Department of Radiology, Bezmialem Vakif University School of Medicine, İstanbul, Turkey.
Clin Imaging. 2013 Nov-Dec;37(6):989-92. doi: 10.1016/j.clinimag.2013.07.010. Epub 2013 Aug 30.
We investigated whether there are differences in metabolite ratios of different brain regions between mild and severe obstructive sleep apnea (OSA) patients.
A total of 17 mild OSA and 14 severe OSA patients were enrolled. N-acetyl aspartate (NAA)/creatine (Cr), choline (Cho)/Cr and NAA/Cho ratios were calculated by using multivoxel magnetic resonance spectroscopy (MRS) (TR: 1500, TE: 135 ms) from hippocampus, putamen, insular cortex, thalamus and temporal white matter. The relationship between the two groups was evaluated with Mann-Whitney U test.
NAA/Cr ratios obtained from hippocampus was found to be significantly increased in severe OSA patients compared to mild OSA patients (P=.004). Cho/Cr ratios obtained from hippocampus and putamen in severe OSA patients were significantly increased when compared to mild OSA patients (P=.003 and P=.004, respectively). In addition, NAA/Cho ratios of putamen were significantly decreased in severe OSA patients when compared to mild OSA (P=.032).
MRS identified hypoxia-related metabolite and microstructural changes in hippocampus and putamen. The metabolite changes of increase in NAA/Cr and Cho/Cr ratios and decrease in NAA/Cho ratio were more pronounced with increasing severity of OSA syndrome.
本研究旨在探讨轻度和重度阻塞性睡眠呼吸暂停（OSA）患者脑内不同区域代谢物比值是否存在差异。
共纳入 17 例轻度 OSA 患者和 14 例重度 OSA 患者。采用多体素磁共振波谱（MRS）（TR：1500，TE：135 ms）测定海马体、壳核、岛叶皮质、丘脑和颞叶白质的 N-乙酰天冬氨酸（NAA）/肌酸（Cr）、胆碱（Cho）/Cr 和 NAA/Cho 比值。采用 Mann-Whitney U 检验评估两组间的关系。
重度 OSA 患者的海马体 NAA/Cr 比值明显高于轻度 OSA 患者（P=.004）。重度 OSA 患者的海马体和壳核的 Cho/Cr 比值明显高于轻度 OSA 患者（P=.003 和 P=.004）。此外，重度 OSA 患者的壳核 NAA/Cho 比值明显低于轻度 OSA 患者（P=.032）。
MRS 可识别海马体和壳核与缺氧相关的代谢物和微观结构变化。随着 OSA 综合征严重程度的增加，NAA/Cr 和 Cho/Cr 比值增加，NAA/Cho 比值降低的代谢物变化更为明显。
