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Restless legs syndrome is a common finding in multiple sclerosis and correlates with cervical cord damage

Sleep Disorders Center, Scientific Institute and University Ospedale San Raffaele, Milan, Italy

M.A. Rocca

Neuroimaging Research Unit, Scientific Institute and University Ospedale San Raffaele, Milan, Italy

L. Ferini-Strambi

Sleep Disorders Center, Scientific Institute and University Ospedale San Raffaele, Milan, Italy

P. Tortorella

Neuroimaging Research Unit, Scientific Institute and University Ospedale San Raffaele, Milan, Italy

F. Agosta

Neuroimaging Research Unit, Scientific Institute and University Ospedale San Raffaele, Milan, Italy

G. Comi

Department of Neurology, Scientific Institute and University Ospedale San Raffaele, Milan, Italy

M. Filippi

Neuroimaging Research Unit, Scientific Institute and University Ospedale San Raffaele, Milan, Italy, filippi.massimo{at}hsr.it, Department of Neurology, Scientific Institute and University Ospedale San Raffaele, Milan, Italy

In this prospective study, we estimated the prevalence of restless legs syndrome (RLS) in multiple sclerosis (MS) patients, and compared the extent of brain and cervical cord damage between patients with and without RLS using conventional and diffusion tensor magnetic resonance imaging (MRI). Eighty-two consecutive MS patients were evaluated. Each patient underwent a medical history interview, a neurological examination and brain/cervical cord MRI. Global and regional dual-echo lesion load (LL), number of cervical cord lesions, mean diffusivity (MD) and fractional anisotropy (FA) histograms metrics of the normal-appearing tissues of the brain and cervical cord were assessed. Thirty subjects had RLS; they showed a higher Expanded Disability Status Scale score than patients without. No difference between the two groups was found in whole brain, cerebellar and brainstem T₂-LLs; MD and FA histograms derived metrics of the normal appearing brain tissues; basal ganglia MD; number of cervical cord lesions and cord MD histograms derived metrics. Cervical cord average FA was significantly reduced in MS patients with RLS compared to those without. RLS symptoms are very common in MS. This form of RLS should be considered as symptomatic. Higher disability and cervical cord damage represent a significant risk factor for RLS in MS patients. Multiple Sclerosis 2008; 14: 86—93. http://msj.sagepub.com

Key Words: cervical cord damage • diffusion tensor imaging • disability • MRI • multiple sclerosis • restless legs syndrome

This version was published on January 1, 2008

Multiple Sclerosis, Vol. 14, No. 1, 86-93 (2008)
DOI: 10.1177/1352458507080734


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