Versace Viviana, Langthaler Patrick B, Sebastianelli Luca, Golaszewski Stefan, Kunz Alexander B, Brigo Francesco, Saltuari Leopold, Nardone Raffaele
Department of Neurorehabilitation, Hospital of Vipiteno, Research Unit for Neurorehabilitation of South Tyrol, Italy.
Department of Neurology, Christian Doppler Klinik, Paracelsus Medical University, Salzburg, Austria; Department of Mathematics, Paris Lodron University of Salzburg, Austria.
Sleep Med. 2017 Sep;37:113-118. doi: 10.1016/j.sleep.2017.06.021. Epub 2017 Jul 12.
BACKGROUND/OBJECTIVE: Odor identification and discrimination are reduced in subjects with obstructive sleep apnea syndrome (OSAS), but the pathophysiology of the olfactory dysfunction in OSAS is still poorly understood. Experimental evidence suggests that olfactory impairment could be related to central cholinergic dysfunction. Short latency afferent inhibition (SAI) is a paired-pulse transcranial magnetic stimulation (TMS) protocol that gives the opportunity to test an inhibitory cholinergic circuit in the human cerebral motor cortex. The objective of the study was to assess the cholinergic function, as measured by SAI, in OSAS patients with olfactory impairment.
We applied SAI technique in 20 patients with OSAS and in 20 healthy control subjects; SAI values were correlated with the Sniffin' Sticks olfactory test results.
SAI was reduced in OSAS patients when compared with control subjects. We also found a strong negative correlation between olfactory parameters and SAI.
These findings suggest that cholinergic dysfunction is a robust determinant of hyposmia also in OSAS patients. Reduced SAI values and presence of olfactory impairment might indicate an increased risk of cognitive decline in patients with OSAS.
背景/目的：阻塞性睡眠呼吸暂停综合征（OSAS）患者的气味识别和辨别能力下降，但OSAS嗅觉功能障碍的病理生理学仍知之甚少。实验证据表明，嗅觉障碍可能与中枢胆碱能功能障碍有关。短潜伏期传入抑制（SAI）是一种成对脉冲经颅磁刺激（TMS）方案，它为测试人类大脑运动皮层中的抑制性胆碱能回路提供了机会。本研究的目的是评估嗅觉受损的OSAS患者中通过SAI测量的胆碱能功能。
我们对20例OSAS患者和20例健康对照者应用了SAI技术；SAI值与嗅觉棒嗅觉测试结果相关。
与对照组相比，OSAS患者的SAI降低。我们还发现嗅觉参数与SAI之间存在强烈的负相关。
这些发现表明，胆碱能功能障碍也是OSAS患者嗅觉减退的一个重要决定因素。SAI值降低和嗅觉障碍的存在可能表明OSAS患者认知功能下降的风险增加。
