Thalamic Atrophy Contributes to Low Slow Wave Sleep in Neuromyelitis Optica Spectrum Disorder
Su Lei1, Han Yujuan2, Xue Rong1, Wood Kristofer3, Shi Fu-Dong1,3, Liu Yaou1,4,5, Fu Ying1,*
1Department of Neurology, Tianjin Neurological Institute, Tianjin Medical University General Hospital, Tianjin 300052, China 2Department of Radiology, Tianjin Third Central Hospital, Tianjin, 300170, China 3Department of Neurology, Barrow Neurological Institute, St. Joseph’s Hospital and Medical Center, Phoenix, AZ 85013, USA 4Department of Radiology and Nuclear Medicine, Neuroscience Campus Amsterdam, VU University Medical Center, Amsterdam, Amsterdam 1007 MB, The Netherlands 5Department of Radiology, Xuanwu Hospital, Capital Medical University, Beijing 100053, China
Slow wave sleep abnormality has been reported in neuromyelitis optica spectrum disorder (NMOSD), but mechanism for such abnormality is unknown. To determine the structural defects in the brain that account for the decrease of slow wave sleep in NMOSD patients. Thirty-three NMOSD patients and 18 matched healthy controls (HC) were enrolled. Polysomnography was used to monitor slow wave sleep and three-dimensional T1-weighted MRIs were obtained to assess the alterations of grey matter volume. The percentage of deep slow wave sleep decreased in 93% NMOSD patients. Compared to HC, a reduction of grey matter volume was found in the bilateral thalamus of patients with a lower percentage of slow wave sleep (FWE corrected at cluster-level, p < 0.05, cluster size > 400 voxels). Furthermore, the right thalamic fraction was positively correlated with the decrease in the percentage of slow wave sleep in NMOSD patients (p < 0.05, FDR corrected, cluster size > 200 voxels). Our study identified that thalamic atrophy is associated with the decrease of slow wave sleep in NMOSD patients. Further studies should evaluate whether neurotransmitters or hormones which stem from thalamus are involved in the decrease of slow wave sleep.
Table 1 Characteristics of neuromyelitis optica spectrum disorder patients with low slow wave sleep and healthy controls.
Figure 1. Association of grey matter volume (GMV) with the percentage of slow wave sleep (SWS) in patients with neuromyelitis optica spectrum disorder (NMOSD). (A) Comparison of the total GMV between healthy controls (HC) and NMOSD patients with low SWS. Comparison of (B) right thalamic fraction (TF) and (C) left TF between healthy controls (HC) to NMOSD patients with low SWS. (D) Comparison of GMV between healthy controls (HC) and NMOSD patients with low SWS based on voxel-level analysis (FWE corrected at cluster-level, p < 0.05, cluster size > 400 voxels). (E) Correlation between the percentage of SWS and bilateral thalamus volume by voxel-level analysis (FDR corrected, p < 0.05, cluster size > 200 voxels). TF were tested by Student’s t-test, and Pearson correlation tests were used to examine associations between TF and percentage of SWS. Statistical significance is defined as p<0.05. Bars represent group mean values; standard deviation of the mean was used.
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