AUTHOR=Yang Shuna , Yin Jiangmei , Qin Wei , Yang Lei , Hu Wenli 

TITLE=Poor Sleep Quality Associated With Enlarged Perivascular Spaces in Patients With Lacunar Stroke

JOURNAL=Frontiers in Neurology

VOLUME=12

YEAR=2022

URL=https://www.frontiersin.org/journals/neurology/articles/10.3389/fneur.2021.809217

DOI=10.3389/fneur.2021.809217

ISSN=1664-2295

ABSTRACT=<sec><title>Background and Objective</title><p>Enlarged perivascular spaces (EPVSs) are considered as an MRI marker of cerebral small vessel diseases and were reported to be associated with brain waste clearance dysfunction. A previous study found that interstitial fluid clearance in the mouse brain occurred mainly during sleep. However, the relationship between sleep quality and EPVS in humans has not been well-understood. Thus, we aimed to investigate the relationship between sleep and EPVS in humans.</p></sec><sec><title>Methods</title><p>This retrospective study was conducted in patients with lacunar stroke in the Neurology Department of Beijing Chaoyang Hospital. Patients with EPVS &gt;10 on one side of the basal ganglia (BG) and white matter slice containing the maximum amount were defined as the BG-EPVS group and the white matter (WM)-EPVS group, respectively. Patients with EPVS &lt;10 in the slice containing the maximum amount were defined as the control group. Sleep quality was evaluated by the Pittsburgh Sleep Quality Index (PSQI) including seven components, where a score of 6 or higher indicated poor sleep quality. Spearman's correlation analysis and the binary logistic regression analysis were performed to analyze the relationship between poor sleep quality and BG-EPVS and WM-EPVS, respectively.</p></sec><sec><title>Results</title><p>A total of 398 patients were enrolled in this study, including 114 patients in the BG-EPVS group and 85 patients in the WM-EPVS group. The proportion of poor sleep quality in the BG-EPVS group was higher than that in the control group (58.8 vs. 32.5%, <italic>p</italic> &lt; 0.001). The score of PSQI, subjective sleep quality, sleep latency, sleep duration, and sleep efficiency were higher in the BG-EPVS group than that in the control group (<italic>p</italic> &lt; 0.05). The proportion of poor sleep quality was also higher in the WM-EPVS group than that in the control group (50.6 vs. 35.3%, <italic>p</italic> = 0.031). The score of sleep duration and sleep disturbances was higher in the WM-EPVS group than that in the control group. Spearman's correlation analysis showed that poor sleep quality was positively associated with BG-EPVS (ρ = 0.264, <italic>p</italic> &lt; 0.001) and WM-EPVS (ρ = 0.154, <italic>p</italic> = 0.044). The binary logistic regression analysis showed that poor sleep quality, longer sleep latency, and less sleep duration were independently related to BG-EPVS and poor sleep quality, less sleep duration, and more serious sleep disturbances were independently related to WM-EPVS after adjusting for confounders (<italic>P</italic> &lt; 0.05).</p></sec><sec><title>Conclusion</title><p>Poor sleep quality was independently associated with EPVS in BG and WM.</p></sec>