MRI-visible perivascular space volumes, sleep duration and daytime dysfunction in adults with cerebrovascular disease

Authors

Joel Ramirez, University of Toronto
Melissa F. Holmes, University of Toronto
Courtney Berezuk, University of Toronto
Donna Kwan, Queen's University, Centre for Neuroscience Studies, Kingston
Brian Tan, Rotman Research Institute
Derek Beaton, Rotman Research Institute
Christopher J.M. Scott, University of Toronto
Miracle Ozzoude, University of Toronto
Fuqiang Gao, University of Toronto
Di Yu, University of Toronto
Walter Swardfager, University of Toronto
Jane Lawrence-Dewar, Thunder Bay Regional Health Research Institute
Dar Dowlatshahi, Ottawa Hospital Research Institute
Gustavo Saposnik, Saint Michael's Hospital University of Toronto
Mark I. Boulos, University of Toronto
Brian J. Murray, University of Toronto
Sean Symons, University of Toronto
Robert Bartha, Robarts Research InstituteFollow
Sandra E. Black, University of Toronto
Richard H. Swartz, University of Toronto
Michael Strong
Peter Kleinstiver
Natalie Rashkovan
Susan Bronskill
Michael Borrie
Elizabeth Finger
Corinne Fischer
Andrew Frank
Morris Freedman
Sanjeev Kumar
Stephen Pasternak
Bruce Pollock

Document Type

Article

Publication Date

7-1-2021

Journal

Sleep Medicine

Volume

83

First Page

83

Last Page

88

URL with Digital Object Identifier

10.1016/j.sleep.2021.03.043

Abstract

Objectives: Recent studies suggest that interindividual genetic differences in glial-dependent CSF flow through the brain parenchyma, known as glymphatic flow, may trigger compensatory changes in human sleep physiology. In animal models, brain perivascular spaces are a critical conduit for glymphatic flow. We tested the hypothesis that MRI-visible PVS volumes, a putative marker of perivascular dysfunction, are associated with compensatory differences in real-world human sleep behavior. Methods: We analyzed data from 152 cerebrovascular disease patients from the Ontario Neurodegenerative Disease Research Initiative (ONDRI). PVS volumes were measured using 3T-MRI. Self-reported total sleep time, time in bed, and daytime dysfunction were extracted from the Pittsburgh Sleep Quality Index. Results: Individuals with greater PVS volumes reported longer time in bed (+0.85 h per log10 proportion of intracranial volume (ICV) occupied by PVS, SE = 0.30, p = 0.006) and longer total sleep times (+0.70 h per log10 proportion of ICV occupied by PVS volume, SE = 0.33, p = 0.04), independent of vascular risk factors, sleep apnea, nocturnal sleep disturbance, depression, and global cognitive status. Further analyses suggested that the positive association between PVS volumes and total sleep time was mediated by greater time in bed. Moreover, despite having on average greater total sleep times, individuals with greater basal ganglia PVS volumes were more likely to report daytime dysfunction (OR 5.63 per log10 proportion of ICV occupied by PVS, 95% CI: 1.38–22.26, p = 0.018). Conclusions: Individuals with greater PVS volumes spend more time in bed, resulting in greater total sleep time, which may represent a behavioral compensatory response to perivascular space dysfunction.