Kumar Rajesh, Macey Paul M, Cross Rebecca L, Woo Mary A, Yan-Go Frisca L, Harper Ronald M
Department of Neurobiology, David Geffen School of Medicine, University of California at Los Angeles, Los Angeles, California 90095-1763, USA.
Depress Anxiety. 2009;26(5):480-91. doi: 10.1002/da.20531.
Neuropsychological comorbidities, including anxiety symptoms, accompany obstructive sleep apnea (OSA); structural and functional brain alterations also occur in the syndrome. The objective was to determine whether OSA patients expressing anxiety symptoms show injury in specific brain sites.
Magnetic resonance T2-relaxometry was performed in 46 OSA and 66 control subjects. Anxiety symptoms were evaluated using the Beck Anxiety Inventory (BAI); subjects with BAI scores >9 were classified anxious. Whole brain T2-relaxation maps were compared between anxious and nonanxious groups using analysis of covariance (covariates, age and gender).
Sixteen OSA and seven control subjects showed anxiety symptoms, and 30 OSA and 59 controls were nonanxious. Significantly higher T2-relaxation values, indicating tissue injury, appeared in anxious OSA versus nonanxious OSA subjects in subgenu, anterior, and mid-cingulate, ventral medial prefrontal and bilateral insular cortices, hippocampus extending to amygdala and temporal, and bilateral parietal cortices. Brain injury emerged in anxious OSA versus nonanxious controls in bilateral insular cortices, caudate nuclei, anterior fornix, anterior thalamus, internal capsule, mid-hippocampus, dorsotemporal, dorsofrontal, ventral medial prefrontal, and parietal cortices.
Anxious OSA subjects showed injury in brain areas regulating emotion, with several regions lying outside structures affected by OSA alone, suggesting additional injurious processes in anxious OSA subjects.
神经心理学共病，包括焦虑症状，常伴随阻塞性睡眠呼吸暂停（OSA）；该综合征中也会出现大脑结构和功能改变。目的是确定表现出焦虑症状的OSA患者在特定脑区是否存在损伤。
对46名OSA患者和66名对照者进行磁共振T2弛豫测量。使用贝克焦虑量表（BAI）评估焦虑症状；BAI评分>9分的受试者被归类为焦虑患者。使用协方差分析（协变量为年龄和性别）比较焦虑组和非焦虑组的全脑T2弛豫图。
16名OSA患者和7名对照者表现出焦虑症状，30名OSA患者和59名对照者无焦虑症状。与非焦虑的OSA受试者相比，焦虑的OSA受试者在膝下、前扣带回中部、腹内侧前额叶和双侧岛叶皮质、延伸至杏仁核和颞叶的海马以及双侧顶叶皮质中出现显著更高的T2弛豫值，表明存在组织损伤。与非焦虑的对照者相比，焦虑的OSA患者在双侧岛叶皮质、尾状核、前穹窿、前丘脑、内囊、海马中部、背颞叶、背额叶、腹内侧前额叶和顶叶皮质中出现脑损伤。
焦虑的OSA受试者在调节情绪的脑区出现损伤，其中几个区域位于仅受OSA影响的结构之外，这表明焦虑的OSA受试者存在额外的损伤过程。
