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. 2014 Sep 9;83(11):967-73.
doi: 10.1212/WNL.0000000000000774. Epub 2014 Sep 3.

Poor Sleep Quality Is Associated With Increased Cortical Atrophy in Community-Dwelling Adults

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Free PMC article

Poor Sleep Quality Is Associated With Increased Cortical Atrophy in Community-Dwelling Adults

Claire E Sexton et al. Neurology. .
Free PMC article

Abstract

Objective: To examine the relationship between sleep quality and cortical and hippocampal volume and atrophy within a community-based sample, explore the influence of age on results, and assess the possible confounding effects of physical activity levels, body mass index (BMI), and blood pressure.

Methods: In 147 community-dwelling adults (92 female; age 53.9 ± 15.5 years), sleep quality was measured using the Pittsburgh Sleep Quality Index and correlated with cross-sectional measures of volume and longitudinal measures of atrophy derived from MRI scans separated by an average of 3.5 years. Exploratory post hoc analysis compared correlations between different age groups and included physical activity, BMI, and blood pressure as additional covariates.

Results: Poor sleep quality was associated with reduced volume within the right superior frontal cortex in cross-sectional analyses, and an increased rate of atrophy within widespread frontal, temporal, and parietal regions in longitudinal analyses. Results were largely driven by correlations within adults over the age of 60, and could not be explained by variation in physical activity, BMI, or blood pressure. Sleep quality was not associated with hippocampal volume or atrophy.

Conclusions: We found that longitudinal measures of cortical atrophy were widely correlated with sleep quality. Poor sleep quality may be a cause or a consequence of brain atrophy, and future studies examining the effect of interventions that improve sleep quality on rates of atrophy may hold key insights into the direction of this relationship.

Figures

Figure 1
Figure 1. Correlations between sleep quality and cross-sectional estimates of cortical volume
(A) Spatial maps display regions where poor sleep quality was significantly associated with reduced cortical volume (p < 0.05, after correction for multiple comparisons across the surface). Age, sex, interval between MRI and Pittsburgh Sleep Quality Inventory (PSQI) acquisition, and intracranial volume were included as covariates. (B) Scatterplot of the correlation between sleep quality and cortical volume within the significant cluster (expressed as a z score).
Figure 2
Figure 2. Spatial maps of correlations between sleep quality and longitudinal estimates of change in cortical volume
Spatial maps display regions where poor sleep quality was significantly associated with increased rate of cortical atrophy (p < 0.05, after correction for multiple comparisons across the surface). Age, sex, interval between T1 and T2, and interval between T2 and Pittsburgh Sleep Quality Inventory acquisition were included as covariates.
Figure 3
Figure 3. Scatterplots of the correlations between sleep quality and longitudinal estimates of change in cortical volume
Participants younger than 60 years at timepoint 2 are displayed in red; participants older than 60 at timepoint 2 are displayed in blue. PSQI = Pittsburgh Sleep Quality Inventory.

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