Department of Epidemiology, Erasmus MC, Rotterdam, The Netherlands.
Department of Radiology, Erasmus MC, Rotterdam, The Netherlands.
Eur J Neurol. 2015 Nov;22(11):1482-7. doi: 10.1111/ene.12775. Epub 2015 Jul 24.
Cerebral small vessel disease is common in elderly persons. Patients with dementia or stroke frequently have cerebral small vessel disease and often experience disturbances in the sleep-wake rhythm. It is unknown whether cerebral small vessel disease is related to disturbances in sleep and 24-h activity rhythms.
This study was conducted in the Rotterdam Study. A total of 970 community-dwelling persons (mean age 59.2 years) underwent brain magnetic resonance imaging and actigraphy. Cerebral small vessel disease was defined as white matter lesions (total volume in millilitres) and the presence of cerebral microbleeds and lacunar infarcts. Twenty-four hour activity rhythms and sleep were measured with actigraphy by estimating the instability and fragmentation of the activity rhythm and total sleep time. Sleep quality was assessed with the Pittsburgh Sleep Quality Index. White matter lesions, instability, fragmentation and sleep quality were standardized for analyses.
Higher white matter lesion volume (B = 0.09 per SD, 95% confidence interval 0.02; 0.15) and cerebral microbleeds (B = 0.19 per SD, 95% confidence interval 0.02; 0.37) were significantly related to more fragmented 24-h activity rhythms. None of the small vessel disease markers was related to total sleep time or sleep quality.
White matter lesion volume and the presence of cerebral microbleeds are related to disturbed activity rhythms. This suggests that subclinical brain damage affects the 24-h activity rhythm.
脑小血管病常见于老年人。痴呆或中风患者常伴有脑小血管病,并常出现睡眠-觉醒节律紊乱。目前尚不清楚脑小血管病是否与睡眠和 24 小时活动节律紊乱有关。
本研究在鹿特丹研究中进行。共有 970 名居住在社区的人(平均年龄 59.2 岁)接受了脑部磁共振成像和活动记录仪检查。脑小血管病定义为脑白质病变(以毫升计的总容积)、脑微出血和腔隙性梗死的存在。通过估计活动节律的不稳定性和碎片化以及总睡眠时间,使用活动记录仪测量 24 小时活动节律和睡眠。使用匹兹堡睡眠质量指数评估睡眠质量。对脑白质病变、不稳定性、碎片化和睡眠质量进行标准化分析。
脑白质病变体积较高(每标准差增加 0.09,95%置信区间 0.02;0.15)和脑微出血(每标准差增加 0.19,95%置信区间 0.02;0.37)与 24 小时活动节律碎片化程度显著相关。小血管病标志物均与总睡眠时间或睡眠质量无关。
脑白质病变体积和脑微出血的存在与活动节律紊乱有关。这表明亚临床脑损伤影响了 24 小时活动节律。