title: The association of sleep-disordered breathing with high cerebral pulsatility might not be related to diffuse small vessel disease. A pilot study.
abstract: BACKGROUND
  In a population-based sampling study conducted in community-dwelling older adults living in rural Ecuador, we aimed to assess the relation among sleep-disordered breathing, cerebral pulsatility index, and diffuse small vessel disease.
  
  
  METHODS
  Of 25 participants, 9 (36%) had moderate-to-severe sleep-disordered breathing, characterized by an apnea/hypopnea index ≥15 per hour, and 10 (40%) had moderate-to-severe white matter hyperintensities, graded according to the modified Fazekas scale. Mean (SD) pulsatility index in the middle cerebral artery was 1.18 (0.19) and positively correlated with the apnea/hypopnea index (R = .445, P = .03, [Pearson's correlation coefficient]). The middle cerebral artery pulsatility index was increased in persons with moderate-to-severe sleep-disordered breathing compared with persons who had none-to-mild sleep-disordered breathing (mean [SD] 1.11 [0.12] vs. 1.3 [0.23], P = .01). No significant differences were found in the prevalence of moderate-to-severe white matter hyperintensities across groups of sleep-disordered breathing (P = .40) or in the mean apnea/hypopnea index across groups of persons with none-to-mild or moderate-to-severe white matter hyperintensities (P = .16).
  
  
  CONCLUSIONS
  This pilot study shows that moderate-to-severe sleep-disordered breathing correlates with cerebral pulsatility, but such association might be independent of diffuse small vessel disease.
authors.affiliation: Division of Sleep Medicine, Mayo Clinic, 4500 San Pablo Rd, Jacksonville, FL, 32224, USA. castillo.pablo@mayo.edu.
authors.forename: Pablo R
authors.initials: PR
authors.lastname: Castillo
authors.affiliation: School of Medicine, Universidad Espíritu Santo-Ecuador, Guayaquil, Ecuador. oscardelbrutto@hotmail.com.
authors.forename: Oscar H
authors.initials: OH
authors.lastname: Del Brutto
authors.affiliation: Department of Neurology, Hospital Médica Sur, Mexico City, Mexico. dopmas04@hotmail.com.
authors.forename: María de la Luz
authors.initials: Mde L
authors.lastname: Andrade
authors.affiliation: Community Center, The Atahualpa Project, Atahualpa, Ecuador. zamaleon@hotmail.com.
authors.forename: Mauricio
authors.initials: M
authors.lastname: Zambrano
authors.affiliation: Department of Neurology, Hospital Médica Sur, Mexico City, Mexico. juan.nader.k@gmail.com.
authors.forename: Juan A
authors.initials: JA
authors.lastname: Nader
mesh_terms: D000368:Aged; D054022:Cerebrum / Q000098:blood supply / Q000503:physiopathology*; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D010865:Pilot Projects; D011673:Pulsatile Flow; D012119:Respiration; D012893:Sleep Wake Disorders / Q000503:physiopathology*; D017585:Ultrasonography, Doppler, Transcranial