Association between lesion location and symptoms of restless leg syndrome (RLS) among patients with multiple...

PURPOSE.: Restless legs syndrome (RLS) is a common but under-recognised non-motor symptom in multiple sclerosis (MS), potentially linked to central nervous system lesion distribution. This study aimed to assess the anatomical distribution of MRI-detected lesions in MS patients with and without RLS. METHODS.: A retrospective cohort study was conducted at King Saud University Medical City between April 2023 and March 2024. MRI lesion patterns, fatigue (Fatigue Severity Scale, FSS), sleep quality (Pittsburgh Sleep Quality Index, PSQI), and vitamin D3 levels were compared between MS patients with and without RLS. RESULTS.: Of 96 MS patients (62.5% female; mean age 32.9 ± 9.6 years), 28.1% had RLS, of whom 74.1% were classified as severe. RLS patients were significantly older and exhibited higher fatigue scores (p < 0.05). Lesions in the spinal cord, frontal, temporal, cerebellar, and insular regions were more prevalent in the RLS group; however, no statistically significant association was identified between lesion location and RLS. Sub-insular lesions were significantly associated with male sex and greater fatigue severity. CONCLUSION.: This study did not identify a statistically meaningful association between brain or spinal cord lesion distribution and the development of RLS in patients with MS. Restless legs syndrome (RLS) is a common but under-recognised non-motor symptom in multiple sclerosis (MS), potentially linked to central nervous system lesion distribution. We aim to assess the anatomical distribution of MRI-detected MS lesions in patients with and without RLS. A retrospective cohort study was conducted at King Saud University Medical City between April 2023 and March 2024. MRI lesion patterns, fatigue (FSS), sleep quality (PSQI), and vitamin D3 levels were compared between MS patients with and without RLS. Of 96 MS patients (62.5% females, mean age 32.9 ± 9.6 years), 28.1% had RLS, with 74.1% classified as severe. RLS patients were older and exhibited higher fatigue (p < 0.05). Lesions in the spinal cord, frontal, temporal, cerebellar, and insular cerebral regions were more prevalent in RLS patients, though no statistically significant association was found between lesion location and RLS. Sub-insular lesions were significantly associated with male gender and fatigue severity. This study did not identify a statistically meaningful association between brain or spinal cord lesion involvement and the development of restless legs syndrome in patients with MS.