Cerebellum white matter reductions in restless legs syndrome are associated with psychiatric symptom severity

Purpose: Various imaging techniques were used to examine putative changes in restless legs syndrome (RLS), in which the central nervous system and peripheral nervous system play a role by using many biochemical pathways and neurotransmitters. In this study, the cerebellar volumes of drug-naive patients with RLS were examined and compared with healthy control groups. Additionally, the relationship between psychiatric symptom severity and cerebellar white matter (WM) volume was examined. Materials and Methods: The current study included 44 RLS patients and 53 age- and gender-matched healthy controls. The symptom severity of RLS group was assessed by using the International Restless Legs Syndrome Study Group Rating Scale (RLSRS) and the Symptom Checklist-90-Revised (SCL-90-R). Brain magnetic resonance imaging (MRI) volumes were calculated with Volbrain software. Results: The patient group consisted of 24 males and 20 females, while the control group included 29 males and 24 females. The mean age in the patient cohort was 36.23±5.43 years, compared to 34.20±5.22 years in the control cohort. The right cerebellum WM (1.10±0.26) and left cerebellum WM (0.90±0.23) percentages of the patient group were significantly lower than the healthy control group (right cerebellum WM=1.27±0.31; left cerebellum WM=1.03±0.26). The right cerebellum WM (15.41±4.03) and left cerebellum WM (12.63±3.05) volumes of the patient group were significantly lower than those of the healthy control group (right cerebellum WM=17.49±4.12; left cerebellum WM=14.25±3.53). In the RLS group, a significant negative correlation was found between cerebellum WM volumes and percentages and SCL-90-R and RLSRS scores. Conclusion: This study demonstrates that drug-naive RLS is associated with significant cerebellar WM volume reductions, which may indicate early structural brain abnormalities. The observed correlation between cerebellar WM changes and psychiatric symptom severity highlights the need for further research into the neurological and psychiatric interplay in RLS.