Structural neuroimaging findings in migraine patients with restless legs syndrome

One out of three migraine patients might have accompanying restless legs syndrome (RLS). In our study, we aimed to compare the volumes of the brain structures of migraineurs with and without RLS.

We had 37 female patients with migraine and 17 females as the control group. Nineteen migraineurs had no RLS (RLS₀) and 18 migraineurs had comorbidity of RLS (RLS₁). The volumes of the brain structures were obtained by manual measurements, volBrain, and voxel-based morphometry (VBM). Manually, we measured caudate and putamen volumes. We used age, years of education, depression, anxiety scores, and total intracranial volume as covariates.

According to VBM analyses, the volumes of the left superior occipital gyrus and precuneus were increased, and the substantia nigra and cuneus were decreased in the RLS₁ group compared with the RLS₀ group. RLS₁ patients had larger superior temporal gyrus, Brodmann area 38, and left insula, and RLS₀ patients had larger Brodmann area 22, right superior temporal gyrus, and Heschl gyrus compared with controls. Migraine and RLS₀ patients had a smaller corpus callosum anteriorly, whereas RLS₁ patients had a smaller splenium. Caudate volumes were larger in migraine patients via the three techniques. There was a positive relation between the caudate and putamen volumes and attack frequency.

Comorbidity of RLS might be a confounding factor in structural neuroimaging studies in migraine. Deficits in the visual network seem to be related to accompanying RLS; deficits in the auditory network are particularly related to migraine.