Silent Cerebral Small Vessel Disease in Restless Legs Syndrome

Raffaele Ferri, Filomena I.I. Cosentino, Michael Moussouttas, Bartolo Lanuzza, Debora Aricò, Kanika Bagai, Lily Wang, Beth Ann McLaughlin, Arthur S. Walters

Research output: Contribution to journalArticle

13 Citations (Scopus)

Abstract

Study Objectives: 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. Methods: 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. Results: 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. Conclusion: 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.

Original languageEnglish (US)
Pages (from-to)1371-1377
Number of pages7
JournalSleep
Volume39
Issue number7
DOIs
StatePublished - Jul 1 2016
Externally publishedYes

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Cerebral Small Vessel Diseases
Restless Legs Syndrome
Stroke
Cerebrovascular Disorders
Sleep Initiation and Maintenance Disorders
Risk-Taking

Keywords

  • Cerebral small vessel disease
  • MRI
  • Restless legs syndrome
  • Stroke
  • Willis-Ekbom disease

ASJC Scopus subject areas

  • Clinical Neurology
  • Physiology (medical)

Cite this

Ferri, R., Cosentino, F. I. I., Moussouttas, M., Lanuzza, B., Aricò, D., Bagai, K., ... Walters, A. S. (2016). Silent Cerebral Small Vessel Disease in Restless Legs Syndrome. Sleep, 39(7), 1371-1377. https://doi.org/10.5665/sleep.5966

Silent Cerebral Small Vessel Disease in Restless Legs Syndrome. / Ferri, Raffaele; Cosentino, Filomena I.I.; Moussouttas, Michael; Lanuzza, Bartolo; Aricò, Debora; Bagai, Kanika; Wang, Lily; McLaughlin, Beth Ann; Walters, Arthur S.

In: Sleep, Vol. 39, No. 7, 01.07.2016, p. 1371-1377.

Research output: Contribution to journalArticle

Ferri, R, Cosentino, FII, Moussouttas, M, Lanuzza, B, Aricò, D, Bagai, K, Wang, L, McLaughlin, BA & Walters, AS 2016, 'Silent Cerebral Small Vessel Disease in Restless Legs Syndrome', Sleep, vol. 39, no. 7, pp. 1371-1377. https://doi.org/10.5665/sleep.5966
Ferri R, Cosentino FII, Moussouttas M, Lanuzza B, Aricò D, Bagai K et al. Silent Cerebral Small Vessel Disease in Restless Legs Syndrome. Sleep. 2016 Jul 1;39(7):1371-1377. https://doi.org/10.5665/sleep.5966
Ferri, Raffaele ; Cosentino, Filomena I.I. ; Moussouttas, Michael ; Lanuzza, Bartolo ; Aricò, Debora ; Bagai, Kanika ; Wang, Lily ; McLaughlin, Beth Ann ; Walters, Arthur S. / Silent Cerebral Small Vessel Disease in Restless Legs Syndrome. In: Sleep. 2016 ; Vol. 39, No. 7. pp. 1371-1377.
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abstract = "Study Objectives: 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. Methods: 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. Results: 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. Conclusion: 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.",
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