Association between periodic limb movements during sleep and neuroimaging features of cerebral small vessel disease: A preliminary cross‐sectional study

Abstract

Summary Evidence on the relationship between periodic limb movements during sleep (PLMS) and cerebral small vessel disease is lacking. This study aimed to assess the association between the PLMS index and the neuroimaging features of cerebral small vessel disease on magnetic resonance imaging. Consecutive patients diagnosed with cerebral small vessel disease were enrolled. Data on the clinical characteristics, polysomnography, and brain magnetic resonance imaging were collected. The Accubrain software was used to calculate automatically the volume of white matter hyperintensities, the number of lacunar infarctions, and cerebral microbleeds. The severity of white matter hyperintensities, enlarged basal ganglia perivascular spaces, and the total cerebral small vessel disease scores were also rated visually using semiquantitative scales. The severity of PLMS was measured using the PLMS index, and the patients were divided into two groups using an established cut‐off value of ≥15 per hour. Logistic regression was used to examine the association between PLMS and the neuroimaging features of cerebral small vessel disease. In total, 37 patients were included in the final analyses. The mean age was 66.49 ± 11.31 years, and 73.0% were males. The mean PLMS index was 19.30 ± 10.18. In univariate analyses, it was found that patients with cerebral small vessel disease with a PLMS index ≥15 had increased enlarged basal ganglia perivascular spaces (OR 6.136, 95%CI 1.101–34.214) and increased total cerebral small vessel disease scores (OR 6.0, 95%CI 1.253–28.742). Only the association between the PLMS index and the total cerebral small vessel disease burden score remained statistically significant after adjusting for age, sex, and the presence of moderate to severe obstructive sleep apnea syndrome. In conclusion, an elevated PLMS index is likely to be associated with a greater cerebral small vessel disease burden. PLMS might be a novel potential marker of cerebral small vessel disease.

Association of late-life blood pressure change with cerebral small vessel disease in the MIND-China study

“…Cerebral microbleeds (CMBs) were defined as focal rounded hypointense lesions with a diameter of > 5 mm, as measured on SWI. For quantification, we used AccuBrain ® (BrainNow Medical Technology Co., Ltd., Shenzhen, Guangdong, China) [ 14 , 15 ], employing a fully connected neural network trained in deep learning technology to detect CMBs on SWI images. The network generated a probability map indicating the location of CMBs within the image.…”

Periodic limb movements in sleep: evolving role of autonomic nervous system

“…A systematic review examining HTN risk in patients with PLMS found a significant association between having PLMS and HTN, with an overall 1.26-fold increased risk of HTN compared to those who did not have PLMS [9]. The association between PLMS and cerebrovascular disease is uncertain in the literature, with some studies showing an association and others not [10,11]. In order to better establish the relationship of this association, finding the cause of autonomic nervous system activity before, during, and/or after, a PLMS series was needed.…”