Department of Otolaryngology, Head and Surgery, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, 100045, China.
School of Computer and Information Technology, Beijing Jiaotong University, Beijing, China.
Sleep Med. 2021 Jun;82:134-143. doi: 10.1016/j.sleep.2020.08.026. Epub 2020 Aug 28.
To investigate alterations in neurocognitive, attention, paediatric sleep questionnaire (PSQ) scores and whole brain white matter (WM) integrity between children with mild and severe obstructive sleep apnoea (OSA) according to sex and whether these changes are associated with OSA severity.
Fifty-seven children (36 males and 21 females) diagnosed with OSA were recruited for this study. Children of both sexes were divided into mild (male-MG, female-MG) and severe (male-SG, female-SG) groups according to OSA severity. Polysomnography (PSG), neurocognitive, attention and PSQ tests were compared between groups by one-way samples analysis of variance (ANOVA) F test. Diffusion tensor imaging (DTI) was scanned using a 3T GE MRI scanner and analysed by Tract-based Spatial Statistics (TBSS). Spearman correlation was calculated between DTI Eigenvalues and clinical characteristics.
Compared to mild OSA patients, severe OSA patients presented greater severity of obstructive apnoea hypopnea index (OAHI), neurocognition, PSQ and attention tests in both male and female patients. Brain WM integrity in the male-SG, compared to the male-MG, demonstrated significantly reduced fractional anisotropy (FA) values in the right middle frontal gyrus and the right frontal sub-gyral regions and increased axial diffusivity (AD) values in the right inferior frontal gyrus, left parietal angular gyrus and sub-gyral regions, while no differences were found between the female-MG and female-SG. Alterations in male-SG brain regions were observably correlated with severity in male OSA patients.
The integrity of WM, which regulates autonomic, cognitive, and attention functions, is impaired in male, but not female, children with severe OSA.
研究轻度和重度阻塞性睡眠呼吸暂停（OSA）儿童的神经认知、注意力、小儿睡眠问卷（PSQ）评分和全脑白质（WM）完整性变化，并根据性别和这些变化是否与 OSA 严重程度相关进行分析。
本研究招募了 57 名患有 OSA 的儿童（36 名男性和 21 名女性）。根据 OSA 严重程度，男女儿童均分为轻度（男-MG，女-MG）和重度（男-SG，女-SG）组。通过单因素样本方差分析（ANOVA）F 检验比较组间多导睡眠图（PSG）、神经认知、注意力和 PSQ 测试结果。使用 3T GE MRI 扫描仪进行弥散张量成像（DTI）扫描，并通过基于体素的空间统计学（TBSS）进行分析。计算 DTI 特征值与临床特征之间的 Spearman 相关性。
与轻度 OSA 患者相比，重度 OSA 患者无论男女患者的阻塞性呼吸暂停低通气指数（OAHI）、神经认知、PSQ 和注意力测试的严重程度均更高。与男-MG 相比，男-SG 的 WM 完整性在右侧额中回和额下回区域的各向异性分数（FA）值明显降低，在右侧额下回、左侧顶下小叶角回和下小叶区域的轴向弥散度（AD）值明显增加，而女-MG 和女-SG 之间没有差异。男-SG 脑区的改变与男 OSA 患者的严重程度明显相关。
调节自主神经、认知和注意力功能的 WM 完整性在重度 OSA 男性儿童中受损，但在女性儿童中没有受损。
