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Cortical involvement in the generation of "involuntary" movements in restless legs syndrome

From the Cortical Physiology Research Group, Department of General Neurology, Hertie Institute for Clinical Brain Research, University of Tuebingen, Germany.

Address correspondence and reprint requests to Dr. C. Gerloff, Cortical Physiology Research Group, Department of General Neurology, Hertie Institute for Clinical Brain Research, University of Tuebingen, Hoppe-Seyler-Str. 3, 72076 Tuebingen, Germany; e-mail: christian.gerloff{at}uni-tuebingen.de

The pathophysiology of the restless legs syndrome (RLS) is poorly understood. One index symptom is the urge to move, increasing at night. It is largely accepted that movement in RLS is "involuntary" and that the generators are below the level of the neocortex. Here the authors provide evidence that characteristic leg movements in RLS are preceded by preparatory cortical activation that cannot be attributed to sensory processing or to the expectancy of movement.

Received August 14, 2003. Accepted in final form November 26, 2003.