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Szentkirályi A, Hermesdorf M, Sundermann B, Czira M, Teismann H, Wulms N, Minnerup H, Young P, Berger K. Periodic limb movements in sleep are linked to decreased hippocampus and amygdala volumes in the population-based BiDirect Study. Sleep 2023; 46:6795532. [PMID: 36330698 DOI: 10.1093/sleep/zsac263] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Revised: 09/30/2022] [Indexed: 11/06/2022] Open
Abstract
STUDY OBJECTIVES Even though numerous studies indicate that sleep disorders are associated with altered brain morphology, MRI studies focusing on periodic limb movements in sleep (PLMS) are scarce. Our aim was to investigate the association of PLMS with global and regional gray matter volumes as well as white matter hyperintensity (WMH) volume. METHODS One hundred and eighty-nine subjects (57.0 ± 7.8 years, women: 50.5%) of the population-based BiDirect Study underwent a single-night polysomnography (PSG). Standard criteria of the American Academy of Sleep Medicine were applied to evaluate sleep characteristics and calculate the PLMS index (PLMSI). T1w and FLAIR images were acquired with cerebral MRI at 3 Tesla. Voxel-based morphometry was performed to determine the total gray matter volume as well as the volume of cortical segments and subcortical gray matter areas using SPM12 and CAT12. The WMH volume was quantified with the Brain Intensity AbNormality Classification Algorithm. The independent relationship between MRI markers and PLMSI was analyzed using multivariable linear regression with adjustment for age, sex, body mass index, intracranial volume, PSG scorer, PSG device, sleep apnea, and the use of antidepressants. RESULTS PLMSI was not significantly related to global gray matter volume and WMH volume. However, significant inverse associations of the PLMSI with the volume of the hippocampus (left and right hemisphere) and left amygdala were observed. CONCLUSIONS A significant relationship between a higher PLMSI and lower volumes of the hippocampus and amygdala was found among the participants of the BiDirect Study. Since these associations are based on exploratory analyses, further replications are required before drawing firm conclusions.
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Affiliation(s)
- András Szentkirályi
- Institute of Epidemiology and Social Medicine, University of Münster, Münster, Germany
| | - Marco Hermesdorf
- Institute of Epidemiology and Social Medicine, University of Münster, Münster, Germany
| | - Benedikt Sundermann
- Clinic of Radiology, University Hospital Münster, Münster, Germany.,Institute of Radiology and Neuroradiology, Evangelisches Krankenhaus, Medical Campus University of Oldenburg, Oldenburg, Germany.,Research Center Neurosensory Science, University of Oldenburg, Oldenburg, Germany
| | - Maria Czira
- Johannes Keller General Practice, Greven, Germany
| | - Henning Teismann
- Institute of Epidemiology and Social Medicine, University of Münster, Münster, Germany
| | - Niklas Wulms
- Institute of Epidemiology and Social Medicine, University of Münster, Münster, Germany
| | - Heike Minnerup
- Institute of Epidemiology and Social Medicine, University of Münster, Münster, Germany
| | - Peter Young
- Medical Park/Neurological Clinic Reithofpark, Bad Feilnbach, Germany
| | - Klaus Berger
- Institute of Epidemiology and Social Medicine, University of Münster, Münster, Germany
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Ouyang F, Wang M, Liao M, Lan L, Liu X, Li H, Mo R, Shi L, Fan Y. Association between periodic limb movements during sleep and neuroimaging features of cerebral small vessel disease: A preliminary cross‐sectional study. J Sleep Res 2022; 31:e13573. [DOI: 10.1111/jsr.13573] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2021] [Revised: 02/11/2022] [Accepted: 02/13/2022] [Indexed: 11/29/2022]
Affiliation(s)
- Fubing Ouyang
- Department of Neurology National Key Clinical Department and Key Discipline of Neurology The First Affiliated Hospital Guangdong Provincial Key Laboratory for Diagnosis and Treatment of Major Neurological Diseases Sun Yat‐sen University Guangzhou China
| | - Meng Wang
- Department of Radiology The First Affiliated Hospital Sun Yat‐sen University Guangzhou China
| | - Mengshi Liao
- Department of Neurology National Key Clinical Department and Key Discipline of Neurology The First Affiliated Hospital Guangdong Provincial Key Laboratory for Diagnosis and Treatment of Major Neurological Diseases Sun Yat‐sen University Guangzhou China
| | - Linfan Lan
- Department of Neurology National Key Clinical Department and Key Discipline of Neurology The First Affiliated Hospital Guangdong Provincial Key Laboratory for Diagnosis and Treatment of Major Neurological Diseases Sun Yat‐sen University Guangzhou China
| | - Xiaolu Liu
- Department of Neurology National Key Clinical Department and Key Discipline of Neurology The First Affiliated Hospital Guangdong Provincial Key Laboratory for Diagnosis and Treatment of Major Neurological Diseases Sun Yat‐sen University Guangzhou China
| | - Hao Li
- Department of Neurology National Key Clinical Department and Key Discipline of Neurology The First Affiliated Hospital Guangdong Provincial Key Laboratory for Diagnosis and Treatment of Major Neurological Diseases Sun Yat‐sen University Guangzhou China
| | - Rong Mo
- Department of Neurology National Key Clinical Department and Key Discipline of Neurology The First Affiliated Hospital Guangdong Provincial Key Laboratory for Diagnosis and Treatment of Major Neurological Diseases Sun Yat‐sen University Guangzhou China
| | - Lin Shi
- Department of Imaging and Interventional Radiology The Chinese University of Hong Kong Hong Kong China
| | - Yuhua Fan
- Department of Neurology National Key Clinical Department and Key Discipline of Neurology The First Affiliated Hospital Guangdong Provincial Key Laboratory for Diagnosis and Treatment of Major Neurological Diseases Sun Yat‐sen University Guangzhou China
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Del Brutto OH, Mera RM, Del Brutto VJ, Castillo PR. Lack of Association between Periodic Limb Movements during Sleep and Neuroimaging Signatures of Cerebral Small Vessel Disease in Stroke-Free Community-Dwelling Older Adults. The Atahualpa Project. J Stroke Cerebrovasc Dis 2019; 29:104497. [PMID: 31810723 DOI: 10.1016/j.jstrokecerebrovasdis.2019.104497] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2019] [Revised: 10/20/2019] [Accepted: 10/22/2019] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Evidence of the relationship between periodic limb movements during sleep (PLMS) and cerebral small vessel disease (cSVD) is limited and inconsistent. Here, we aimed to assess the independent association between PLMS and the different neuroimaging signatures of cSVD. METHODS Atahualpa residents aged more than or equal to 60 years enrolled in the Atahualpa Project undergoing polysomnography and MRI with time intervals less than or equal to 6 months were included. MRI readings focused on white matter hyperintensities (WMH) of presumed vascular origin, deep cerebral microbleeds (CMB), silent lacunar infarcts (LI), and more than 10 enlarged basal ganglia-perivascular spaces (BG-PVS). Data from single-night polysomnograms were interpreted according to recommendations of the American Academy of Sleep Medicine. Associations between the PLMS index and neuroimaging signatures of cSVD (as dependent variables) were assessed by means of logistic regression models, adjusted for relevant confounders. RESULTS A total of 146 individuals (mean age: 71.4 ± 7.5 years; 64% women) were included. A PLMS index more than or equal to 15 per hour were noted in 48 (33%) participants. Moderate-to-severe WMH were present in 33 individuals (23%), deep CMB in 9 (6%), silent LI in 16 (11%), and more than 10 BG-PVS in 44 (30%). In univariate analyses, silent LI (P = .035) and the presence of more than 10 enlarged BG-PVS (P = .034) were significantly higher among participants with a PLMS index more than or equal to 15 per hour. However, fully-adjusted multivariate models showed no significant association between PLMS index more than or equal to 15 per hour and any of the neuroimaging signatures of cSVD. CONCLUSIONS This study shows no independent association between the PLMS index and neuroimaging signatures of cSVD in stroke-free community-dwelling older adults.
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Affiliation(s)
- Oscar H Del Brutto
- School of Medicine, Universidad Espíritu Santo - Ecuador, Samborondón, Ecuador.
| | - Robertino M Mera
- Department of Epidemiology, Gilead Sciences, Inc, Foster City, CaliforniaA
| | - Victor J Del Brutto
- Department of Neurology, Miller School of Medicine, University of Miami, Miami, Florida
| | - Pablo R Castillo
- Sleep Disorders Center, Mayo Clinic College of Medicine, Jacksonville, Florida
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Boulos MI, Muir RT, Gao F, Lim AS, Swartz RH, Black SE, Walters AS, Murray BJ. Reply to: "Periodic Limb Movements During Sleep and White Matter MRI Hyperintensity in Minor Stroke or TIA". Sleep 2017; 40:3823356. [PMID: 28510763 PMCID: PMC5806546 DOI: 10.1093/sleep/zsx060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/13/2017] [Indexed: 11/15/2022] Open
Affiliation(s)
- Mark I Boulos
- L.C. Campbell Cognitive Neurology Research Unit, Heart and Stroke Foundation Canadian Partnership for Stroke Recovery, Brain Sciences Research Program, Sunnybrook Health Sciences Centre (SHSC), Toronto, Canada
- Department of Medicine, Division of Neurology, University of Toronto, Toronto, Canada
- Sleep Laboratory, SHSC, Toronto, Canada
- Sunnybrook Research Institute, SHSC, Toronto, Canada
- University of Toronto Stroke Program, Toronto, Canada
| | - Ryan T Muir
- L.C. Campbell Cognitive Neurology Research Unit, Heart and Stroke Foundation Canadian Partnership for Stroke Recovery, Brain Sciences Research Program, Sunnybrook Health Sciences Centre (SHSC), Toronto, Canada
- Department of Medicine, Division of Neurology, University of Toronto, Toronto, Canada
| | - Fuqiang Gao
- L.C. Campbell Cognitive Neurology Research Unit, Heart and Stroke Foundation Canadian Partnership for Stroke Recovery, Brain Sciences Research Program, Sunnybrook Health Sciences Centre (SHSC), Toronto, Canada
- Department of Medicine, Division of Neurology, University of Toronto, Toronto, Canada
| | - Andrew S Lim
- L.C. Campbell Cognitive Neurology Research Unit, Heart and Stroke Foundation Canadian Partnership for Stroke Recovery, Brain Sciences Research Program, Sunnybrook Health Sciences Centre (SHSC), Toronto, Canada
- Department of Medicine, Division of Neurology, University of Toronto, Toronto, Canada
- Sleep Laboratory, SHSC, Toronto, Canada
- Sunnybrook Research Institute, SHSC, Toronto, Canada
| | - Richard H Swartz
- L.C. Campbell Cognitive Neurology Research Unit, Heart and Stroke Foundation Canadian Partnership for Stroke Recovery, Brain Sciences Research Program, Sunnybrook Health Sciences Centre (SHSC), Toronto, Canada
- Department of Medicine, Division of Neurology, University of Toronto, Toronto, Canada
- Sleep Laboratory, SHSC, Toronto, Canada
- Sunnybrook Research Institute, SHSC, Toronto, Canada
- University of Toronto Stroke Program, Toronto, Canada
| | - Sandra E Black
- L.C. Campbell Cognitive Neurology Research Unit, Heart and Stroke Foundation Canadian Partnership for Stroke Recovery, Brain Sciences Research Program, Sunnybrook Health Sciences Centre (SHSC), Toronto, Canada
- Department of Medicine, Division of Neurology, University of Toronto, Toronto, Canada
- Sleep Laboratory, SHSC, Toronto, Canada
- Sunnybrook Research Institute, SHSC, Toronto, Canada
- University of Toronto Stroke Program, Toronto, Canada
| | - Arthur S Walters
- Department of Neurology, Vanderbilt University School of Medicine, Nashville, TN
| | - Brian J Murray
- L.C. Campbell Cognitive Neurology Research Unit, Heart and Stroke Foundation Canadian Partnership for Stroke Recovery, Brain Sciences Research Program, Sunnybrook Health Sciences Centre (SHSC), Toronto, Canada
- Department of Medicine, Division of Neurology, University of Toronto, Toronto, Canada
- Sleep Laboratory, SHSC, Toronto, Canada
- Sunnybrook Research Institute, SHSC, Toronto, Canada
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