Relationship between cortical activation and sleep quality in cerebral small vessel disease patients: a functional...

Sleep disturbance is common in patients with cerebral small vessel disease (CSVD). The impact of insomnia on cortical activation in CSVD patients and its association with sleep quality remains unclear. Our study used functional near-infrared pectroscopy (fNIRS) to investigate differences in cortex activation in CSVD patients with sleep disturbance (CSVD + S) and CSVD patients without sleep disturbance (CSVD - S) during the verbal fluency task (VFT), and further explored its relationship with sleep quality.

59 CSVD + S and 69 CSVD - S matched for age, gender, and educational level were recruited. Sleep quality was assessed by the Pittsburgh Sleep Quality Index (PSQI). fNIRS was used to assess frontotemporal activation in CSVD patients during the VFT.

The prevalence of sleep disturbance in CSVD patients was 46.01%. Compared to CSVD - S, CSVD + S exhibited lower cortex activation in the bilateral medial prefrontal cortex (mPFC) and dorsolateral prefrontal cortex (DLPFC) (false discovery rate corrected p < 0.05). Correlation analysis showed bilateral mPFC and DLPFC activation negatively correlateed with PSQI scores in CSVD patients. Further stepwise multiple linear regression found right mPFC activation had the strongest negative correlation with PSQI scores after adjusting for confounding factors.

Our study used fNIRS to demonstrate that CSVD patients with sleep disturbance showed poorer prefrontal cortex activation during the VFT, which is associated with poorer sleep quality.