T2 MRI 可见帕金森病血管周围间隙:临床意义及与多导睡眠图测量睡眠的关联。

IF 5.6 2区 医学 Q1 Medicine Sleep Pub Date : 2024-10-08 DOI:10.1093/sleep/zsae233
Lena Meinhold, Antonio G Gennari, Heide Baumann-Vogel, Esther Werth, Simon J Schreiner, Christian Ineichen, Christian R Baumann, Ruth O'Gorman Tuura
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引用次数: 0

摘要

睡眠质量差可能会在睡眠过程中因大脑废物清除功能不足而导致神经退行性疾病的风险和进展。在这项回顾性横断面研究中,我们探讨了帕金森病(PD)患者增大的血管周围间隙(PVS)与睡眠质量和运动症状之间的联系。对20名患者和17名健康对照者的T2加权核磁共振成像图像进行了目测,以评估基底节(BG)和半卵圆中心(CSO)的PVS。患者组还接受了单夜多导睡眠图检查。读数包括多导睡眠图睡眠特征和慢波活动(SWA),慢波活动是睡眠深度的定量脑电图标记。通过相关分析和回归分析评估了 PVS 计数、帕金森病症状(MDS-UPDRS 评分)和睡眠参数之间的关联。用加权科恩卡帕系数评估了评分者内部和评分者之间的可重复性。患者和对照组的 BG 和 CSO PVS 计数在组间无显著差异。在患者中,两个脑区的 PVS 均与 SWA(1-2Hz)呈负相关(BG:r(15)=-0.58,padj=0.015;CSO:r(15)=-0.6,padj=0.015)。控制年龄后,基底节 PVS 计数与日常生活运动症状(IRR=1.05,CI [1.01,1.09],p=0.007,padj=0.026)和使用抗抑郁药(IRR=1.37,CI [1.05,1.80],p=0.021,padj=0.043)呈正相关。患者的半脑室中心 PVS 计数与快速动眼期睡眠行为障碍的诊断呈正相关(IRR=1.39,CI [1.06 , 1.84]),p=0.018,padj=0.11)。这些结果进一步证明,睡眠恶化可能会通过血管周围功能的改变而影响血糖清除,从而可能导致帕金森病患者的疾病严重程度。
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T2 MRI visible Perivascular Spaces in Parkinson`s Disease: clinical significance and association with polysomnography measured sleep.

Poor sleep quality might contribute to the risk and progression of neurodegenerative disorders via deficient cerebral waste clearance functions during sleep. In this retrospective cross-sectional study, we explore the link between enlarged perivascular spaces (PVS), a putative marker of sleep-dependent glymphatic clearance, with sleep quality and motor symptoms in Parkinson`s disease (PD) patients. T2-weighted MRI images of 20 patients and 17 healthy control subjects were estimated visually for PVS in the basal ganglia (BG) and centrum semiovale (CSO). The patient group additionally underwent a single-night polysomnography. Readouts included polsyomnographic sleep features and slow-wave activity (SWA), a quantitative EEG marker of sleep depth. Associations between PVS counts, PD symptoms (MDS-UPDRS scores) and sleep parameters were evaluated using correlation and regression analyses. Intra- and inter-rater reproducibility was assessed with weighted Cohen`s kappa coefficient. BG and CSO PVS counts in both patients and controls did not differ significantly between groups. In patients, PVS in both brain regions were negatively associated with SWA (1-2Hz) (BG: r(15)=-0.58, padj=0.015 and CSO: r(15)=-0.6, padj=0.015). Basal ganglia PVS counts were positively associated with motor symptoms of daily living (IRR=1.05, CI [1.01, 1.09], p=0.007, padj=0.026) and antidepressant use (IRR=1.37, CI [1.05, 1.80], p=0.021, padj=0.043) after controlling for age. Centrum Semiovale PVS counts in patients were positively associated with a diagnosis of REM sleep behaviour disorder (IRR=1.39, CI [1.06 , 1.84]), p=0.018, padj=0.11). These results add evidence that sleep deterioration may play a role in impairing glymphatic clearance via altered perivascular function, potentially contributing to disease severity in PD patients.

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来源期刊
Sleep
Sleep Medicine-Neurology (clinical)
CiteScore
8.70
自引率
10.70%
发文量
0
期刊介绍: SLEEP® publishes findings from studies conducted at any level of analysis, including: Genes Molecules Cells Physiology Neural systems and circuits Behavior and cognition Self-report SLEEP® publishes articles that use a wide variety of scientific approaches and address a broad range of topics. These may include, but are not limited to: Basic and neuroscience studies of sleep and circadian mechanisms In vitro and animal models of sleep, circadian rhythms, and human disorders Pre-clinical human investigations, including the measurement and manipulation of sleep and circadian rhythms Studies in clinical or population samples. These may address factors influencing sleep and circadian rhythms (e.g., development and aging, and social and environmental influences) and relationships between sleep, circadian rhythms, health, and disease Clinical trials, epidemiology studies, implementation, and dissemination research.
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