Multimodal assessment of sleep and regional brain volumes in AQP4-IgG-positive neuromyelitis optica spectrum disorder: An exploratory cross-sectional study.

Authors

Dachathorn Tharacheewin, Natapong Thaneerat, Sasitorn Siritho, Tatchaporn Ongphichetmetha, Jiraporn Jitprapaikulsan, Chawanont Pimolsri, Wattanachai Chotinaiwattarakul, Chanon Ngamsombat, Ekdanai Uawithya

Published in

Multiple sclerosis and related disorders. Volume 115. Pages 107890. Aug 27, 2026. Epub Aug 27, 2026.

Abstract

Sleep disturbance is common in aquaporin-4 immunoglobulin G (AQP4-IgG)-positive neuromyelitis optica spectrum disorder (NMOSD), but its clinical and neurobiological correlates remain incompletely characterized; prior studies used single-modality assessments. In this exploratory cross-sectional study we characterized sleep-wake patterns in clinically stable AQP4-IgG-positive NMOSD and explored volume-sleep associations. Patients and controls underwent questionnaires, 7-day wrist actigraphy and structural MRI; intracranial volume-normalized regional volumes and within-patient volume-sleep associations were examined, with Benjamini-Hochberg false discovery rate (FDR) correction. Twenty-four patients and 26 controls were enrolled; 20 patients and 20 database-derived controls contributed MRI. Patients were older than controls (49.7 versus 33.0 years; g = 1.40); analyses were adjusted for age and body mass index (BMI). After adjustment, patients showed longer time in bed (+58 min) and total sleep time (+50 min), whereas sleep efficiency and wake after sleep onset did not differ. Higher BMI was associated with lower sleep efficiency (r = -0.44) and longer sleep onset latency. Subjective sleep disturbance and pain-related quality of life were worse in NMOSD. After FDR correction, volume reductions were observed in bilateral hippocampal molecular-layer subfields and all five corpus callosum segments, with suggestive thalamic reductions; no volume-sleep association survived. Sleep disturbance in clinically stable AQP4-IgG-positive NMOSD was characterized by greater subjective sleep burden and altered sleep-wake timing, with associations observed with clinical and metabolic factors. These hypothesis-generating findings are consistent with a multifactorial pattern of associations and highlight the need for longitudinal studies integrating objective sleep measurement, neuroimaging and biomarkers.

PMID:
42700625
Bibliographic data and abstract were imported from PubMed on 06 Sep 2026.

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