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Neurology 1999;53:1201
© 1999 American Academy of Neurology
Articles

Changes in excitability of motor cortical circuitry in primary restless legs syndrome

M. Entezari-Taher, MD, J. R. Singleton, MD, C. R. Jones, MD, G. Meekins, MD, J. H. Petajan, MD and A. G. Smith, MD

From the Department of Neurology, University of Utah, Salt Lake City, UT.

Address correspondence and reprint requests to Dr. Mohammad Entezari-Taher, Department of Neurology, University of Utah, University Hospital, 50 North Medical Drive, Salt Lake City, UT 84132.

OBJECTIVE: To investigate the excitability of segmental and suprasegmental systems in patients with primary restless legs syndrome (pRLS) by measuring the cortical silent period (C-SP) and the peripheral silent period (P-SP).

BACKGROUND: There is some evidence that RLS may be the motor manifestation of normal CNS periodicity that becomes disinhibited under certain conditions. The mechanism of this disinhibition is unclear.

DESIGN/METHODS: Ten patients with pRLS and 10 normal age-matched subjects were studied. The mixed nerve P-SP produced by electrical stimulation of the median and common peroneal nerves was recorded during maximal contraction of the abductor pollicis brevis (APB) and tibialis anterior (TA) muscles. The C-SP produced by a single magnetic shock to motor cortex at 150% of resting threshold was also measured during maximal contraction of the APB and TA muscles. The average of 5 to 10 trials at each site was obtained and compared using Student’s t-test.

RESULTS: Resting central motor threshold was not significantly different between pRLS patients and the control group. The average duration of the C-SP was shorter in the APB (74.5 ± 37.7 versus 129.56 ± 35.95 msec, p < 0.05) and TA (66.81 ± 25.63 versus 136.1 ± 40.35 msec, p < 0.05) in patients with pRLS. The P-SP duration, however, was not significantly different between two groups in either limb.

CONCLUSION: The supraspinal inhibitory system is impaired in pRLS.

Key words: Primary restless legs syndrome—Transcranial magnetic stimulation—Dopaminergic neurons—Cortical silent period—Peripheral silent period.




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