UCLA School of Nursing, University of California, Los Angeles, California, United States of America.
Department of Neurobiology, University of California, Los Angeles, California, United States of America.
PLoS One. 2021 Feb 18;16(2):e0246368. doi: 10.1371/journal.pone.0246368. eCollection 2021.
Brain regulation of autonomic function in obstructive sleep apnea (OSA) is disrupted in a sex-specific manner, including in the insula, which may contribute to several comorbidities. The insular gyri have anatomically distinct functions with respect to autonomic nervous system regulation; yet, OSA exerts little effect on the organization of insular gyral responses to sympathetic components of an autonomic challenge, the Valsalva. We further assessed neural responses of insular gyri in people with OSA to a static handgrip task, which principally involves parasympathetic withdrawal.
We measured insular function with blood oxygen level dependent functional MRI. We studied 48 newly-diagnosed OSA (age mean±std:46.5±9 years; AHI±std:32.6±21.1 events/hour; 36 male) and 63 healthy (47.2±8.8 years;40 male) participants. Subjects performed four 16s handgrips (1 min intervals, 80% subjective maximum strength) during scanning. fMRI time trends from five insular gyri-anterior short (ASG); mid short (MSG); posterior short (PSG); anterior long (ALG); and posterior long (PLG)-were assessed for within-group responses and between-group differences with repeated measures ANOVA (p<0.05) in combined and separate female-male models; age and resting heart-rate (HR) influences were also assessed.
Females showed greater right anterior dominance at the ASG, but no differences emerged between OSA and controls in relation to functional organization of the insula in response to handgrip. Males showed greater left anterior dominance at the ASG, but there were also no differences between OSA and controls. The males showed a group difference between OSA and controls only in the ALG. OSA males had lower left activation at the ALG compared to control males. Responses were mostly influenced by HR and age; however, age did not impact the response for right anterior dominance in females.
Insular gyri functional responses to handgrip differ in OSA vs controls in a sex-based manner, but only in laterality of one gyrus, suggesting anterior and right-side insular dominance during sympathetic activation but parasympathetic withdrawal is largely intact, despite morphologic injury to the overall structure.
阻塞性睡眠呼吸暂停（OSA）中大脑对自主功能的调节存在性别特异性紊乱，包括在岛叶，这可能导致多种合并症。岛叶回具有不同的解剖功能，涉及自主神经系统调节；然而，OSA 对岛叶回对自主挑战的交感成分（瓦尔萨尔瓦）的反应组织几乎没有影响。我们进一步评估了 OSA 患者在进行静态握力任务时岛叶回的神经反应，该任务主要涉及副交感神经的撤出。
我们使用血氧水平依赖功能磁共振成像测量了岛叶功能。我们研究了 48 名新诊断的 OSA 患者（年龄平均±标准差：46.5±9 岁；AHI±标准差：32.6±21.1 次/小时；36 名男性）和 63 名健康人（47.2±8.8 岁；40 名男性）。受试者在扫描期间进行了四次 16 秒的握力（1 分钟间隔，80%主观最大强度）。使用重复测量方差分析（p<0.05）评估了来自五个岛叶回（前短回 [ASG]；中短回 [MSG]；后短回 [PSG]；前长回 [ALG]；和后长回 [PLG]）的组内反应和组间差异，在合并和单独的女性-男性模型中；还评估了年龄和静息心率（HR）的影响。
女性在右侧前短回（ASG）表现出更大的右侧优势，但 OSA 组与对照组在岛叶对握力的功能组织方面没有差异。男性在 ASG 处表现出更大的左侧前优势，但 OSA 组与对照组之间也没有差异。仅在 ALG 中，男性 OSA 组与对照组之间存在组间差异。与对照组男性相比，OSA 男性的左 ALG 激活程度较低。反应主要受 HR 和年龄影响；然而，年龄并不影响女性右侧优势的反应。
岛叶回对握力的反应在 OSA 与对照组之间存在性别差异，但仅在一个回的侧性上存在差异，这表明在交感神经激活期间存在前侧和右侧岛叶优势，但自主神经撤离时的副交感神经优势基本完整，尽管整体结构存在形态损伤。
