title: Cerebral small vessel disease is related to disturbed 24-h activity rhythms: a population-based study.
abstract: OBJECTIVE
  Cerebral small vessel disease is common in elderly persons. Patients with dementia or stroke frequently have cerebral small vessel disease and often experience disturbances in the sleep-wake rhythm. It is unknown whether cerebral small vessel disease is related to disturbances in sleep and 24-h activity rhythms.
  
  
  METHODS
  This study was conducted in the Rotterdam Study. A total of 970 community-dwelling persons (mean age 59.2 years) underwent brain magnetic resonance imaging and actigraphy. Cerebral small vessel disease was defined as white matter lesions (total volume in millilitres) and the presence of cerebral microbleeds and lacunar infarcts. Twenty-four hour activity rhythms and sleep were measured with actigraphy by estimating the instability and fragmentation of the activity rhythm and total sleep time. Sleep quality was assessed with the Pittsburgh Sleep Quality Index. White matter lesions, instability, fragmentation and sleep quality were standardized for analyses.
  
  
  RESULTS
  Higher white matter lesion volume (B = 0.09 per SD, 95% confidence interval 0.02; 0.15) and cerebral microbleeds (B = 0.19 per SD, 95% confidence interval 0.02; 0.37) were significantly related to more fragmented 24-h activity rhythms. None of the small vessel disease markers was related to total sleep time or sleep quality.
  
  
  CONCLUSIONS
  White matter lesion volume and the presence of cerebral microbleeds are related to disturbed activity rhythms. This suggests that subclinical brain damage affects the 24-h activity rhythm.
authors.affiliation: Department of Epidemiology, Erasmus MC, Rotterdam, The Netherlands.
authors.forename: L A
authors.initials: LA
authors.lastname: Zuurbier
authors.affiliation: Department of Epidemiology, Erasmus MC, Rotterdam, The Netherlands.|Department of Radiology, Erasmus MC, Rotterdam, The Netherlands.|Department of Neurology, Erasmus MC, Rotterdam, The Netherlands.
authors.forename: M A
authors.initials: MA
authors.lastname: Ikram
authors.affiliation: Department of Epidemiology, Erasmus MC, Rotterdam, The Netherlands.
authors.forename: A I
authors.initials: AI
authors.lastname: Luik
authors.affiliation: Department of Epidemiology, Erasmus MC, Rotterdam, The Netherlands.
authors.forename: A
authors.initials: A
authors.lastname: Hofman
authors.affiliation: Department of Sleep and Cognition, Netherlands Institute for Neuroscience, Amsterdam, The Netherlands.|Departments of Integrative Neurophysiology and Medical Psychology, VU University Medical Center, Amsterdam, The Netherlands.
authors.forename: E J W
authors.initials: EJ
authors.lastname: Van Someren
authors.affiliation: Department of Epidemiology, Erasmus MC, Rotterdam, The Netherlands.|Department of Radiology, Erasmus MC, Rotterdam, The Netherlands.
authors.forename: M W
authors.initials: MW
authors.lastname: Vernooij
authors.affiliation: Department of Epidemiology, Erasmus MC, Rotterdam, The Netherlands.|Department of Child and Adolescent Psychiatry, Erasmus MC, Rotterdam, The Netherlands.|Department of Psychiatry, Erasmus MC, Rotterdam, The Netherlands.
authors.forename: H
authors.initials: H
authors.lastname: Tiemeier
mesh_terms: D056044:Actigraphy; D000368:Aged; D059345:Cerebral Small Vessel Diseases / Q000473:pathology / Q000503:physiopathology*; D002940:Circadian Rhythm / Q000502:physiology*; D015331:Cohort Studies; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D066127:White Matter / Q000473:pathology*
keywords: cerebral small vessel diseases; circadian rhythm; cohort studies; magnetic resonance imaging; sleep