Deans' stroke musings: Periodic Limb Movements Linked to White Matter Changes After Minor Stroke

Changing stroke rehab and research worldwide now.Time is Brain! trillions and trillions of neurons that DIE each day because there are NO effective hyperacute therapies besides tPA(only 12% effective). I have 523 posts on hyperacute therapy, enough for researchers to spend decades proving them out. These are my personal ideas and blog on stroke rehabilitation and stroke research. Do not attempt any of these without checking with your medical provider. Unless you join me in agitating, when you need these therapies they won't be there.

What this blog is for:

My blog is not to help survivors recover, it is to have the 10 million yearly stroke survivors light fires underneath their doctors, stroke hospitals and stroke researchers to get stroke solved. 100% recovery. The stroke medical world is completely failing at that goal, they don't even have it as a goal. Shortly after getting out of the hospital and getting NO information on the process or protocols of stroke rehabilitation and recovery I started searching on the internet and found that no other survivor received useful information. This is an attempt to cover all stroke rehabilitation information that should be readily available to survivors so they can talk with informed knowledge to their medical staff. It lays out what needs to be done to get stroke survivors closer to 100% recovery. It's quite disgusting that this information is not available from every stroke association and doctors group.

Thursday, March 20, 2025

Periodic Limb Movements Linked to White Matter Changes After Minor Stroke

Ask your competent? doctor what this means, I have no clue.

Periodic Limb Movements Linked to White Matter Changes After Minor Stroke

Individuals with an elevated PLM index had significantly higher Fazekas and ARWMC total scores than those with a lower PLM index.

Periodic limb movements (PLMs) during sleep are associated with white matter hyperintensities (WMHs) among patients with incident minor stroke and transient ischemic attack (TIA), according to study results published in Sleep.

Previous studies have reported that PLMs during sleep are associated with nocturnal fluctuations in heart rate and blood pressure and vascular events. As such, some researchers posit that PLMs may contribute to cerebrovascular and cardiovascular disease – although this relationship remains debated.

To evaluate the relationship between PLMs and cerebral small vessel disease, investigators conducted a study using data from the Sleep Disorders Managed and Assessed Rapidly in TIA and In Early Stroke (SMARTIES; NCT01528462) and SLEep APnea Screening Using Mobile Ambulatory Recorders After TIA/Stroke (SLEAP SMART; NCT02454023) studies. The investigators assessed periodic limb movement index (PLMI), PLM arousal index (PLMAI), and signs of cerebral small vessel disease (CSVD) among patients (N=86) with recent, first-ever stroke or TIA. Limb movement outcomes were measured using polysomnography and CSVD outcomes were measured using magnetic resonance imaging.

Of the 86 patients included in the study, 66.3% were male, 52.3% had hypertension, 10.5% had diabetes mellitus, 29.1% smoked, 29.1% had microbleeds, and 24.4% had lacunar infarcts. The patients had a mean age of 62.2 (SD=14.3) years and a body mass index (BMI) of 28.1 (SD=5.7) kg/m².

In conclusion, this study adds to the literature examining the relationship between PLMs and CSVD in patients with cerebrovascular disease,

The patients had a median Fazekas total score of 2 (IQR, 1-3) and an age-related white matter changes (ARWMC) total score of 5 (IQR, 2-10). The subset of patients with a PLMI of 5 or greater (n=36) had significantly higher Fazekas (P =.003) and ARWMC (P =.007) total scores than those with lower PLMI.

In the adjusted models, Fazekas total score was significantly associated with a PLMAI of 5 or greater (adjusted odds ratio [aOR], 5.9; 95% CI, 1.5-23.8; P =.01), PLMI of 5 or greater (aOR, 2.8; 95% CI, 1.2-6.8; P =.02), and a PLMI of the upper limit of normal or higher (aOR, 2.6; 95% CI, 1.0-6.5; P =.04). Additionally, ARWMC total scores were associated with a PLMAI of 5 or greater (adjusted b [ab], 3.8; 95% CI, 0.5-7.1; P =.027) and a PLMI of 5 or greater (ab, 2.3; 95% CI, 0.07-4.4; P =.043).

In a subgroup analysis among only patients with an elevated PLMI, no significant trends in CSVD outcomes were observed on the basis of obstructive sleep apnea status.

“In conclusion, this study adds to the literature examining the relationship between PLMs and CSVD in patients with cerebrovascular disease,” the study authors noted. “These findings suggested that an elevated PLM index was independently associated with WMHs; further work is needed to determine the directionality of this association.”

Study limitations include potential unaccounted confounding and the inability to determine the directionality of the findings.

This article originally appeared on Sleep Wake Advisor