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阻塞性睡眠呼吸暂停综合征患者持续气道正压通气治疗后的执行功能障碍和学习效应。

Executive dysfunction and learning effect after continuous positive airway pressure treatment in patients with obstructive sleep apnea syndrome.

机构信息

Department of Neurology and Rehabilitation, Tampere University Hospital, Tampere, Finland. tiia.saunamaki @ uta.fi

出版信息

Eur Neurol. 2010;63(4):215-20. doi: 10.1159/000278301. Epub 2010 Mar 9.

Abstract

AIMS

To assess the impact of continuous positive airway pressure (CPAP) treatment on executive dysfunction in patients with obstructive sleep apnea syndrome (OSAS).

METHODS

At baseline, 20 OSAS patients and 17 healthy controls underwent polysomnography and neuropsychological assessment focusing on executive functions. After at least 6 months of CPAP treatment, the patients returned for one more full-night polysomnography and neuropsychological control assessment, while the controls underwent a neuropsychological control assessment.

RESULTS

All patients and controls were working-age males. OSAS severity ranged from mild to severe. Before CPAP, patients showed poorer performance than controls in the copy of the Rey-Osterrieth Complex Figure Test, the Block Design, the Digit Symbol, the Trails B and the Intra-Extra Dimensional Set-Shifting task. Patients' executive performance showed no improvement after CPAP, and it remained poorer than the performance of controls. In addition, patients showed no learning effect in the executive tests, whereas the controls did.

CONCLUSION

Even long-term CPAP treatment does not seem to improve OSAS patients' mental set-shifting performance or their visuospatial organizational skills. In addition, OSAS patients have impaired learning effect in executive tests.

摘要

目的

评估持续气道正压通气(CPAP)治疗对阻塞性睡眠呼吸暂停综合征(OSAS)患者执行功能的影响。

方法

在基线时,20 名 OSAS 患者和 17 名健康对照者接受多导睡眠图和神经心理学评估,重点评估执行功能。在至少 6 个月的 CPAP 治疗后,患者再次进行一整晚的多导睡眠图和神经心理学对照评估,而对照组则进行神经心理学对照评估。

结果

所有患者和对照者均为工作年龄段的男性。OSAS 严重程度从轻度到重度不等。在 CPAP 治疗前,患者在 Rey-Osterrieth 复杂图形测试的复制、方块设计、数字符号、Trails B 和内外维度转移任务中的表现均不如对照组。患者的执行功能在 CPAP 治疗后没有改善,仍不如对照组。此外,患者在执行测试中没有学习效果,而对照组则有。

结论

即使长期 CPAP 治疗似乎也不能改善 OSAS 患者的心理转换表现或他们的视空间组织技能。此外,OSAS 患者在执行测试中的学习效果受损。

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