Aribisala Benjamin S, Valdés Hernández Maria Del C, Okely Judith A, Cox Simon R, Ballerini Lucia, Dickie David Alexander, Wiseman Stewart J, Riha Renata L, Muñoz Maniega Susana, Radakovic Ratko, Taylor Adele, Pattie Alison, Corley Janie, Redmond Paul, Bastin Mark E, Deary Ian, Wardlaw Joanna M
Department of Neuroimaging Sciences, University of Edinburgh, Edinburgh, UK; Lothian Birth Cohort Studies, Department of Psychology, University of Edinburgh, Edinburgh, UK; Department of Computer Science, Lagos State University, Lagos, Nigeria.
Department of Neuroimaging Sciences, University of Edinburgh, Edinburgh, UK; Lothian Birth Cohort Studies, Department of Psychology, University of Edinburgh, Edinburgh, UK; UK Dementia Research Institute Centre at the University of Edinburgh, UK.
Sleep Med. 2023 Jun;106:123-131. doi: 10.1016/j.sleep.2023.03.016. Epub 2023 Mar 16.
Sleep is thought to play a major role in brain health and general wellbeing. However, few longitudinal studies have explored the relationship between sleep habits and imaging markers of brain health, particularly markers of brain waste clearance such as perivascular spaces (PVS), of neurodegeneration such as brain atrophy, and of vascular disease, such as white matter hyperintensities (WMH). We explore these associations using data collected over 6 years from a birth cohort of older community-dwelling adults in their 70s.
We analysed brain MRI data from ages 73, 76 and 79 years, and self-reported sleep duration, sleep quality and vascular risk factors from community-dwelling participants in the Lothian Birth Cohort 1936 (LBC1936) study. We calculated sleep efficiency (at age 76), quantified PVS burden (at age 73), and WMH and brain volumes (age 73 to 79), calculated the white matter damage metric, and used structural equation modelling (SEM) to explore associations and potential causative pathways between indicators related to brain waste cleaning (i.e., sleep and PVS burden), brain and WMH volume changes during the 8th decade of life.
Lower sleep efficiency was associated with a reduction in normal-appearing white matter (NAWM) volume (β = 0.204, P = 0.009) from ages 73 to 79, but not concurrent volume (i.e. age 76). Increased daytime sleep correlated with less night-time sleep (r = -0.20, P < 0.001), and with increasing white matter damage metric (β = -0.122, P = 0.018) and faster WMH growth (β = 0.116, P = 0.026). Shorter night-time sleep duration was associated with steeper 6-year reduction of NAWM volumes (β = 0.160, P = 0.011). High burden of PVS at age 73 (volume, count, and visual scores), was associated with faster deterioration in white matter: reduction of NAWM volume (β = -0.16, P = 0.012) and increasing white matter damage metric (β = 0.37, P < 0.001) between ages 73 and 79. On SEM, centrum semiovale PVS burden mediated 5% of the associations between sleep parameters and brain changes.
Sleep impairments, and higher PVS burden, a marker of impaired waste clearance, were associated with faster loss of healthy white matter and increasing WMH in the 8th decade of life. A small percentage of the effect of sleep in white matter health was mediated by the burden of PVS consistent with the proposed role for sleep in brain waste clearance.
睡眠被认为在脑健康和总体幸福感中起主要作用。然而，很少有纵向研究探讨睡眠习惯与脑健康影像标志物之间的关系，特别是脑废物清除标志物，如血管周围间隙（PVS）；神经退行性变标志物，如脑萎缩；以及血管疾病标志物，如白质高信号（WMH）。我们利用从一个70多岁的老年社区居住成年人出生队列中收集的6年数据来探究这些关联。
我们分析了来自洛锡安出生队列1936（LBC1936）研究中社区居住参与者在73岁、76岁和79岁时的脑部MRI数据，以及自我报告的睡眠时间、睡眠质量和血管危险因素。我们计算了睡眠效率（76岁时），量化了PVS负担（73岁时），以及WMH和脑容量（73岁至79岁），计算了白质损伤指标，并使用结构方程模型（SEM）来探究与脑废物清除相关指标（即睡眠和PVS负担）、生命第八个十年期间脑容量和WMH变化之间的关联及潜在因果途径。
较低的睡眠效率与73岁至79岁时正常白质（NAWM）体积减少相关（β = 0.204，P = 0.009），但与同期体积（即76岁时）无关。白天睡眠时间增加与夜间睡眠时间减少相关（r = -0.20，P < 0.001），且与白质损伤指标增加相关（β = -0.122，P = 0.018）以及WMH增长加快相关（β = 0.116，P = 0.026）。较短的夜间睡眠时间与NAWM体积6年更急剧减少相关（β = 0.160，P = 0.011）。73岁时PVS的高负担（体积、数量和视觉评分）与白质更快恶化相关：73岁至79岁之间NAWM体积减少（β = -0.16，P = 0.012）以及白质损伤指标增加（β = 0.37，P < 0.001）。在SEM中，半卵圆中心PVS负担介导了睡眠参数与脑变化之间5%的关联。
睡眠障碍以及更高的PVS负担（废物清除受损的标志物）与生命第八个十年期间健康白质更快丧失和WMH增加相关。睡眠对白质健康影响的一小部分是由PVS负担介导的，这与睡眠在脑废物清除中的作用一致。
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