Neurological Clinic, Marche Polytechnic University, Ancona, Italy.
Internal and Subintensive Medicine, Ospedali Riuniti, Ancona, Italy.
J Alzheimers Dis. 2017;60(3):1195-1203. doi: 10.3233/JAD-170445.
Sleep breathing disorders can affect cognitive performances through complex brain anatomical and functional changes.
Our aim was to evaluate the correlations between cognitive performances and obstructive sleep apnea syndrome (OSAS), as well as the possible influence of vascular factors.
Thirty-four non-demented OSAS patients and 34 controls were submitted to a neuropsychological evaluation and to a vascular screening including the study of cerebrovascular reactivity by means of the breath-holding index (BHI) calculation. After 6 months, polisomnographic, neuropsychologic, and hemodynamics assessment was repeated in patients.
At baseline, some cognitive performances involved in executive and memory functions were significantly lower in patients with respect to controls. Significantly lower values in mean BHI were also detected in patients with respect to controls (p < 0.0001). At the 6-month evaluation, 18 patients had a reduction in OSAS severity (group 1) and 16 remained stable (group 2). Group 1 patients had a significant improvement in left and mean BHI (p < 0.001) and in short-term (p = 0.02) and long-term Rey Auditory Verbal Learning Test (p < 0.001). No change in cerebrovascular reactivity and cognitive profile was detected in group 2 patients.
Patients with OSAS may experience a reduced cognitive efficiency. Improvement of OSAS was associated to favorable hemodynamic changes and increased level of performances in verbal memory tasks so suggesting an involvement of vascular underlying mechanisms in sustaining cognitive dysfunctions in OSAS. Our preliminary data suggest the need for further studies to deepen the knowledge about the relationships between OSAS, cerebral hemodynamic compromise, and cognitive impairment risk.
睡眠呼吸障碍可通过复杂的脑解剖和功能变化影响认知表现。
我们旨在评估认知表现与阻塞性睡眠呼吸暂停综合征（OSAS）之间的相关性，以及血管因素的可能影响。
34 名非痴呆 OSAS 患者和 34 名对照者接受神经心理评估和血管筛查，包括通过计算屏气指数（BHI）评估脑血管反应性。6 个月后，对患者进行重复睡眠呼吸暂停、神经心理学和血液动力学评估。
在基线时，与对照组相比，一些涉及执行和记忆功能的认知表现患者明显较低。与对照组相比，患者的平均 BHI 值也明显较低（p<0.0001）。在 6 个月的评估中，18 名患者 OSAS 严重程度降低（第 1 组），16 名患者保持稳定（第 2 组）。第 1 组患者左 BHI 和平均 BHI 显著改善（p<0.001），短期（p=0.02）和长期 Rey 听觉言语学习测试（p<0.001）。第 2 组患者的脑血管反应性和认知特征无变化。
OSAS 患者可能会经历认知效率降低。OSAS 的改善与有利的血液动力学变化和言语记忆任务表现水平的提高有关，因此表明血管潜在机制在维持 OSAS 认知功能障碍中起作用。我们的初步数据表明，需要进一步研究以加深对 OSAS、脑血流灌注不足和认知障碍风险之间关系的认识。
