Transcranial brain sonography in Parkinson's disease with restless legs syndrome

Do Young Kwon, Woo Keun Seo, Ho Kyoung Yoon, Moon Ho Park, Seong Beom Koh, Kun Woo Park

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29 Citations (Scopus)


Substantia nigra (SN) hyperechogenicity assessed by transcranial brain sonography (TCS) is a characteristic finding in idiopathic Parkinson's disease (PD). In contrast, SN hypoechogenicity on TCS has been recently demonstrated in restless legs syndrome (RLS). RLS is one of the most common sleep problems in PD, but the pathophysiologic relationship between these two disorders has not been thoroughly elucidated. We compared the SN echogenicities of PD patients with and without RLS to investigate whether comorbid RLS in PD affects SN echogenicity and to explain the echogenic differences between idiopathic RLS (iRLS) and secondary PD-related RLS (pRLS). Sixty-three PD patients (median age 64.6 ± 10.6 years), 40 iRLS patients (53.1 ± 11.7 years), and 40 healthy controls (69.1 ± 2.3 years) were enrolled in our study. All subjects answered a sleep questionnaire and underwent TCS. PD patients were subdivided into two groups, PD with RLS (PD+RLS, n = 26) and PD without RLS (PD-RLS, n = 37), and the sonographic findings of each group were compared. Although significant hyperechogenicity was detected in both the SN and SN/midbrain ratios in both PD subgroups compared with the controls and the iRLS group (P < 0.001), there were no significant differences in SN echogenicity between the PD+RLS and PD-RLS groups. Meanwhile, iRLS patients showed significant SN hypoechogenicity. In conclusion, comorbid RLS in PD did not have an impact on the sonographic SN findings. These results suggest that the pathogenesis of pRLS and iRLS involve different mechanisms. Further study will be required to clarify the association between RLS and PD.

Original languageEnglish
Pages (from-to)1373-1378
Number of pages6
JournalMovement Disorders
Issue number10
Publication statusPublished - 2010 Jul 30


  • Echogenicity
  • Parkinson's disease
  • Restless legs syndrome
  • Transcranial brain sonography

ASJC Scopus subject areas

  • Neurology
  • Clinical Neurology

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  • Cite this

    Kwon, D. Y., Seo, W. K., Yoon, H. K., Park, M. H., Koh, S. B., & Park, K. W. (2010). Transcranial brain sonography in Parkinson's disease with restless legs syndrome. Movement Disorders, 25(10), 1373-1378.