disorder, classified among the sleep-related movement disorders. Although sensory symptoms appear as key features of the disorder, they are still poorly characterized from a clinical perspective and conceptualized from a pathophysiological point of view. In this review, we aim to describe the clinical and functional substrates of RLS, focusing mainly on its sensory symptoms and on their neurophysiological and anatomical correlates. Knowledge of both subjective sensory symptoms and objective sensory signs are still controversial. Current data also indicate that the sensory component of RLS seems to be subserved by anomalies of sensorimotor integration and by mechanism of central sensitization. Overall, electrophysiological findings highlight the involvement of multiple generators in the pathogenesis of RLS, eventually resulting in an increased nervous system excitability and/or alterations in inhibition within the somatosensory and nociceptive pathways. Structural and functional neuroimaging data show the involvement of several crucial areas and circuits, among which the thalamus appears to play a pivotal role. A holistic approach looking at brain connectivity, structural or functional abnormalities, and their interplay with molecular vulnerability and neurotransmitter alterations is warranted to disentangle the complex framework of RLS.
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Affiliation(s)
- Elena Antelmi
- Neurology Unit, Parkinson Disease and Movement Disorders Division, DIMI Department of Engineering and Medicine of Innovation, University of Verona, Italy.
| | - Maria P Mogavero
- Vita-Salute San Raffaele University, Milan, Italy; San Raffaele Scientific Institute, Division of Neuroscience, Sleep Disorders Center, Milan, Italy
| | - Giuseppe Lanza
- Clinical Neurophysiology Research Unit, Oasi Research Institute-IRCCS, Troina, Italy; University of Catania, Department of Surgery and Medical-Surgical Specialties, Catania, Italy
| | - Sandy M Cartella
- Movement Disorders Centre, Department of Neurology, Policlinico "Madonna Della Consolazione", Reggio Calabria, Italy
| | - Luigi Ferini-Strambi
- Vita-Salute San Raffaele University, Milan, Italy; San Raffaele Scientific Institute, Division of Neuroscience, Sleep Disorders Center, Milan, Italy
| | - Giuseppe Plazzi
- IRCCS, Istituto Delle Scienze Neurologiche di Bologna, Bologna, Italy; Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy
| | - Raffaele Ferri
- Clinical Neurophysiology Research Unit, Oasi Research Institute-IRCCS, Troina, Italy
| | - Michele Tinazzi
- Neurology Unit, Parkinson Disease and Movement Disorders Division, Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Italy
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Hu X, Wang S, Zhou H, Li N, Zhong C, Luo W, Liu S, Fu F, Meng Y, Ding Z, Cheng B. Altered Functional Connectivity Strength in Distinct Brain Networks of Children With Early-Onset Schizophrenia. J Magn Reson Imaging 2023; 58:1617-1623. [PMID: 36932678 DOI: 10.1002/jmri.28682] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2022] [Revised: 03/05/2023] [Accepted: 03/06/2023] [Indexed: 03/19/2023] Open
Abstract
BACKGROUND Schizophrenia is regarded as a brain network or connectome disorder that is associated with neurodevelopment. Children with early-onset schizophrenia (EOS) provide an opportunity to evaluate the neuropathology of schizophrenia at a very early stage without potential confounding factors. But dysfunction in brain networks of schizophrenia is inconsistent. PURPOSE To identify abnormal functional connectivity (FC) in EOS patients and relationships with clinical symptoms, we aimed to reveal neuroimaging phenotypes of EOS. STUDY TYPE Prospective, cross-sectional. POPULATION Twenty-six female/22 male patients (age:14.3 ± 3.45 years) with first-episode EOS, 27 female/22 male age- and gender-matched healthy controls (HC) (age:14.1 ± 4.32). FIELD STRENGTH/SEQUENCE 3-T, resting-state (rs) gradient-echo echo-planar imaging and three-dimensional magnetization-prepared rapid gradient-echo imaging. ASSESSMENT Intelligence quotient (IQ) was measured by the Wechsler Intelligence Scale-Fourth edition for Children (WISC-IV). The clinical symptoms were evaluated by the Positive and Negative Syndrome Scale (PANSS). FC strength (FCS) from rs functional MRI (rsfMRI) was used to investigate functional integrity of global brain regions. In addition, associations between regionally altered FCS and clinical symptoms in EOS patients were examined. STATISTICAL TESTS Two-sample t-test controlling for sample size, diagnostic method, brain volume algorithm, and age of the subjects, Bonferroni correction, Pearson's correlation analysis. A P-value <0.05 with a minimum cluster size of 50 voxels was considered statistically significant. RESULTS Compared with HC, EOS patients had significantly lower total IQ scores (IQ:91.5 ± 16.1), increased FCS in the bilateral precuneus, left dorsolateral prefrontal cortex, left thalamus, and left parahippocampus (paraHIP), and decreased FCS in the right cerebellum posterior lobe and right superior temporal gyrus. The PANSS total score of EOS patients (PANSS total score:74.30 ± 7.23) was found to be positively correlated to FCS in the left paraHIP (r = 0.45). DATA CONCLUSION Our study revealed that disrupted FC of brain hubs illustrate multiple abnormalities in brain networks in EOS patients. EVIDENCE LEVEL 1 TECHNICAL EFFICACY STAGE: 2.
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Affiliation(s)
- Xiao Hu
- Department of Rehabilitation Medicine, West China Second University Hospital, Sichuan University, Chengdu, China
- Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu, China
| | - Song Wang
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu, China
| | - Hui Zhou
- Department of Rehabilitation Medicine, West China Second University Hospital, Sichuan University, Chengdu, China
- Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu, China
| | - Na Li
- Department of Rehabilitation Medicine, West China Second University Hospital, Sichuan University, Chengdu, China
- Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu, China
| | - Can Zhong
- Department of Rehabilitation Medicine, West China Second University Hospital, Sichuan University, Chengdu, China
- Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu, China
| | - Weiling Luo
- Department of Radiology, West China Second University Hospital, Sichuan University, Chengdu, China
| | - Sijia Liu
- School of Sociality and Psychology, Southwest Minzu University, Chengdu, China
| | - Fanghui Fu
- School of Sociality and Psychology, Southwest Minzu University, Chengdu, China
| | - Yajing Meng
- Mental Health Center and Psychiatric Laboratory, the State Key Laboratory of Biotherapy, West China Hospital of Sichuan University, Chengdu, Sichuan, China
| | - Zhiyong Ding
- Department of Medical Imaging, Qujing Maternal and Child Health Care Hospital, Qujing, China
| | - Bochao Cheng
- Department of Radiology, West China Second University Hospital, Sichuan University, Chengdu, China
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Zhang J, Zhang J, Sun H, Yang J, Ma Y, Chen K, Su J, Yu X, Yang F, Zhang Z, Zhao T, Hu X, Zhai Y, Liu Q, Wang J, Liu C, Wang Z. Cerebellum drives functional dysfunctions in restless leg syndrome. Sleep Med 2023; 110:172-178. [PMID: 37595434 DOI: 10.1016/j.sleep.2023.08.014] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Revised: 07/04/2023] [Accepted: 08/14/2023] [Indexed: 08/20/2023]
Abstract
OBJECTIVE Restless legs syndrome (RLS) has serious effects on patients' sleep quality, physical and mental health. However, the pathophysiological mechanisms of RLS remain unclear. This study utilized both static and dynamic functional activity and connectivity analyses approaches as well as effective connectivity analysis to reveal the neurophysiological basis of RLS. METHODS The resting-state functional MRI (rs-fMRI) data from 32 patients with RLS and 33 age-, and gender-matched healthy control (HC) were collected. Dynamic and static amplitude of low frequency fluctuation (ALFF), functional connectivity (FC), and Granger causality analysis (GCA) were employed to reveal the abnormal functional activities and couplings in patients with RLS. RESULTS RLS patients showed over-activities in left parahippocampus and right cerebellum, hyper-connectivities of right cerebellum with left basal ganglia, left postcentral gyrus and right precentral gyrus, and enhanced effective connectivity from right cerebellum to left postcentral gyrus compared to HC. CONCLUSIONS Abnormal cerebellum-basal ganglia-sensorimotor cortex circuit may be the underlying neuropathological basis of RLS. Our findings highlight the important role of right cerebellum in the onset of RLS and suggest right cerebellum may be a potential target for precision therapy.
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Affiliation(s)
- Jiang Zhang
- College of Electrical Engineering, Sichuan University, Chengdu, China; Med-X Center for Informatics, Sichuan University, Chengdu, China
| | - Jingyue Zhang
- College of Electrical Engineering, Sichuan University, Chengdu, China
| | - Hui Sun
- College of Electrical Engineering, Sichuan University, Chengdu, China
| | - Jia Yang
- State Key Laboratory of Primate Biomedical Research, Institute of Primate Translational Medicine, Kunming University of Science and Technology, Kunming, China; Yunnan Key Laboratory of Primate Biomedical Research, Kunming, Yunnan, China
| | - Yingzi Ma
- State Key Laboratory of Primate Biomedical Research, Institute of Primate Translational Medicine, Kunming University of Science and Technology, Kunming, China; Yunnan Key Laboratory of Primate Biomedical Research, Kunming, Yunnan, China
| | - Kexuan Chen
- Medical School, Kunming University of Science and Technology, Kunming, China
| | - Jing Su
- State Key Laboratory of Primate Biomedical Research, Institute of Primate Translational Medicine, Kunming University of Science and Technology, Kunming, China; Yunnan Key Laboratory of Primate Biomedical Research, Kunming, Yunnan, China
| | - Xiaohui Yu
- State Key Laboratory of Primate Biomedical Research, Institute of Primate Translational Medicine, Kunming University of Science and Technology, Kunming, China; Yunnan Key Laboratory of Primate Biomedical Research, Kunming, Yunnan, China
| | - Futing Yang
- State Key Laboratory of Primate Biomedical Research, Institute of Primate Translational Medicine, Kunming University of Science and Technology, Kunming, China; Yunnan Key Laboratory of Primate Biomedical Research, Kunming, Yunnan, China
| | - Zhiwei Zhang
- College of Electrical Engineering, Sichuan University, Chengdu, China
| | - Tianyu Zhao
- College of Electrical Engineering, Sichuan University, Chengdu, China
| | - Xiuying Hu
- Med-X Center for Informatics, Sichuan University, Chengdu, China; Innovation Center of Nursing Research, Nursing Key Laboratory of Sichuan Province, West China Hospital, Sichuan University, Chengdu, China
| | - Yiran Zhai
- College of Electrical Engineering, Sichuan University, Chengdu, China; Med-X Center for Informatics, Sichuan University, Chengdu, China
| | - Qihong Liu
- College of Biomedical Engineering, Sichuan University, Chengdu, China
| | - Jiaojian Wang
- State Key Laboratory of Primate Biomedical Research, Institute of Primate Translational Medicine, Kunming University of Science and Technology, Kunming, China; Yunnan Key Laboratory of Primate Biomedical Research, Kunming, Yunnan, China.
| | - Chunyan Liu
- Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, China; Beijing Key Laboratory of Neuromodulation, Beijing, China.
| | - Zhengbo Wang
- State Key Laboratory of Primate Biomedical Research, Institute of Primate Translational Medicine, Kunming University of Science and Technology, Kunming, China; Yunnan Key Laboratory of Primate Biomedical Research, Kunming, Yunnan, China.
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McNamara S, Hon B, Kirshblum S. Restless leg syndrome in spinal cord injury: case report. Spinal Cord Ser Cases 2023; 9:19. [PMID: 37137889 PMCID: PMC10156660 DOI: 10.1038/s41394-023-00576-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2022] [Revised: 04/24/2023] [Accepted: 04/25/2023] [Indexed: 05/05/2023] Open
Abstract
CASE DESCRIPTION Restless leg syndrome (RLS) is a condition infrequently reported in spinal cord injury that causes an uncomfortable sensation in the legs and an urge to move them. We report a case involving a 63-year-old man with incomplete paraplegia with an onset of RLS four years post injury. FINDINGS Based upon history, pramipexole was prescribed for the presumptive diagnosis of RLS, with good effect. Initial workup revealed an anemia (hemoglobin of 9.3 gram/deciliter (g/dl)) and iron deficiency (ferritin of 10 microgram/liter (μg/L)), necessitating further evaluation. CONCLUSION Due to the complexities in diagnosing RLS in patients with SCI, it is important to be cognizant of symptoms and to consider this diagnosis to initiate the appropriate work-up for an etiology, of which iron deficiency anemia is common.
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Affiliation(s)
- Shane McNamara
- Rutgers New Jersey Medical School, Department of Physical Medicine and Rehabilitation, Newark, NJ, USA.
| | - Beverly Hon
- Rutgers New Jersey Medical School, Department of Physical Medicine and Rehabilitation, Newark, NJ, USA
- Spinal Cord Injury & Disorders Department, Veteran Administration New Jersey Healthcare System, East Orange, NJ, USA
| | - Steven Kirshblum
- Rutgers New Jersey Medical School, Department of Physical Medicine and Rehabilitation, Newark, NJ, USA
- Kessler Institute for Rehabilitation, West Orange, New Jersey. Kessler Foundation, West Orange, NJ, USA
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Zhao C, Chen M, Ding Z, Liu C, Wu X. Altered functional association and couplings: Effective diagnostic neuromarkers for Alzheimer’s disease. Front Aging Neurosci 2022; 14:1009632. [PMID: 36313014 PMCID: PMC9606803 DOI: 10.3389/fnagi.2022.1009632] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2022] [Accepted: 09/05/2022] [Indexed: 11/29/2022] Open
Abstract
Alzheimer’s disease (AD) is a common neurodegenerative disorder causing dementia in the elderly population. Functional disconnection of brain is considered to be the main cause of AD. In this study, we applied a newly developed association (Asso) mapping approach to directly quantify the functional disconnections and to explore the diagnostic effects for AD with resting-state functional magnetic resonance imaging data from 36 AD patients and 42 age-, gender-, and education-matched healthy controls (HC). We found that AD patients showed decreased Asso in left dorsoanterior insula (INS) while increased functional connections of INS with right medial prefrontal cortex (MPFC) and left posterior cingulate cortex (PCC). The changed Asso and functional connections were closely associated with cognitive performances. In addition, the reduced Asso and increased functional connections could serve as effective neuromarkers to distinguish AD patients from HC. Our research provided new evidence for functional disconnections in AD and demonstrated that functional disconnections between cognition-memory networks may be potential early biomarkers for AD.
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Affiliation(s)
- Chongyi Zhao
- Faculty of Life Science and Technology, Kunming University of Science and Technology, Kunming, China
- Department of Gynecology, The First People’s Hospital of Yunnan Province, Kunming University of Science and Technology, Kunming, China
| | - Meiling Chen
- Department of Clinical Psychology, The First People’s Hospital of Yunnan Province, Kunming University of Science and Technology, Kunming, China
| | - Zhiyong Ding
- Department of Medical Imaging, Qujing Maternal and Child Health Care Hospital, Kunming University of Science and Technology, Qujing, China
- *Correspondence: Zhiyong Ding,
| | - Chunyan Liu
- Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, China
- Beijing Key Laboratory of Neuromodulation, Beijing, China
- Chunyan Liu,
| | - Xiaomei Wu
- Department of Gynecology, The First People’s Hospital of Yunnan Province, Kunming University of Science and Technology, Kunming, China
- Xiaomei Wu,
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Cheng B, Guo Y, Chen X, Lv B, Liao Y, Qu H, Hu X, Yang H, Meng Y, Deng W, Wang J. Postpartum depression and major depressive disorder: the same or not? Evidence from resting-state functional MRI. PSYCHORADIOLOGY 2022; 2:121-128. [PMID: 38665602 PMCID: PMC10917173 DOI: 10.1093/psyrad/kkac015] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/21/2022] [Revised: 10/18/2022] [Accepted: 10/27/2022] [Indexed: 04/28/2024]
Abstract
Background Although postpartum depression (PPD) and non-peripartum major depressive disorder (MDD) occurring within and outside the postpartum period share many clinical characteristics, whether PPD and MDD are the same or not remains controversial. Methods The current study was devoted to identify the shared and different neural circuits between PPD and MDD by resting-state functional magnetic resonance imaging data from 77 participants (22 first-episodic drug-naïve MDD, 26 drug-naïve PPD, and 29 healthy controls (HC)). Results Both the PPD and MDD groups exhibited higher fractional amplitude of low-frequency fluctuation (fALFF) in left temporal pole relative to the HC group; the MDD group showed specifically increased degree centrality in the right cerebellum while PPD showed specifically decreased fALFF in the left supplementary motor area and posterior middle temporal gyrus (pMTG_L), and specifically decreased functional connectivities between pMTG and precuneus and between left subgeneual anterior cingulate cortex (sgACC_L) and right sgACC. Moreover, sgACC and left thalamus showed abnormal regional homogeneity of functional activities between any pair of HC, MDD, and PPD. Conclusions These results provide initial evidence that PPD and MDD have common and distinct neural circuits, which may facilitate understanding the neurophysiological basis and precision treatment for PPD.
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Affiliation(s)
- Bochao Cheng
- Department of Radiology, West China Second University Hospital of Sichuan University, Chengdu 610041, China
- Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu 610041, China
| | - Yi Guo
- Department of Radiology, West China Second University Hospital of Sichuan University, Chengdu 610041, China
| | - Xijian Chen
- Department of Radiology, West China Second University Hospital of Sichuan University, Chengdu 610041, China
| | - Bin Lv
- Department of Gynecology and Obstetrics, West China Second University Hospital, Sichuan University, Chengdu 610041, China
| | - Yi Liao
- Department of Radiology, West China Second University Hospital of Sichuan University, Chengdu 610041, China
| | - Haibo Qu
- Department of Radiology, West China Second University Hospital of Sichuan University, Chengdu 610041, China
| | - Xiao Hu
- Department of Rehabilitation Medicine, West China Second University Hospital, Sichuan University, Chengdu 610041, China
| | - Haoxiang Yang
- Department of Radiology, West China Second University Hospital of Sichuan University, Chengdu 610041, China
| | - Yajing Meng
- Department of Psychiatry, West China Hospital of Sichuan University, Chengdu 610041, China
| | - Wei Deng
- Department of Psychiatry, West China Hospital of Sichuan University, Chengdu 610041, China
- Affiliated Mental Health Center & Hangzhou Seventh People's Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang 310063, China
| | - Jiaojian Wang
- State Key Laboratory of Primate Biomedical Research, Institute of Primate Translational Medicine, Kunming University of Science and Technology, Kunming 650500, China
- Yunnan Key Laboratory of Primate Biomedical Research, Kunming, Yunnan 650500, China
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Zang QL, Zheng JH, Ma JJ, Zhang Q, Huang PP, Shen NN, Miao W. Neuroanatomy and Functional Connectivity in Patients with Parkinson's Disease with or without Restless Legs Syndrome. Neurol Ther 2022; 11:1625-1636. [PMID: 35999489 DOI: 10.1007/s40120-022-00397-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/15/2022] [Accepted: 08/08/2022] [Indexed: 11/30/2022] Open
Abstract
INTRODUCTION Restless legs syndrome (RLS) is a common non-motor symptom in Parkinson's disease (PD), but its pathogenesis remains unclear. This study aimed to explore the potential neural substrates of RLS in a large sample of patients with PD. METHODS A total of 42 patients with PD with RLS and 124 patients with PD without RLS were prospectively recruited at our hospital between February 2019 and October 2020 and underwent structural and resting-state functional magnetic resonance imaging. Differences between the two patient groups were assessed using voxel-based morphometry and functional connectivity analysis. PD duration, Part III of the Movement Disorder Society's Unified Parkinson's Disease Rating Scale (MDS-UPDRS-III) score, and levodopa equivalent daily dose were treated as covariates. RESULTS Patients with PD with RLS had significantly larger gray matter volume in the bilateral posterior cingulate cortex than patients with PD without RLS (FDR-adjusted P < 0.05). Compared to patients without RLS, those with RLS had significantly lower functional connectivity between the left central opercular cortex and the bilateral precentral gyri and postcentral gyri (FDR-adjusted P < 0.001). CONCLUSION Our study provides the first evidence that in patients with PD, RLS is associated with significantly larger gray matter volume in the posterior cingulate cortex and lower resting-state functional connectivity within the sensorimotor network. Our results may help clarify the pathophysiology of RLS in PD and identify possible therapeutic targets.
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Affiliation(s)
- Qiu Ling Zang
- Department of Neurology, The First Affiliated Hospital of Zhengzhou University, 1 Jian She East Road, Zhengzhou, 450007, Henan Province, People's Republic of China
| | - Jin Hua Zheng
- Department of Neurology, Henan Provincial People's Hospital, No. 7, Weiwu Road, Zhengzhou, 450003, Henan Province, People's Republic of China
| | - Jian Jun Ma
- Department of Neurology, Henan Provincial People's Hospital, No. 7, Weiwu Road, Zhengzhou, 450003, Henan Province, People's Republic of China.
| | - Qi Zhang
- Department of Neurology, The First Affiliated Hospital of Zhengzhou University, 1 Jian She East Road, Zhengzhou, 450007, Henan Province, People's Republic of China
| | - Pei Pei Huang
- Department of Neurology, The First Affiliated Hospital of Zhengzhou University, 1 Jian She East Road, Zhengzhou, 450007, Henan Province, People's Republic of China
| | - Nan Nan Shen
- Department of Neurology, The First Affiliated Hospital of Zhengzhou University, 1 Jian She East Road, Zhengzhou, 450007, Henan Province, People's Republic of China
| | - Wang Miao
- Department of Neurology, The First Affiliated Hospital of Zhengzhou University, 1 Jian She East Road, Zhengzhou, 450007, Henan Province, People's Republic of China.
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Park KM, Kim KT, Kang KW, Park JA, Seo JG, Kim J, Chang H, Kim EY, Cho YW. Alterations of Functional Connectivity in Patients With Restless Legs Syndrome. J Clin Neurol 2022; 18:290-297. [PMID: 35589318 PMCID: PMC9163943 DOI: 10.3988/jcn.2022.18.3.290] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2022] [Revised: 01/28/2022] [Accepted: 02/03/2022] [Indexed: 11/17/2022] Open
Abstract
Restless legs syndrome (RLS) is a common neurological illness marked by a strong desire to move one’s legs, usually in association with uncomfortable sensations. Recent studies have investigated brain networks and connectivity in RLS. The advent of network analysis has greatly improved our understanding of the brain and various neurological disorders. A few studies have investigated alterations in functional connectivity in patients with RLS. This article reviews functional connectivity studies of patients with RLS, which have identified significant alterations relative to healthy controls in several brain networks including thalamic, salience, default-mode, and small-world networks. In addition, network changes related to RLS treatment have been found, including to repetitive transcranial magnetic stimulation, transcutaneous spinal cord direct-current stimulation, and dopaminergic drugs. These findings suggest that the underlying pathogenesis of RLS includes alterations in the functional connectivity in the brain and that RLS is a network disorder.
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Affiliation(s)
- Kang Min Park
- Department of Neurology, Haeundae Paik Hospital, Inje University College of Medicine, Busan, Korea
| | - Keun Tae Kim
- Department of Neurology, Keimyung University School of Medicine, Daegu, Korea
| | - Kyung Wook Kang
- Department of Neurology, Chonnam National University Hospital, Gwangju, Korea
| | - Jung A Park
- Department of Neurology, Daegu Catholic University Medical Center, Daegu, Korea
| | - Jong-Geun Seo
- Department of Neurology, School of Medicine, Kyungpook National University, Daegu, Korea
| | - Jiyoung Kim
- Department of Neurology, Pusan National University School of Medicine, Busan, Korea
| | - Hyeyeon Chang
- Department of Neurology, Konyang University School of Medicine, Daejeon, Korea
| | - Eun Young Kim
- Department of Neurology, Chungnam National University Sejong Hospital, Sejong, Korea
| | - Yong Won Cho
- Department of Neurology, Keimyung University School of Medicine, Daegu, Korea.
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Li Q, Liu S, Cao X, Li Z, Fan YS, Wang Y, Wang J, Xu Y. Disassociated and concurrent structural and functional abnormalities in the drug-naïve first-episode early onset schizophrenia. Brain Imaging Behav 2022; 16:1627-1635. [PMID: 35179706 PMCID: PMC9279212 DOI: 10.1007/s11682-021-00608-3] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/17/2021] [Indexed: 11/26/2022]
Abstract
Schizophrenia which is an abnormally developmental disease has been widely reported to show abnormal brain structure and function. Enhanced functional integration is a predominant neural marker for brain mature. Abnormal development of structure and functional integration may be a biomarker for early diagnosis of schizophrenia. Fifty-five patients with early onset schizophrenia (EOS) and 79 healthy controls were enrolled in this study. Voxel-based morphometry (VBM) and functional connectivity density (FCD) were performed to explore gray matter volume (GMV) lesion, abnormal functional integration, and concurrent structural and functional abnormalities in the brain. Furthermore, the relationships between abnormalities structural and function and clinical characteristics were evaluated in EOS. Compared with healthy controls, EOS showed significantly decreased GMV in the bilateral OFC, frontal, temporal, occipital, parietal and limbic system. EOS also showed decreased FCD in precuneus and increased FCD in cerebellum. Moreover, we found concurrent changes of structure and function in left lateral orbitofrontal cortex (lOFC). Finally, correlation analyses did not find significant correlation between abnormal neural measurements and clinical characteristic in EOS. The results reveal disassociated and bound structural and functional abnormalities patterns in EOS suggesting structural and functional measurements play different roles in delineating the abnormal patterns of EOS. The concurrent structural and functional changes in lOFC may be a biomarker for early diagnosis of schizophrenia. Our findings will deepen our understanding of the pathophysiological mechanisms in EOS.
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Affiliation(s)
- Qiang Li
- Shanxi Key Laboratory of Artificial Intelligence Assisted Diagnosis and Treatment for Mental Disorder/Department of Psychiatry, First Hospital of Shanxi Medical University, No. 85 Jiefang Nan Road, Taiyuan, China
- Department of Psychiatry, First Hospital/First Clinical Medical College of Shanxi Medical University, Taiyuan, China
| | - Sha Liu
- Shanxi Key Laboratory of Artificial Intelligence Assisted Diagnosis and Treatment for Mental Disorder/Department of Psychiatry, First Hospital of Shanxi Medical University, No. 85 Jiefang Nan Road, Taiyuan, China
- Department of Psychiatry, First Hospital/First Clinical Medical College of Shanxi Medical University, Taiyuan, China
| | - Xiaohua Cao
- Shanxi Key Laboratory of Artificial Intelligence Assisted Diagnosis and Treatment for Mental Disorder/Department of Psychiatry, First Hospital of Shanxi Medical University, No. 85 Jiefang Nan Road, Taiyuan, China
- Department of Psychiatry, First Hospital/First Clinical Medical College of Shanxi Medical University, Taiyuan, China
| | - Zexuan Li
- Shanxi Key Laboratory of Artificial Intelligence Assisted Diagnosis and Treatment for Mental Disorder/Department of Psychiatry, First Hospital of Shanxi Medical University, No. 85 Jiefang Nan Road, Taiyuan, China
- Department of Psychiatry, First Hospital/First Clinical Medical College of Shanxi Medical University, Taiyuan, China
| | - Yun-Shuang Fan
- School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu, 625014, China
| | - Yanfang Wang
- Shanxi Key Laboratory of Artificial Intelligence Assisted Diagnosis and Treatment for Mental Disorder/Department of Psychiatry, First Hospital of Shanxi Medical University, No. 85 Jiefang Nan Road, Taiyuan, China
- Department of Psychiatry, First Hospital/First Clinical Medical College of Shanxi Medical University, Taiyuan, China
| | - Jiaojian Wang
- Center for Language and Brain, Shenzhen Institute of Neuroscience, Shenzhen, 518057, China
| | - Yong Xu
- Shanxi Key Laboratory of Artificial Intelligence Assisted Diagnosis and Treatment for Mental Disorder/Department of Psychiatry, First Hospital of Shanxi Medical University, No. 85 Jiefang Nan Road, Taiyuan, China.
- Department of Psychiatry, First Hospital/First Clinical Medical College of Shanxi Medical University, Taiyuan, China.
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11
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Social support mediates the influence of cerebellum functional connectivity strength on postpartum depression and postpartum depression with anxiety. Transl Psychiatry 2022; 12:54. [PMID: 35136017 PMCID: PMC8826948 DOI: 10.1038/s41398-022-01781-9] [Citation(s) in RCA: 36] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/08/2021] [Revised: 12/09/2021] [Accepted: 12/21/2021] [Indexed: 02/05/2023] Open
Abstract
Post-Partum Depression (PPD) is the most common health issue impacting emotional well being in women and is often comorbid with anxiety (PPD-A). Previous studies have shown that adequate social support can protect against PPD and PPD-A. However, how the brain connectome is disrupted in PPD and PPD-A and the neural basis underlying the role of social support in PPD and PPD-A remains unclear. The present study aims to explore these issues in patients with PPD and PPD-A. Well-established questionnaires and resting-state functional Magnetic Resonance Imaging (rsfMRI) were performed in 45 PPD, 31 PDD-A patients and 62 Healthy Postnatal Women (HPW). Brain functional integration was measured by analysis of Functional Connectivity Strength (FCS). Association and mediation analyses were performed to investigate relationships between FCS, PPD and PPD-A symptoms and social support. PPD patients showed specifically higher FCS in right parahippocampus, whereas PPD-A patients showed specifically higher FCS in left ventrolateral prefrontal cortex. In all postpartum women, depression symptoms positively correlated with FCS in left paracentral lobule; depression and anxiety symptoms were negatively correlated with FCS in right cerebellem posterior lobe (CPL), a brain region implicated in supporting social cognition and regulation of emotion. Subsequent mediation analysis revealed that perceived social support mediated the association between right CPL FCS and PPD and PPD-A symptoms. Measurement of FCS in disorder-specific neural circuits offers a potential biomarker to study and measure the efficacy of social support for PPD and PPD-A.
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12
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Restless Legs Syndrome: Known Knowns and Known Unknowns. Brain Sci 2022; 12:brainsci12010118. [PMID: 35053861 PMCID: PMC8773543 DOI: 10.3390/brainsci12010118] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2021] [Revised: 01/09/2022] [Accepted: 01/12/2022] [Indexed: 02/06/2023] Open
Abstract
Although restless legs syndrome (RLS) is a common neurological disorder, it remains poorly understood from both clinical and pathophysiological perspectives. RLS is classified among sleep-related movement disorders, namely, conditions characterized by simple, often stereotyped movements occurring during sleep. However, several clinical, neurophysiological and neuroimaging observations question this view. The aim of the present review is to summarize and query some of the current concepts (known knowns) and to identify open questions (known unknowns) on RLS pathophysiology. Based on several lines of evidence, we propose that RLS should be viewed as a disorder of sensorimotor interaction with a typical circadian pattern of occurrence, possibly arising from neurochemical dysfunction and abnormal excitability in different brain structures.
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13
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Liu C, Han T, Xu Z, Liu J, Zhang M, Du J, Zhou Q, Duan Y, Li Y, Wang J, Cui D, Wang Y. Modulating Gamma Oscillations Promotes Brain Connectivity to Improve Cognitive Impairment. Cereb Cortex 2021; 32:2644-2656. [PMID: 34751749 DOI: 10.1093/cercor/bhab371] [Citation(s) in RCA: 41] [Impact Index Per Article: 13.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2021] [Revised: 09/09/2021] [Accepted: 09/10/2021] [Indexed: 12/30/2022] Open
Abstract
Dementia causes a substantial global economic burden, but effective treatment is lacking. Recently, studies have revealed that gamma-band waves of electrical brain activity, particularly 40 Hz oscillations, are closely associated with high-order cognitive functions and can activate microglia to clear amyloid-β deposition. Here, we found that compared with sham stimulation, applying 40-Hz high-frequency repetitive transcranial magnetic stimulation (rTMS) over the bilateral angular gyrus in patients with probable Alzheimer's disease (AD; n = 37) resulted in up to 8 weeks of significantly improved cognitive function. Power spectral density analysis of the resting-state electroencephalography (EEG) demonstrated that 40-Hz rTMS modulated gamma-band oscillations in the left posterior temporoparietal region. Further testing with magnetic resonance imaging and TMS-EEG revealed the following: 40-Hz rTMS 1) prevented gray matter volume loss, 2) enhanced local functional integration within bilateral angular gyrus, as well as global functional integration in bilateral angular gyrus and the left middle frontal gyrus, 3) strengthened information flow from the left posterior temporoparietal region to the frontal areas and strengthened the dynamic connectivity between anterior and posterior brain regions. These findings demonstrate that modulating gamma-band oscillations effectively improves cognitive function in patients with probable AD by promoting local, long-range, and dynamic connectivity within the brain.
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Affiliation(s)
- Chunyan Liu
- Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, China.,Beijing Key Laboratory of Neuromodulation, Beijing, China
| | - Tao Han
- Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, China.,Beijing Key Laboratory of Neuromodulation, Beijing, China.,Department of Neurology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, China
| | - Zhexue Xu
- Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, China.,Beijing Key Laboratory of Neuromodulation, Beijing, China
| | - Jianghong Liu
- Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, China.,Institute of Sleep and Consciousness Disorders, Beijing Institute of Brain Disorders, Capital Medical University, Beijing, China
| | - Mo Zhang
- Department of Radiology, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Jialin Du
- Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, China.,Beijing Key Laboratory of Neuromodulation, Beijing, China
| | - Qilin Zhou
- Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, China.,Beijing Key Laboratory of Neuromodulation, Beijing, China
| | - Yiran Duan
- Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, China.,Beijing Key Laboratory of Neuromodulation, Beijing, China
| | - Yuanyuan Li
- State Key Laboratory of Primate Biomedical Research, Institute of Primate Translational Medicine, Kunming University of Science and Technology, Kunming, China
| | - Jiaojian Wang
- State Key Laboratory of Primate Biomedical Research, Institute of Primate Translational Medicine, Kunming University of Science and Technology, Kunming, China
| | - Dehua Cui
- Beijing Key Laboratory of MRI Devices and Technology, Department of Neurology, Peking University Third Hospital, School of Medical Technology of Peking University, China
| | - Yuping Wang
- Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, China.,Beijing Key Laboratory of Neuromodulation, Beijing, China.,Institute of Sleep and Consciousness Disorders, Beijing Institute of Brain Disorders, Capital Medical University, Beijing, China
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14
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Chen K, Wang L, Zeng J, Chen A, Gao Z, Wang J. Voxel-Wise Quantitative Mapping of the Brain Association Ability. Front Neurosci 2021; 15:746894. [PMID: 34720865 PMCID: PMC8555663 DOI: 10.3389/fnins.2021.746894] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2021] [Accepted: 09/22/2021] [Indexed: 11/24/2022] Open
Abstract
The association cortices of the brain are essential for integrating multimodal information that subserves complex and high-order cognitive functions. To delineate the changing pattern of associative cortices can provide critical insight into brain development, aging, plasticity, and disease-triggered functional abnormalities. However, how to quantitatively characterize the association capability of the brain is elusive. Here, we developed a new method of association index (Asso) at the voxel level to quantitatively characterize the brain association ability. Using the Asso method, we found high Asso values in association cortical networks, and low values in visual and limbic networks, suggesting a pattern of significant gradient distribution in neural functions. The spatial distribution patterns of Asso show high similarities across different thresholds suggesting that Asso mapping is a threshold-free method. In addition, compared with functional connectivity strength, i.e., degree centrality method, Asso mapping showed different patterns for association cortices and primary cortices. Finally, the Asso method was applied to investigate aging effects and identified similar findings with previous studies. All these results indicated that Asso can characterize the brain association patterns effectively and open a new avenue to reveal a neural basis for development, aging, and brain disorders.
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Affiliation(s)
- Kai Chen
- School of Automation Engineering, University of Electronic Science and Technology of China, Chengdu, China
| | - Lijie Wang
- School of Computer Science and Engineering, University of Electronic Science and Technology of China, Chengdu, China
| | - Jianguang Zeng
- School of Economics and Business Administration, Chongqing University, Chongqing, China
| | - Ai Chen
- Department of Pediatric Neurology-Gastroenterology and Newborn Screening Center, Sichuan Provincial Maternity and Child Health Care Hospital, Affiliated Women's and Children's Hospital of Chengdu Medical College, Chengdu, China
| | - Zhao Gao
- Key Laboratory for NeuroInformation of the Ministry of Education, School of Foreign Languages, University of Electronic Science and Technology of China, Chengdu, China
| | - Jiaojian Wang
- State Key Laboratory of Primate Biomedical Research, Institute of Primate Translational Medicine, Kunming University of Science and Technology, Kunming, China
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15
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Song L, Yang H, Yang M, Liu D, Ge Y, Long J, Dong P. Professional chess expertise modulates whole brain functional connectivity pattern homogeneity and couplings. Brain Imaging Behav 2021; 16:587-595. [PMID: 34453664 DOI: 10.1007/s11682-021-00537-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/07/2021] [Indexed: 11/26/2022]
Abstract
Previous studies have revealed changed functional connectivity patterns between brain areas in chess players using resting-state functional magnetic resonance imaging (rs-fMRI). However, how to exactly characterize the voxel-wise whole brain functional connectivity pattern changes in chess players remains unclear. It could provide more convincing evidence for establishing the relationship between long-term chess practice and brain function changes. In this study, we employed newly developed whole brain functional connectivity pattern homogeneity (FcHo) method to identify the voxel-wise changes of functional connectivity patterns in 28 chess master players and 27 healthy novices. Seed-based functional connectivity analysis was used to identify the alteration of corresponding functional couplings. FcHo analysis revealed significantly increased whole brain functional connectivity pattern similarity in anterior cingulate cortex (ACC), anterior middle temporal gyrus (aMTG), primary visual cortex (V1), and decreased FcHo in thalamus and precentral gyrus in chess players. Resting-state functional connectivity analyses identified chess players showing decreased functional connections between V1 and precentral gyrus. Besides, a linear support vector machine (SVM) based classification achieved an accuracy of 85.45%, a sensitivity of 85.71% and a specificity of 85.19% to differentiate chess players from novices by leave-one-out cross-validation. Finally, correlation analyses revealed that the mean FcHo values of thalamus were significantly negatively correlated with the training time. Our findings provide new evidences for the important roles of ACC, aMTG, V1, thalamus and precentral gyrus in chess players. The findings also indicate that long-term professional chess training may enhance the semantic and episodic processing, efficiency of visual-motor transformation, and cognitive ability.
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Affiliation(s)
- Limei Song
- School of Medical Imaging, Weifang Medical University, Weifang, 261053, Shandong, China.
| | - Huadong Yang
- Department of Oncology, Affiliated Hospital of North Sichuan Medical College, Nanchong, 637000, China
| | - Mingdong Yang
- Shouguang People's Hospital, Shouguang, 262700, China
| | - Dianmei Liu
- School of Medical Imaging, Weifang Medical University, Weifang, 261053, Shandong, China
- Medical Imaging Center, Affiliated Hospital of Weifang Medical University, Weifang, 261031, China
| | - Yanming Ge
- School of Medical Imaging, Weifang Medical University, Weifang, 261053, Shandong, China
- Medical Imaging Center, Affiliated Hospital of Weifang Medical University, Weifang, 261031, China
| | - Jinfeng Long
- School of Medical Imaging, Weifang Medical University, Weifang, 261053, Shandong, China
| | - Peng Dong
- School of Medical Imaging, Weifang Medical University, Weifang, 261053, Shandong, China.
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16
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Sheng L, Zhao P, Ma H, Qi L, Yi Z, Shi Y, Zhong J, Shi H, Dai Z, Pan P. Grey matter alterations in restless legs syndrome: A coordinate-based meta-analysis. J Sleep Res 2021; 30:e13298. [PMID: 33554365 DOI: 10.1111/jsr.13298] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2020] [Revised: 01/14/2021] [Accepted: 01/15/2021] [Indexed: 01/18/2023]
Abstract
Brain structural abnormalities in idiopathic restless legs syndrome have long been debated. Voxel-based morphometry is an objective structural magnetic resonance imaging technique to investigate regional grey matter volume or density differences between groups. In the last decade, voxel-based morphometry studies have exhibited inconsistent and conflicting findings regarding the presence and localization of brain grey matter alterations in restless legs syndrome. We therefore conducted a coordinate-based meta-analysis to quantitatively examine whether there were consistent grey matter findings in restless legs syndrome using the latest algorithms, seed-based d mapping with permutation of subject images. We included 12 voxel-based morphometry studies (13 datasets, 375 patients and 385 healthy controls). Our coordinate-based meta-analysis did not identify evidence of consistent grey matter alterations in restless legs syndrome. Grey matter alterations via voxel-based morphometry analysis are not therefore recommended to be used as a reliable surrogate neuroimaging marker for restless legs syndrome. This lack of consistency may be attributed to differences in sample size, genetics, gender distribution and age at onset, clinical heterogeneity (clinical course, anatomical distribution of symptoms, disease severity, disease duration, abnormal sensory profiles and comorbidity), and variations in imaging acquisition, data processing and statistical strategies. Longitudinal studies with multimodal neuroimaging techniques are needed to determine whether structural changes are dynamic and secondary to functional abnormalities.
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Affiliation(s)
- LiQin Sheng
- Department of Neurology, Kunshan Hospital of Traditional Chinese Medicine, Kunshan, China
| | - PanWen Zhao
- Department of Central Laboratory, Affiliated Yancheng Hospital, School of Medicine, Southeast University, Yancheng, China
| | - HaiRong Ma
- Department of Neurology, Kunshan Hospital of Traditional Chinese Medicine, Kunshan, China
| | - Liang Qi
- Second People's Hospital of Huai'an City, The Affiliated Huai'an Hospital of Xuzhou Medical University, Huai'an, China
| | - ZhongQuan Yi
- Department of Central Laboratory, Affiliated Yancheng Hospital, School of Medicine, Southeast University, Yancheng, China
| | - YuanYuan Shi
- Department of Central Laboratory, Affiliated Yancheng Hospital, School of Medicine, Southeast University, Yancheng, China
| | - JianGuo Zhong
- Department of Neurology, Affiliated Yancheng Hospital, School of Medicine, Southeast University, Yancheng, China
| | - HaiCun Shi
- Department of Neurology, Affiliated Yancheng Hospital, School of Medicine, Southeast University, Yancheng, China
| | - ZhenYu Dai
- Department of Radiology, Affiliated Yancheng Hospital, School of Medicine, Southeast University, Yancheng, China
| | - PingLei Pan
- Department of Central Laboratory, Affiliated Yancheng Hospital, School of Medicine, Southeast University, Yancheng, China.,Department of Neurology, Affiliated Yancheng Hospital, School of Medicine, Southeast University, Yancheng, China
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17
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Tuovinen N, Stefani A, Mitterling T, Heidbreder A, Frauscher B, Gizewski ER, Poewe W, Högl B, Scherfler C. Functional connectivity and topology in patients with restless legs syndrome: a case-control resting-state functional magnetic resonance imaging study. Eur J Neurol 2020; 28:448-458. [PMID: 33032390 PMCID: PMC7820983 DOI: 10.1111/ene.14577] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2020] [Revised: 09/29/2020] [Accepted: 10/05/2020] [Indexed: 02/05/2023]
Abstract
Background and purpose Functional connectivity studies revealed alterations within thalamic, salience, and default mode networks in restless legs syndrome patients. Methods Eighty‐two patients with restless legs syndrome (untreated, n = 30; on dopaminergic medication, n = 42; on alpha‐2‐delta ligands as mono‐ or polytherapy combined with dopaminergic medication, n = 10), and 82 individually age‐ and gender‐matched healthy controls were studied with resting‐state functional magnetic resonance imaging. Connectivity of 12 resting‐state networks was investigated with independent component analysis, and network topology was studied with graph methods among 410 brain regions. Results Patients with restless legs syndrome showed significantly higher connectivity within salience (p = 0.029), executive (p = 0.001), and cerebellar (p = 0.041) networks, as well as significantly lower (p < 0.05) cerebello‐frontal communication compared to controls. In addition, they had a significantly higher (p < 0.05) clustering coefficient and local efficiency in motor and frontal regions; lower clustering coefficient in the central sulcus; and lower local efficiency in the central opercular cortex, temporal, parieto‐occipital, cuneus, and occipital regions compared to controls. Untreated patients had significantly lower (p < 0.05) cerebello‐parietal communication compared to healthy controls. Connectivity between the thalamus and frontal regions was significantly increased (p < 0.05) in patients on dopaminergic medication compared to untreated patients and controls. Conclusions Networks with higher intranetwork connectivity (i.e., salience, executive, cerebellar) and lower cerebello‐frontal connectivity in the restless legs syndrome patients, as well as lower cerebello‐parietal connectivity in untreated patients, correspond to regions associated with attention, response inhibitory control, and processing of sensory information. Intact cerebello‐parietal communication and increased thalamic connectivity to the prefrontal regions in patients on dopaminergic medication suggests a treatment effect on thalamus.
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Affiliation(s)
- N Tuovinen
- Department of Psychiatry, Psychotherapy and Psychosomatics, Division of Psychiatry I, Medical University of Innsbruck, Innsbruck, Austria.,Department of Neurology, Medical University of Innsbruck, Innsbruck, Austria
| | - A Stefani
- Department of Neurology, Medical University of Innsbruck, Innsbruck, Austria
| | - T Mitterling
- Department of Neurology, Medical University of Innsbruck, Innsbruck, Austria.,Neurologie 1, Kepler Universitätsklinikum GmbH, Neuromed Campus, Linz, Austria.,Johannes Kepler University, Linz, Austria
| | - A Heidbreder
- Department of Neurology, Medical University of Innsbruck, Innsbruck, Austria.,Department of Neurology, University Hospital Münster, Münster, Germany
| | - B Frauscher
- Department of Neurology, Medical University of Innsbruck, Innsbruck, Austria.,Analytical Neurophysiology Lab, Montreal Neurological Institute & Hospital, McGill University, Montreal, Quebec, Canada
| | - E R Gizewski
- Neuroimaging Research Core Facility, Medical University of Innsbruck, Innsbruck, Austria.,Department of Neuroradiology, Medical University of Innsbruck, Innsbruck, Austria
| | - W Poewe
- Department of Neurology, Medical University of Innsbruck, Innsbruck, Austria
| | - B Högl
- Department of Neurology, Medical University of Innsbruck, Innsbruck, Austria
| | - C Scherfler
- Department of Neurology, Medical University of Innsbruck, Innsbruck, Austria.,Neuroimaging Research Core Facility, Medical University of Innsbruck, Innsbruck, Austria
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18
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Altered cortical gray matter volume and functional connectivity after transcutaneous spinal cord direct current stimulation in idiopathic restless legs syndrome. Sleep Med 2020; 74:254-261. [DOI: 10.1016/j.sleep.2020.07.026] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/21/2020] [Revised: 07/18/2020] [Accepted: 07/20/2020] [Indexed: 01/18/2023]
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19
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Zeng M, Wang L, Cheng B, Qi G, He J, Xu Z, Han T, Liu C, Wang Y. Transcutaneous Spinal Cord Direct-Current Stimulation Modulates Functional Activity and Integration in Idiopathic Restless Legs Syndrome. Front Neurosci 2020; 14:873. [PMID: 32982669 PMCID: PMC7475652 DOI: 10.3389/fnins.2020.00873] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2020] [Accepted: 07/27/2020] [Indexed: 11/13/2022] Open
Abstract
Idiopathic restless legs syndrome (RLS) is a sensorimotor disorder and is suggested to be caused by central nervous system abnormalities. Non-invasive transcutaneous spinal direct-current stimulation (tsDCS) was recently used for RLS therapy. However, the neurophysiological basis of tsDCS treatment is still unknown. In this study, we explored the neural basis of tsDCS in 15 RLS patients and 20 gender- and age-matched healthy controls using resting-state functional magnetic resonance imaging. We calculated the whole-brain voxel-wise fractional amplitude of low-frequency fluctuations (fALFF), regional homogeneity (ReHo), and weighted degree centrality (DC) to characterize the intrinsic functional activities and the local and global functional integration. We found that tsDCS can effectively improve the sleep and RLS symptoms in RLS patients. Moreover, after tsDCS therapy, the RLS patients showed decreased fALFF in the right anterior insula/temporal pole, decreased ReHo in the supplementary motor area, increased weighted DC in the left primary visual cortex, and decreased weighted DC in the right posterior cerebellum. The changed patterns were consistent with that found between RLS patients and healthy controls. The weighted DC in the left primary visual cortex after treatment and the fALFF in the right anterior insula/temporal pole before treatment were significantly and marginally correlated with sleep and RLS symptom scores, respectively. These results revealed that tsDCS can normalize the functional patterns of RLS patients and is an effective way for RLS therapy. Our findings provide the neurophysiological basis for tsDCS treatment and may facilitate understanding the neuropathology of RLS and directing other neuromodulation treatments.
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Affiliation(s)
- Min Zeng
- Department of Radiology, Pidu District People's Hospital, Chengdu, China
| | - Li Wang
- Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, China.,Beijing Key Laboratory of Neuromodulation, Beijing, China
| | - Bochao Cheng
- Department of Radiology, West China Second University Hospital of Sichuan University, Chengdu, China
| | - Guiqiang Qi
- Department of Radiology, Pidu District People's Hospital, Chengdu, China
| | - Junwei He
- Department of Radiology, Pidu District People's Hospital, Chengdu, China
| | - Zhexue Xu
- Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, China.,Beijing Key Laboratory of Neuromodulation, Beijing, China
| | - Tao Han
- Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, China.,Beijing Key Laboratory of Neuromodulation, Beijing, China
| | - Chunyan Liu
- Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, China.,Beijing Key Laboratory of Neuromodulation, Beijing, China
| | - Yuping Wang
- Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, China.,Beijing Key Laboratory of Neuromodulation, Beijing, China
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20
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Kocar TD, Müller HP, Kassubek J. Differential functional connectivity in thalamic and dopaminergic pathways in restless legs syndrome: a meta-analysis. Ther Adv Neurol Disord 2020; 13:1756286420941670. [PMID: 32821291 PMCID: PMC7412904 DOI: 10.1177/1756286420941670] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2020] [Accepted: 06/22/2020] [Indexed: 12/13/2022] Open
Abstract
Objective: Restless legs syndrome (RLS) is a sensorimotor disorder with alterations in somatosensory processing in association with a dysfunctional cerebral network, involving the basal ganglia, limbic network, and sensorimotor pathways. Resting state functional magnetic resonance imaging (MRI) is a powerful tool to provide in vivo insight into functional processing and as such is of special interest in RLS considering the widespread pattern of networks involved in this disorder. In this meta-analysis of resting state functional MRI studies, we analyzed the preponderance of functional connectivity changes associated with RLS and discussed possible links to sensorimotor dysfunction and somatosensory processing. Methods: A systematic research using the online library PubMed was conducted and a total of seven studies passed the inclusion criteria of the meta-analysis. The results of these studies were merged and a statistical probability map was generated that indicated the likelihood of functional connectivity changes within the combined cohort, both for increased and decreased connectivity. Results: The meta-analysis demonstrated decreased functional connectivity within the dopaminergic network in participants with RLS compared with healthy controls, including the nigrostriatal, mesolimbic, and mesocortical pathways. Increased functional connectivity was observed bilaterally in the thalamus, including its ventral lateral, ventral anterior, and ventral posterior lateral nuclei, and the pulvinar. Discussion: Sensorimotor dysfunction in RLS seems to be reflected by decreased functional connectivity within the dopaminergic pathways. Network extension in the thalamus can be regarded as an adaptation to somatosensory dysfunction in RLS. This differential functional connectivity pattern extends prior findings on cerebral somatosensory processing in RLS and offers an explanation for the efficacy of dopaminergic treatment.
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Affiliation(s)
| | | | - Jan Kassubek
- Department of Neurology, University of Ulm, Oberer Eselsberg 45, Ulm, 89081, Germany
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de Paiva JPQ, Magalhães SC, Moura LM, Sato JR, Amaro E, Sterr A, Schlaffke L, Eckeli AL, do Prado GF, Conforto AB. Sensorimotor white matter projections and disease severity in primary Restless Legs Syndrome/Willis-Ekbom disease: a multimodal DTI analysis. Sleep Med 2020; 73:106-116. [PMID: 32805477 DOI: 10.1016/j.sleep.2020.05.040] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/17/2020] [Revised: 05/22/2020] [Accepted: 05/26/2020] [Indexed: 01/18/2023]
Abstract
BACKGROUND Restless Legs Syndrome, a potentially disabling sleep disorder, also known as Willis-Ekbom disease (RLS/WED), may be caused by loss of inhibitory modulation of descending central motor pathways, structural changes in the somatosensory cortex, abnormal connectivity between motor and sensory areas, as well as by subtle abnormalities in white matter micro-organization. OBJECTIVE To compare diffusion-tensor imaging (DTI) metrics in areas associated with sensory or motor function, as well as sensorimotor integration, between subjects with primary mild-to-severe RLS/WED and controls. METHODS DTI metrics were assessed in 38 subjects with RLS/WED (14 mild to moderate, 24 severe to very severe) and 24 healthy age-matched controls with whole-brain Tract Based Spatial Statistics (TBSS), Region-of-interest (ROI) and probabilistic tractography based analyses. The ROIs corresponded to the corticospinal tract (CST) at the level of the cerebral peduncle; the superior, middle and inferior cerebellar peduncles. Subgroup analyses were made according to the severity of RLS/WED symptoms. The corticospinal tract was evaluated with probabilistic tractography. We also explored associations between significant findings and severity of symptoms with the Spearman's correlation coefficient. RESULTS TBSS analysis revealed decreased axial diffusivity (AD) in the left posterior thalamic radiation in RLS/WED. In subjects with severe RLS/WED, AD was reduced in the left posterior corona radiata and this reduction was negatively correlated with severity of symptoms. ROI-based analysis showed that radial diffusivity (RD) was increased in the superior cerebellar peduncles of individuals with severe RLS/WED. Tractography did not show between-group or subgroup differences. CONCLUSIONS Our results are consistent with subtle white matter changes, prominently in RLS/WED subjects with more severe symptoms, in areas related to sensory or motor function, as well as to sensorimotor integration, compared to controls. These findings support the hypothesis, raised by prior pathophysiological studies, of defective integration within these networks.
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Affiliation(s)
- Joselisa Péres Queiroz de Paiva
- Brain Institute, Hospital Israelita Albert Einstein (HIAE), São Paulo, SP, Brazil; Imaging Research Center, Hospital Israelita Albert Einstein (HIAE), São Paulo, SP, Brazil.
| | - Samir Câmara Magalhães
- Brain Institute, Hospital Israelita Albert Einstein (HIAE), São Paulo, SP, Brazil; Universidade de Fortaleza (UNIFOR), Unifor, Fortaleza, CE, Brazil
| | - Luciana Monteiro Moura
- Imaging Research Center, Hospital Israelita Albert Einstein (HIAE), São Paulo, SP, Brazil
| | - João Ricardo Sato
- Center for Mathematics, Computing and Cognition, Universidade Federal do ABC (UFABC), São Bernardo do Campo, SP, Brazil
| | - Edson Amaro
- Brain Institute, Hospital Israelita Albert Einstein (HIAE), São Paulo, SP, Brazil; Imaging Research Center, Hospital Israelita Albert Einstein (HIAE), São Paulo, SP, Brazil; Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, SP, Brazil
| | - Annette Sterr
- School of Psychology, University of Surrey, Guildford, UK
| | - Lara Schlaffke
- Department of Neurology, BG University Clinic Bergmannsheil, Ruhr-University Bochum, Bochum, Germany
| | - Alan Luiz Eckeli
- Department of Neurosciences and Behavioral Sciences, Medical School, University of São Paulo, Ribeirão Preto, SP, Brazil
| | | | - Adriana Bastos Conforto
- Brain Institute, Hospital Israelita Albert Einstein (HIAE), São Paulo, SP, Brazil; Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, SP, Brazil
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Aldemir A, Yucel K, Güven H, Kamaşak B, Dilli A, Acer N, Çomoğlu S. Structural neuroimaging findings in migraine patients with restless legs syndrome. Neuroradiology 2020; 62:1301-1313. [PMID: 32488307 DOI: 10.1007/s00234-020-02451-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2020] [Accepted: 04/28/2020] [Indexed: 12/27/2022]
Abstract
PURPOSE One out of three migraine patients might have accompanying restless legs syndrome (RLS). In our study, we aimed to compare the volumes of the brain structures of migraineurs with and without RLS. METHODS We had 37 female patients with migraine and 17 females as the control group. Nineteen migraineurs had no RLS (RLS0) and 18 migraineurs had comorbidity of RLS (RLS1). The volumes of the brain structures were obtained by manual measurements, volBrain, and voxel-based morphometry (VBM). Manually, we measured caudate and putamen volumes. We used age, years of education, depression, anxiety scores, and total intracranial volume as covariates. RESULTS According to VBM analyses, the volumes of the left superior occipital gyrus and precuneus were increased, and the substantia nigra and cuneus were decreased in the RLS1 group compared with the RLS0 group. RLS1 patients had larger superior temporal gyrus, Brodmann area 38, and left insula, and RLS0 patients had larger Brodmann area 22, right superior temporal gyrus, and Heschl gyrus compared with controls. Migraine and RLS0 patients had a smaller corpus callosum anteriorly, whereas RLS1 patients had a smaller splenium. Caudate volumes were larger in migraine patients via the three techniques. There was a positive relation between the caudate and putamen volumes and attack frequency. CONCLUSIONS Comorbidity of RLS might be a confounding factor in structural neuroimaging studies in migraine. Deficits in the visual network seem to be related to accompanying RLS; deficits in the auditory network are particularly related to migraine.
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Affiliation(s)
- Arzu Aldemir
- Department of Neurology, Acıbadem Hospital, Eskişehir, Turkey
| | - Kaan Yucel
- Department of Anatomy, Aksaray University Medical School, Aksaray, Turkey.
| | - Hayat Güven
- Department of Neurology, Dışkapı Yıldırım Beyazıt Training and Research Hospital, University of Health Sciences, Ankara, Turkey
| | - Burcu Kamaşak
- Department of Anatomy, Ahi Evran University Medical School, Kırşehir, Turkey
| | - Alper Dilli
- Department of Radiology, Dışkapı Yıldırım Beyazıt Training and Research Hospital, University of Health Sciences, Ankara, Turkey
| | - Niyazi Acer
- Department of Anatomy, Erciyes University Medical School, Kayseri, Turkey
| | - Selçuk Çomoğlu
- Department of Neurology, Dışkapı Yıldırım Beyazıt Training and Research Hospital, University of Health Sciences, Ankara, Turkey
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Song L, Peng Q, Liu S, Wang J. Changed hub and functional connectivity patterns of the posterior fusiform gyrus in chess experts. Brain Imaging Behav 2019; 14:797-805. [PMID: 30612341 DOI: 10.1007/s11682-018-0020-0] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
The hubs of the brain network play a key role in integrating and transferring information between different functional modules. However, the effects of long-term practice on functional network hubs in chess experts are largely undefined. Here, we investigated whether alterations of hubs can be detected in chess experts using resting-state functional magnetic resonance imaging (rs-fMRI) and graph theory methods. We first mapped the whole-brain voxel-wise functional connectivity and calculated the functional connectivity strength (FCS) map in each of the 28 chess players and 27 gender- and age-matched healthy novice players. Whole-brain resting-state functional connectivity analyses for the changed hub areas were conducted to further elucidate the corresponding changes of functional connectivity patterns in chess players. The hub analysis revealed increased FCS in the right posterior fusiform gyrus of the chess players, which was supported by analyses of this area's regional homogeneity (ReHo), amplitude of low frequency fluctuations (ALFF), and fractional amplitude of low frequency fluctuations (fALFF). The following functional connectivity analyses revealed increased functional connectivities between the right posterior fusiform gyrus and the visuospatial attention and motor networks in chess players. These findings demonstrate that cognitive expertise has a positive influence on the functions of the brain regions associated with the chess expertise and that increased functional connections might in turn facilitate within and between networks communication for expert behavior to get superior performance.
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Affiliation(s)
- Limei Song
- Research Center for Sectional and Imaging Anatomy, Shandong University Cheeloo College of Medicine, Jinan, Shandong, China
| | - Qinmu Peng
- School of Electronic Information and Communications, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Shuwei Liu
- Research Center for Sectional and Imaging Anatomy, Shandong University Cheeloo College of Medicine, Jinan, Shandong, China.
| | - Jiaojian Wang
- The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Lab for Neuroinformation, University of Electronic Science and Technology of China, Chengdu, Sichuan, China.
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Zhang L, Wu H, Xu J, Shang J. Abnormal Global Functional Connectivity Patterns in Medication-Free Major Depressive Disorder. Front Neurosci 2018; 12:692. [PMID: 30356761 PMCID: PMC6189368 DOI: 10.3389/fnins.2018.00692] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2018] [Accepted: 09/18/2018] [Indexed: 01/15/2023] Open
Abstract
Mounting studies have applied resting-state functional magnetic resonance imaging (rs-fMRI) to study major depressive disorder (MDD) and have identified abnormal functional activities. However, how the global functional connectivity patterns change in MDD is still unknown. Using rs-fMRI, we investigated the alterations of global resting-state functional connectivity (RSFC) patterns in MDD using weighted global brain connectivity (wGBC) method. First, a whole brain voxel-wise wGBC map was calculated for 23 MDD patients and 34 healthy controls. Two-sample t-tests were applied to compare the wGBC and RSFC maps and the significant level was set at p < 0.05, cluster-level correction with voxel-level p < 0.001. MDD patients showed significantly decreased wGBC in left temporal pole (TP) and increased wGBC in right parahippocampus (PHC). Subsequent RSFC analyses showed decreased functional interaction between TP and right posterior superior temporal cortex and increased functional interaction between PHC and right inferior frontal gyrus in MDD patients. These results revealed the abnormal global FC patterns and its corresponding disrupted functional connectivity in MDD. Our findings present new evidence for the functional interruption in MDD.
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Affiliation(s)
- Lu Zhang
- Lab of Learning Sciences, Graduate School of Education, Peking University, Beijing, China
| | - Huawang Wu
- The Affiliated Brain Hospital of Guangzhou Medical University (Guangzhou Hui'ai Hospital), Guangzhou, China
| | - Jinping Xu
- Institute of Biomedical and Health Engineering, Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen, China
| | - Junjie Shang
- Lab of Learning Sciences, Graduate School of Education, Peking University, Beijing, China
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Rizzo G, Plazzi G. Neuroimaging Applications in Restless Legs Syndrome. INTERNATIONAL REVIEW OF NEUROBIOLOGY 2018; 143:31-64. [DOI: 10.1016/bs.irn.2018.09.012] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
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