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

Background: Disruption of circadian rest-activity rhythm (RAR) has been found in many neurological disorders. Objective: In this study, actigraphic data were collected and analyzed to identify the RAR pattern in the elderly with cerebral small vessel disease. Methods: 115 cerebral small vessel disease (CSVD) cases were recruited. The presence of lacune infarct, white matter hyperintensities, and cerebral microbleeds in magnetic resonance imaging (MRI) images were rated independently, as well as using a simple MRI score of 0–3 points. Each subject wore an Actigraph device in their nondominant hand for 4–7 days to collect raw data. RAR parameters were generated using both extended cosinor model (RAR α, RAR β, amplitude, acrophase, up-mesor, down-mesor, and pseudo-F statistic) and non-parametric methods (interdaily stability, intradaily variability, and relative amplitude). Results: Elder patients with a simple MRI score of 2–3 points showed a statistically lower amplitude compared with individuals with a simple MRI score of 0 points in the extended cosinor model. For the non-parametric method, elderly people with a simple MRI score of 1–3 points exhibited higher intradaily variability relative to those participants with a simple MRI score of 0 points. However, no differences were found regarding sleep quality among individuals with different simple MRI scores. White matter hyperintensities, lacune infarct, and cerebral microbleeds were independently associated with RAR β, RAR α, and intradaily variability, respectively. Conclusions: The RAR pattern was disturbed in elderly adults with CSVD. Abnormal RAR parameters were independently associated with CSVD MRI markers.