Toshiaki Taoka: Department of Innovative Biomedical Visualization (iBMV), Nagoya University Graduate School of Medicine, Nagoya, Aichi, Japan. ORCID
Kunihiro Iwamoto: Department of Psychiatry, Nagoya University Graduate School of Medicine, Nagoya, Aichi, Japan.
Seiko Miyata: Department of Psychiatry, Nagoya University Graduate School of Medicine, Nagoya, Aichi, Japan.
Rintaro Ito: Department of Innovative Biomedical Visualization (iBMV), Nagoya University Graduate School of Medicine, Nagoya, Aichi, Japan.
Rei Nakamichi: Department of Radiology, Nagoya University Graduate School of Medicine, Nagoya, Aichi, Japan.
Toshiki Nakane: Department of Radiology, Nagoya University Graduate School of Medicine, Nagoya, Aichi, Japan.
Ippei Okada: Department of Psychiatry, Nagoya University Graduate School of Medicine, Nagoya, Aichi, Japan.
Kazushige Ichikawa: Department of Radiological Technology, Nagoya University Hospital, Nagoya, Aichi, Japan.
Hirohito Kan: Department of Integrated Health Sciences, Nagoya University Graduate School of Medicine, Nagoya, Aichi, Japan.
Koji Kamagata: Department of Radiology, Juntendo University of Medicine, Tokyo, Japan.
Junko Kikuta: Department of Radiology, Juntendo University of Medicine, Tokyo, Japan.
Shigeki Aoki: Department of Radiology, Juntendo University of Medicine, Tokyo, Japan.
Akihiro Fujimoto: Medical Headquarters, Eisai Co., Ltd., Tokyo, Japan.
Yuki Kogo: Medical Headquarters, Eisai Co., Ltd., Tokyo, Japan.
Nobuyasu Ichinose: Department of Innovative Biomedical Visualization (iBMV), Nagoya University Graduate School of Medicine, Nagoya, Aichi, Japan.
Shinji Naganawa: Department of Radiology, Nagoya University Graduate School of Medicine, Nagoya, Aichi, Japan.
Norio Ozaki: Department of Pathophysiology of Mental Disorders, Nagoya University Graduate School of Medicine, Nagoya University, Nagoya, Aichi, Japan.
PURPOSE: The purpose of this study was to assess the extent to which improvement in sleep with lemborexant contributed to changes in interstitial fluid dynamics. METHODS: The 3 methods including diffusion tensor image analysis along the perivascular space (DTI-ALPS), dynamic contrast-enhanced method to assess tissue vascular permeability (Ktrans), and choroid plexus volume (CPV) were used. Correlations between these imaging indices and sleep parameters (latency to persistent sleep [LPS], wake after sleep onset [WASO], total sleep time [TST], and sleep efficiency [SE]) were evaluated using Pearson correlation analysis. Additionally, multiple regression analysis and linear mixed model analysis were employed to assess the relationship between baseline sleep status and imaging parameter changes. MRI and sleep assessments were performed before treatment initiation (week 0, w0) and at 12���weeks after lemborexant administration (week 12, w12). RESULTS: The ALPS-index was inversely correlated with LPS and positively correlated with TST and SE at w0. In multiple regression analysis, ALPS-index was lower when sleep parameters other than LPS were poor at w0. A linear mixed model analysis suggested that poor sleep status in LPS and SE at w0 may have an effect on greater ALPS-index. In the evaluation of Ktrans measurement, the single regression analysis showed a statistically significant correlation between the reduction in Ktrans and the shortening in LPS. Examination of CPV and sleep parameters showed a significant negative correlation between TST and CPV at w0 and w12. Multiple regression analysis also showed that TST of w12 had a significant effect on CPV at w12. CONCLUSION: Our results suggested that poor sleep status is related to the greater change of ALPS-index and CPV improvement after lemborexant administration may be related to in part to sleep parameter improvement.
