title: Sleep disturbance correlates with white matter hyperintensity in patients with subcortical ischemic vascular dementia.
abstract: BACKGROUND
  Subcortical ischemic vascular dementia (SIVD) caused by small-artery disease, and hypoperfusion is a major cause of vascular cognitive impairment. Little is known about the relationship between sleep disturbance and white matter hyperintensity (WMH). We investigated the association between sleep disturbance and WMH, measured by magnetic resonance imaging (MRI), in patients with SIVD.
  
  
  METHODS
  Patients with SIVD recruited from our outpatient clinic completed the Sleep Disturbance Symptom Questionnaire (SDSQ) and Geriatric Depression Scale-short form (GDS-S) and underwent brain MRI. Total SDSQ scores were calculated by summing frequency ratings of the instrument's 20 items. We graded WMH on brain MR images using a visual rating scale ranging from 0 (barely detectable) to 9 (extensive changes).
  
  
  RESULTS
  We enrolled 72 patients (31 men, 41 women; mean age, 75.9 ± 7.9 years) with SIVD. The SDSQ scores were positively correlated with WMH grading (r = .337, P = .001) and tended to be associated with higher GDS-S scores (r = .268, P = .022). Patients with diabetes mellitus tended to display higher mean WMH severity than those without diabetes (4.2 vs 3.3, P = .022). After controlling for confounding factors, the multivariate regression model showed that WMH severity was significantly associated with sleep disturbance (P = .002).
  
  
  CONCLUSIONS
  This study showed that manifestations of sleep disturbance were significantly associated with WMH severity, with most symptoms related to daytime hypersomnolence. Disruption of the frontal-subcortical neuronal circuit might play a role in sleep disturbance in patients with SIVD.
authors.affiliation: Department of Neurology, Neurological Institute, Taipei Veterans General Hospital, Taiwan.
authors.forename: Chun-Yu
authors.initials: CY
authors.lastname: Cheng
authors.forename: Chia-Fen
authors.initials: CF
authors.lastname: Tsai
authors.forename: Shuu-Jiun
authors.initials: SJ
authors.lastname: Wang
authors.forename: Chung-Yao
authors.initials: CY
authors.lastname: Hsu
authors.forename: Jong-Ling
authors.initials: JL
authors.lastname: Fuh
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001921:Brain / Q000473:pathology*; D002545:Brain Ischemia / Q000150:complications* / Q000523:psychology*; D003071:Cognition / Q000502:physiology; D015331:Cohort Studies; D015897:Comorbidity; D003627:Data Interpretation, Statistical; D015140:Dementia, Vascular / Q000150:complications* / Q000523:psychology*; D003863:Depression / Q000523:psychology; D039721:Diagnostic and Statistical Manual of Mental Disorders; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D017286:Polysomnography; D012893:Sleep Wake Disorders / Q000473:pathology*; D014145:Trail Making Test
keywords: Sleep Disturbance Symptom Questionnaire; frontal–subcortical neuronal circuit; sleep disturbance; subcortical ischemic vascular dementia; white matter hyperintensity