Laboratory for Research in Neuroimaging, Department of Clinical Neurosciences, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland.
Center for Investigation and Research in Sleep, Department of Medicine, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland.
Ann Neurol. 2020 Jun;87(6):921-930. doi: 10.1002/ana.25728. Epub 2020 Apr 20.
There is much controversy about the neurobiological mechanisms underlying the effects of sleep-disordered breathing on the brain. The aim of this study was to investigate the association between markers of sleep-related hypoxemia and brain anatomy.
We used data from a large-scale cohort from the general population (n = 775, 50.6% males, age range = 45-86 years, mean age = 60.3 ± 9.9) that underwent full polysomnography and brain magnetic resonance imaging to correlate respiratory variables with regional brain volume estimates.
After adjusting for age, gender, and cardiovascular risk factors, only mean oxygen saturation during sleep was associated with bilateral volume of hippocampus (right: p = 0.001; left: p < 0.001), thalamus (right: p < 0.001; left: p < 0.001), putamen (right: p = 0.001; left: p = 0.001), and angular gyrus (right: p = 0.011; left: p = 0.001). We observed the same relationship in left hemispheric amygdala (p = 0.010), caudate (p = 0.008), inferior frontal gyrus (p = 0.004), and supramarginal gyrus (p = 0.003). The other respiratory variables-lowest oxygen saturation, percentage of sleep time with oxygen saturation < 90%, apnea-hypopnea index, and oxygen desaturation index-did not show any significant association with brain volumes.
Lower mean oxygen saturation during sleep was associated with atrophy of cortical and subcortical brain areas known for high sensitivity to oxygen supply. Their vulnerability to hypoxemia may contribute to behavioral phenotype and cognitive decline in patients with sleep-disordered breathing. ANN NEUROL 2020;87:921-930.
关于睡眠呼吸障碍对大脑影响的神经生物学机制存在诸多争议。本研究旨在探讨与睡眠相关低氧血症标志物和大脑解剖结构之间的相关性。
我们使用来自一般人群的大规模队列（n = 775，50.6%为男性，年龄范围为 45-86 岁，平均年龄为 60.3 ± 9.9 岁）的数据，这些人接受了全面的多导睡眠图和脑磁共振成像检查，以将呼吸变量与区域性脑容量估计值相关联。
在调整年龄、性别和心血管危险因素后，只有睡眠期间的平均氧饱和度与双侧海马体体积（右侧：p = 0.001；左侧：p < 0.001）、丘脑（右侧：p < 0.001；左侧：p < 0.001）、壳核（右侧：p = 0.001；左侧：p = 0.001）和角回（右侧：p = 0.011；左侧：p = 0.001）相关。我们在左侧大脑半球杏仁核（p = 0.010）、尾状核（p = 0.008）、下额前回（p = 0.004）和缘上回（p = 0.003）中观察到相同的关系。其他呼吸变量（最低氧饱和度、睡眠期间氧饱和度<90%的时间百分比、呼吸暂停低通气指数和氧减指数）与脑容量无显著相关性。
睡眠期间平均氧饱和度较低与已知对氧供应高度敏感的皮质和皮质下脑区的萎缩有关。它们对低氧血症的易感性可能导致睡眠呼吸障碍患者的行为表型和认知能力下降。
