Restless Legs Syndrome Shows Increased Silent Postmortem Cerebral Microvascular Disease With Gliosis
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 immunologica...
| Main Authors: | , , , , , , |
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| Format: | Article |
| Language: | English |
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Wiley
2021-06-01
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| Series: | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
| Subjects: | |
| Online Access: | https://www.ahajournals.org/doi/10.1161/JAHA.120.019627 |
| _version_ | 1811275145127395328 |
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| author | Arthur S. Walters Paisit Paueksakon Charles H. Adler Michael Moussouttas Leonard B. Weinstock Karen Spruyt Kanika Bagai |
| author_facet | Arthur S. Walters Paisit Paueksakon Charles H. Adler Michael Moussouttas Leonard B. Weinstock Karen Spruyt Kanika Bagai |
| author_sort | Arthur S. Walters |
| collection | DOAJ |
| description | 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. |
| first_indexed | 2024-04-12T23:32:50Z |
| format | Article |
| id | doaj.art-88f052d333d04674b849d90c9350a975 |
| institution | Directory Open Access Journal |
| issn | 2047-9980 |
| language | English |
| last_indexed | 2024-04-12T23:32:50Z |
| publishDate | 2021-06-01 |
| publisher | Wiley |
| record_format | Article |
| series | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
| spelling | doaj.art-88f052d333d04674b849d90c9350a9752022-12-22T03:12:14ZengWileyJournal of the American Heart Association: Cardiovascular and Cerebrovascular Disease2047-99802021-06-01101110.1161/JAHA.120.019627Restless Legs Syndrome Shows Increased Silent Postmortem Cerebral Microvascular Disease With GliosisArthur S. Walters0Paisit Paueksakon1Charles H. Adler2Michael Moussouttas3Leonard B. Weinstock4Karen Spruyt5Kanika Bagai6Sleep Division Department of Neurology Vanderbilt University Medical Center Nashville TNDepartment of Pathology, Microbiology, and Immunology Vanderbilt University Medical Center Nashville TNDepartment of Neurology Mayo Clinic College of Medicine Scottsdale AZCerebrovascular Division Department of Neurology Rutgers Medical School New Brunswick NJSpecialists in Gastroenterology and Washington University Saint Louis MOINSERM Neurocampus Lyon FranceSleep Division Department of Neurology Vanderbilt University Medical Center Nashville TNBackground 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.https://www.ahajournals.org/doi/10.1161/JAHA.120.019627cortexgliosismicrovascular diseaserestless legs syndromeT cells |
| spellingShingle | Arthur S. Walters Paisit Paueksakon Charles H. Adler Michael Moussouttas Leonard B. Weinstock Karen Spruyt Kanika Bagai Restless Legs Syndrome Shows Increased Silent Postmortem Cerebral Microvascular Disease With Gliosis Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease cortex gliosis microvascular disease restless legs syndrome T cells |
| title | Restless Legs Syndrome Shows Increased Silent Postmortem Cerebral Microvascular Disease With Gliosis |
| title_full | Restless Legs Syndrome Shows Increased Silent Postmortem Cerebral Microvascular Disease With Gliosis |
| title_fullStr | Restless Legs Syndrome Shows Increased Silent Postmortem Cerebral Microvascular Disease With Gliosis |
| title_full_unstemmed | Restless Legs Syndrome Shows Increased Silent Postmortem Cerebral Microvascular Disease With Gliosis |
| title_short | Restless Legs Syndrome Shows Increased Silent Postmortem Cerebral Microvascular Disease With Gliosis |
| title_sort | restless legs syndrome shows increased silent postmortem cerebral microvascular disease with gliosis |
| topic | cortex gliosis microvascular disease restless legs syndrome T cells |
| url | https://www.ahajournals.org/doi/10.1161/JAHA.120.019627 |
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