脑干病变与多发性硬化症中的睡眠呼吸暂停有关。
Brainstem lesions are associated with sleep apnea in multiple sclerosis.
作者信息
Levit Elle, Bouley Andrew, Baber Ursela, Djonlagic Ina, Sloane Jacob A
机构信息
Department of Neurology, Beth Israel Deaconess Medical Center, Boston, USA.
Department of Neurology, UMass Medical School, Worcester, USA.
出版信息
Mult Scler J Exp Transl Clin. 2020 Nov 5;6(4):2055217320967955. doi: 10.1177/2055217320967955. eCollection 2020 Oct-Dec.
BACKGROUND
Studies linking MRI findings in MS patients with obstructive sleep apnea severity are limited.
OBJECTIVE
We conducted a retrospective study to assess MRI abnormalities associated with obstructive sleep apnea (OSA) in patients with multiple sclerosis (MS).
METHODS
We performed retrospective chart review of 65 patients with multiple sclerosis who had undergone polysomnography (PSG) for fatigue as well as brain MRI. We measured the number of lesions in the brainstem and calculated the standardized third ventricular width (sTVW) as a measure of brain atrophy, and subsequently performed correlation analyses of the apnea-hypopnea index (AHI) with brainstem lesion location, sTVW, and Expanded Disability Status Scale (EDSS).
RESULTS
MS Patients with OSA were significantly older and had a higher body mass index (BMI) and higher AHI measures than patients without OSA. After adjustment for covariates, significant associations were found between AHI and lesion burden in the midbrain (p < 0.01) and pons (p = 0.05), but not medulla.
CONCLUSIONS
Midbrain and pontine lesions burden correlated with AHI, suggesting MS lesion location could contribute to development of OSA.
背景
将多发性硬化症（MS）患者的MRI检查结果与阻塞性睡眠呼吸暂停严重程度相关联的研究有限。
目的
我们进行了一项回顾性研究，以评估多发性硬化症（MS）患者中与阻塞性睡眠呼吸暂停（OSA）相关的MRI异常情况。
方法
我们对65例因疲劳接受多导睡眠图（PSG）检查以及脑部MRI检查的多发性硬化症患者进行了回顾性病历审查。我们测量了脑干中的病灶数量，并计算了标准化第三脑室宽度（sTVW）作为脑萎缩的指标，随后对呼吸暂停低通气指数（AHI）与脑干病灶位置、sTVW以及扩展残疾状态量表（EDSS）进行了相关性分析。
结果
与无OSA的患者相比，患有OSA的MS患者年龄显著更大，体重指数（BMI）更高，AHI测量值也更高。在对协变量进行调整后，发现AHI与中脑（p < 0.01）和脑桥（p = 0.05）的病灶负荷之间存在显著关联，但与延髓无关。
结论
中脑和脑桥病灶负荷与AHI相关，提示MS病灶位置可能促成OSA的发生。
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