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Publication
Restless Legs Syndrome Shows Increased Silent Postmortem Cerebral Microvascular
Disease With Gliosis.
Authors Walters AS, Paueksakon P, Adler CH, Moussouttas M, Weinstock LB, Spruyt K, Bagai
K
Submitted By Submitted Externally on 12/3/2021
Status Published
Journal Journal of the American Heart Association
Year 2021
Date Published 6/1/2021
Volume : Pages 10 : e019627
PubMed Reference 33998250
Abstract Background Patients with restless legs syndrome (RLS) have increased silent
microvascular disease by magnetic resonance imaging. However, there has been no
previous autopsy confirmation of these magnetic resonance imaging findings. RLS
is also frequently associated with inflammatory and immunologically mediated
medical disorders. The postmortem cortex in patients with RLS was therefore
evaluated for evidence of microvascular and immunological changes. Methods and
Results Ten microvascular injury samples of precentral gyrus in 5 patients with
RLS (3 men, 2 women; mean age, 81 years) and 9 controls (2 men, 7 women; mean
age, 90 years) were studied by hematoxylin and eosin stains in a blinded
fashion. None of the subjects had a history of stroke or neurologic insults. In
a similar manner, the following immunohistochemistry stains were performed: (1)
glial fibrillary acidic protein (representing gliosis, reactive change of glial
cells in response to damage); (2) CD3 (a T-cell marker); (3) CD19 (a B-cell
marker); (4) CD68 (a macrophage marker); and (5) CD117 (a mast cell marker).
Patients with RLS had significantly greater silent microvascular disease
(P=0.015) and gliosis (P=0.003). T cells were increased in RLS compared with
controls (P=0.009) and tended to colocalize with microvascular disease
(P=0.003). Other markers did not differ. There was no correlation between
microvascular lesion load and RLS severity or duration. Conclusions Patients
with RLS had statistically significantly more silent cerebral microvascular
disease and gliosis than controls compatible with previous magnetic resonance
imaging studies and with studies showing a link between RLS and hypertension,
clinical stroke, and cardiovascular disease. T-cell invasion may be a secondary
phenomenon.




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