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STUDY OBJECTIVES: The glymphatic-meningeal lymphatic system plays a crucial role in brain waste clearance. Parasagittal dural (PSD) space contains meningeal lymphatic vessels. Calcification in the PSD space is an under-recognized sign. This study aims to explore the potential associations between PSD space calcification and demographic as well as sleep-related factors. METHODS: In this retrospective study, consecutive patients who visited a sleep clinic between September 2015 and December 2023 were identified. All included individuals underwent a standard polysomnographic examination and a head and neck computed tomography (CT) scan. Demographic and anthropometric data, Epworth Sleepiness Scale scores, and polysomnographic measurements were examined as explanatory variables. CT scans were analyzed for the presence of calcifications in the PSD space. The calcifications were segmented with their volume calculated. Zero-inflated negative binomial regression was used to evaluate the association between calcification volume in the PSD space and the explanatory variables. RESULTS: A total of 72 patients (mean age, 41.14 ± 12.72 standard deviation, 63 men) were included. Of the 72 patients, 17 patients (23.61 per cent) had PSD space calcification. Multivariate analysis revealed that body mass index (BMI) (p < .001), the duration of stage 3 non-rapid eye movement sleep (p < .01), and moderate-to-severe sleep apnea (p = .01) were independently associated with calcification volume in the PSD space. CONCLUSION: Higher BMI, reduced duration of stage 3 non-rapid eye movement sleep, and moderate-to-severe sleep apnea were independently associated with a larger volume of calcification in the PSD space, suggesting a potential link between these factors and impaired meningeal lymphatic function.
Siow et al. (Tue,) studied this question.