Department of Radiology, Juntendo University Graduate School of Medicine, 2-1-1 Hongo, Bunkyoku, Tokyo, 113-8421, Japan.
Faculty of Health Data Science, Juntendo University, Chiba, Japan.
Jpn J Radiol. 2023 Dec;41(12):1335-1343. doi: 10.1007/s11604-023-01463-6. Epub 2023 Jun 27.
This study aimed to evaluate the relationship between sleep quality as assessed using the Pittsburgh Sleep Quality Index (PSQI) and the index of diffusivity along the perivascular space (ALPS index), a possible indirect indicator of glymphatic system activity.
This study included the diffusion magnetic resonance imaging (MRI) data of 317 people with sleep disruption and 515 healthy controls (HCs) from the Human Connectome Project (WU-MINN HCP 1200). The ALPS index was calculated automatically based on diffusion tensor image analysis (DTI)-ALPS of diffusion MRI. The ALPS index of the sleep disruption and HC groups was compared using general linear model (GLM) analysis with covariates, such as age, sex, level of education, and intracranial volume. In addition, to confirm the relationship between sleep quality and the ALPS index in the sleep disruption group as well as evaluate the effect of each PSQI component on the ALPS index, correlation analyses between the ALPS indices and PSQI scores of all the components and between the ALPS index and each PSQI component was performed using GLM analysis with the abovementioned covariates, respectively.
The ALPS index was significantly lower in the sleep disruption group than in the HC group (p = 0.001). Moreover, the ALPS indices showed significant negative correlations with the PSQI scores of all the components (false discovery rate [FDR]-corrected p < 0.001). Two significant negative correlations were also found between the ALPS index and PSQI component 2 (sleep latency, FDR-corrected p < 0.001) and 6 (the use of sleep medication, FDR-corrected p < 0.001).
Our findings suggest that glymphatic system impairment contributes to sleep disruption in young adults.
本研究旨在评估匹兹堡睡眠质量指数（PSQI）评估的睡眠质量与血管周围空间扩散率指数（ALPS 指数）之间的关系，ALPS 指数是血脑屏障水通道（glymphatic system）活动的间接指标。
本研究纳入了来自人类连接组计划（WU-MINN HCP 1200）的 317 名睡眠障碍患者和 515 名健康对照者的弥散磁共振成像（MRI）数据。ALPS 指数是基于弥散张量成像分析（DTI-ALPS）自动计算得出的。采用协方差的一般线性模型（GLM）分析比较睡眠障碍组和健康对照组的 ALPS 指数。此外，为了确认睡眠障碍组中睡眠质量与 ALPS 指数之间的关系，并评估 PSQI 各个组成部分对 ALPS 指数的影响，我们分别采用协方差的 GLM 分析，对所有组成部分的 PSQI 评分与 ALPS 指数之间的相关性以及 ALPS 指数与每个 PSQI 组成部分之间的相关性进行了分析。
睡眠障碍组的 ALPS 指数显著低于健康对照组（p=0.001）。此外，ALPS 指数与 PSQI 所有组成部分的评分均呈显著负相关（经 FDR 校正的 p<0.001）。ALPS 指数与 PSQI 组成部分 2（入睡潜伏期，经 FDR 校正的 p<0.001）和 6（使用睡眠药物，经 FDR 校正的 p<0.001）之间也存在显著负相关。
我们的研究结果表明，glymphatic system 功能障碍可能导致年轻人的睡眠障碍。
