Periodic Limb Movements and White Matter Hyperintensities in First-Ever Minor Stroke or High-Risk Transient Ischemic

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A Versatile Murine Model of Subcortical White Matter Stroke for the Study of Axonal Degeneration and White Matter Neurobiology
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A Versatile Murine Model of Subcortical White Matter Stroke for the Study of Axonal Degeneration and White Matter Neurobiology

Published on: March 17, 2016

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Mark I Boulos1,2,3,4,2, Brian J Murray1,2,3,4, Ryan T Muir1,2

  • 1L.C. Campbell Cognitive Neurology Research Unit, Heart and Stroke Foundation Canadian Partnership for Stroke Recovery, Hurvitz Brain Sciences Research Program, Sunnybrook Health Sciences Centre, Toronto, ON, Canada.

Sleep
|March 23, 2017
PubMed
Abstract

Insights

Periodic limb movements (PLMs) are linked to white matter hyperintensities (WMHs) in stroke and TIA patients. This suggests PLMs may be a risk factor or marker for WMH burden, warranting further research.

Area of Science:

  • Neurology
  • Sleep Medicine
  • Vascular Medicine

Background:

  • Periodic limb movements (PLMs) are increasingly implicated in cerebrovascular disease development.
  • White matter hyperintensities (WMHs) serve as a key biomarker for cerebral small vessel disease, predicting stroke and mortality.
  • The relationship between PLMs and WMH burden in stroke/TIA patients requires further elucidation.

Purpose of the Study:

  • To investigate the association between periodic limb movement (PLM) indices and white matter hyperintensity (WMH) burden.
  • To assess this association in patients presenting with stroke or transient ischemic attack (TIA).
  • To control for confounding factors including vascular risk factors and stroke severity.

Main Methods:

  • Prospective recruitment of 30 patients with recent minor stroke or high-risk TIA.
  • Measurement of PLM severity using polysomnography.
  • Quantification of WMH burden via the Age Related White Matter Changes (ARWMC) scale from neuroimaging.
  • Statistical analysis using partial Spearman's rank-order correlations and multiple linear regression.

Main Results:

  • A significant correlation was found between greater WMH burden and elevated PLM index, as well as stroke volume.
  • The association between WMH burden and PLM index remained significant after controlling for vascular risk factors.
  • PLM index emerged as a significant predictor of elevated ARWMC scores, independent of age, stroke volume, stroke severity, hypertension, and apnea-hypopnea index.

Conclusions:

  • The study demonstrates an association between the quantity of PLMs and WMH burden in patients experiencing their first minor stroke or TIA.
  • PLMs may represent a risk factor or marker for WMH burden, even when accounting for established vascular risk factors and stroke severity.
  • These findings highlight the potential of PLMs as a therapeutic target for reducing WMH and overall stroke burden, meriting further investigation.
Keywords:
Restless Legs Syndrome.magnetic resonance imagingperiodic limb movements of sleepstroketransient ischemic attackwhite matter hyperintensities

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