Center for Advanced Research in Sleep Medicine, Hôpital du Sacré-Coeur de Montréal, Centre Intégré Universitaire de Santé et de Services Sociaux du Nord de l'Île-de-Montréal, Montreal, Quebec, Canada.
Department of Neurosciences, Université de Montréal, Montreal, Quebec, Canada.
Hum Brain Mapp. 2021 Aug 1;42(11):3429-3439. doi: 10.1002/hbm.25443. Epub 2021 May 3.
Obstructive sleep apnea (OSA) is associated with abnormal cerebral perfusion at wakefulness, but whether these anomalies evolve over time is unknown. Here, we examined longitudinal changes in regional cerebral blood flow (rCBF) distribution in late middle-aged and older adults with treated or untreated OSA. Twelve controls (64.8 ± 8.0 years) and 23 participants with newly diagnosed OSA (67.8 ± 6.2 years) were evaluated with polysomnography and cerebral Tc-HMPAO single-photon emission computed tomography during wakeful rest. OSA participants were referred to a sleep apnea clinic and 13 of them decided to start continuous positive airway pressure (CPAP). Participants were tested again after 18 months. Voxel-based analysis and extracted relative rCBF values were used to assess longitudinal changes. Untreated OSA participants showed decreased relative rCBF in the left hippocampus and the right parahippocampal gyrus over time, while treated participants showed trends for increased relative rCBF in the left hippocampus and the right parahippocampal gyrus. No changes were found over time in controls. Untreated OSA is associated with worsening relative rCBF in specific brain areas over time, while treated OSA shows the opposite. Considering that OSA possibly accelerates cognitive decline in older adults, CPAP treatment could help reduce risk for cognitive impairment.
阻塞性睡眠呼吸暂停（OSA）与清醒时的异常脑灌注有关，但这些异常是否随时间演变尚不清楚。在这里，我们研究了经过治疗和未经治疗的 OSA 的中老年患者局部脑血流（rCBF）分布的纵向变化。12 名对照者（64.8±8.0 岁）和 23 名新诊断的 OSA 患者（67.8±6.2 岁）接受了多导睡眠图和清醒休息期间的 Tc-HMPAO 单光子发射计算机断层扫描检查。OSA 患者被转介到睡眠呼吸暂停诊所，其中 13 人决定开始持续气道正压通气（CPAP）。18 个月后，对参与者进行了再次测试。基于体素的分析和提取的相对 rCBF 值用于评估纵向变化。未经治疗的 OSA 患者随着时间的推移，左侧海马体和右侧海马旁回的相对 rCBF 逐渐减少，而经过治疗的患者左侧海马体和右侧海马旁回的相对 rCBF 呈增加趋势。对照组的 rCBF 没有随时间变化。未经治疗的 OSA 与随时间推移特定脑区相对 rCBF 的恶化有关，而经过治疗的 OSA 则相反。由于 OSA 可能会加速老年人的认知能力下降，CPAP 治疗可能有助于降低认知障碍的风险。
