Circadian rest-activity rhythm pattern in the elderly with cerebral small vessel disease: Using multiple estimated...

Area of Science:

• Neurology
• Chronobiology
• Geriatrics

Background:

• Circadian rest-activity rhythm (RAR) disruption is linked to various neurological disorders.
• Cerebral small vessel disease (CSVD) is prevalent in the elderly and can impact neurological function.
• Understanding RAR patterns in CSVD is crucial for assessing disease impact and potential interventions.

Purpose of the Study:

• To investigate the rest-activity rhythm (RAR) patterns in elderly individuals diagnosed with cerebral small vessel disease (CSVD).
• To correlate specific magnetic resonance imaging (MRI) markers of CSVD with objective actigraphy-derived RAR parameters.
• To determine if CSVD severity influences RAR characteristics.

Main Methods:

• 115 elderly CSVD patients underwent actigraphy for 4-7 days to record rest-activity patterns.
• MRI scans were assessed for lacunar infarcts, white matter hyperintensities, and cerebral microbleeds, summarized by a simple MRI score (0-3).
• RAR parameters were analyzed using extended cosinor and non-parametric methods, including amplitude, acrophase, interdaily stability, and intradaily variability.

Main Results:

• Elderly CSVD patients with higher MRI scores (2-3) exhibited significantly lower amplitude (cosinor) and higher intradaily variability (non-parametric) compared to those with a score of 0.
• Specific CSVD markers were independently associated with RAR parameters: white matter hyperintensities with RAR β, lacunar infarcts with RAR α, and cerebral microbleeds with intradaily variability.
• No significant differences in sleep quality were observed across different CSVD severity groups.

Conclusions:

• The study confirms that the rest-activity rhythm (RAR) pattern is disturbed in elderly individuals with cerebral small vessel disease (CSVD).
• Abnormal RAR parameters are independently associated with specific CSVD magnetic resonance imaging (MRI) markers, suggesting a direct link between vascular brain changes and circadian rhythm disruption.
• These findings highlight the potential of actigraphy in assessing neurological impact in CSVD patients.