Modulation of sleep structure can prevent enlargement of the perivascular spaces in the basal ganglia in patients with cerebral small-vessel disease
FENG Xiaoyun
XIA Chongshuang
HE Zhelang
HUANG Tianrong
WANG Ziyin
YANG Canhong
LI Huanmin
Abstract：Objective To explore the relationship between enlarged perivascular spaces in the basal ganglia(BG-EPVS)and sleep structure in patients with cerebral small-vessel disease(CSVD)by polysomnography.Methods Ninety-five CSVD patients who were hospitalized in the Department of Neurology of the Third Affiliated Hospital of Southern Medical University from February 2023 to June 2024 completed 3.0T magnetic resonance imaging were included.The perivascular spaces in the basal ganglia were evaluated and graded by visual quantitative assessment method,and the patients were divided into none to mild BG-EPVS group(n=45)and moderate to severe BG-EPVS group(n=50)according to the grading.All patients underwent overnight polysomnography monitoring and relevant data were recorded.The general clinical data and polysomnography parameters of the two groups were compared.Results There was no statistically significant difference in gender,BMI,smoking and drinking history between the two groups(P>0.05).Compared with the none to mild BG-EPVS group,patients in the moderate to severe BG-EPVS group were older,and the proportion of lacunar infarction and renal insufficiency was higher(P<0.05).Comparison of sleep parameters between the two groups showed that compared with the none to mild BG-EPVS group,the duration of REM sleep and the percentage of REM sleep in total sleep time were decreased in the moderate to severe BG-EPVS group(P<0.05).There was no statistically significant difference in sleep process parameters,sleep quality parameters and other sleep structure parameters between the two groups(P>0.05).Spearman correlation analysis showed that the duration of REM sleep and the percentage of REM sleep in total sleep time were negatively correlated with the BG-EPVS grade(P<0.05),and there was no significant correlation between the duration and percentage of sleep in NREM sleep stages and the BG-EPVS grade(P>0.05).Multivariate logistic regression analysis found that increased age,lacunar infarction,and decreased percentage of REM sleep in total sleep time were independent risk factors for moderate to severe enlargement of perivascular spaces in the basal ganglia(P<0.05).Conclusion Patients with higher age,lacunar infarction,and decreased percentage of REM sleep in total sleep time are more likely to develop BG-EPVS,suggesting that adjusting sleep structure,especially improving the quality of REM sleep,may play an important role in preventing BG-EPVS.
Keywords：cerebral small-vessel diseasebasal ganglia regionperivascular spacesleep structureglymphatic system
Publication Date：2024-11-28
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：7( 1176-1182 )