Mei Lin, Li Xiaodan, Wang Shengcai, Si Run, Ji Tingting, Xu Zhifei, Peng Yun, Liu Yue, Li Hongbin, Zhang Jie, Guo Yongli, Tian Jinghong, Zhou Guifei, Huang Huifang, Tai Jun, Liu Jiangang, Ni Xin
Department of Otolaryngology, Head and Surgery, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, People's Republic of China.
School of Computer and Information Technology, Beijing Jiaotong University, Beijing, People's Republic of China.
Nat Sci Sleep. 2021 Dec 2;13:2125-2135. doi: 10.2147/NSS.S329408. eCollection 2021.
To investigate the impacts of obstructive sleep apnea (OSA) on white matter (WM) integrity and cognitive functions of pediatric patients with different levels of OSA severity.
Fifty-eight children with OSA and thirty-four healthy controls (HC) were recruited. All participants underwent diffusion tensor imaging (DTI) examination, polysomnography (PSG), and neurocognitive assessments. Patients were divided into mild OSA (MG) and moderate-severe OSA (SG) groups. WM integrity, PSG data, and neurocognitive assessment scores were compared among those groups.
For apnea hypopnea index (AHI), obstructive apnea hypopnea index (OAHI), arousal index, SpO nadir, and attention, SG was worse than both MG and HC with MG worse than HC. For baseline SpO and intelligence, SG was worse than both MG and HC with no significant difference between MG and HC. Impaired WM integrity was observed in bilateral anterior thalamic radiation, bilateral inferior fronto-occipital fasciculus, bilateral inferior longitudinal fasciculus, right superior longitudinal fasciculus, right hippocampus, left cingulate gyrus, right uncinate fasciculus, callosum forceps major, and callosum forceps minor only for SG than for HC. WM integrity was significantly correlated with OSA severity and neurocognitive assessment scores only for SG, but not for MG.
Decreased baseline SpO, WM impairment, and intelligence decline were all observed only for SG, but not for MG, implying an associated relationship among decreased SpO, WM impairment and WM impairment. Thus, for SG, additional assessments of brain damage and cognitive function decline are needed for prognostic evaluation of OSA.
探讨阻塞性睡眠呼吸暂停（OSA）对不同严重程度的小儿OSA患者白质（WM）完整性和认知功能的影响。
招募了58名OSA患儿和34名健康对照（HC）。所有参与者均接受了扩散张量成像（DTI）检查、多导睡眠图（PSG）检查和神经认知评估。患者被分为轻度OSA（MG）组和中重度OSA（SG）组。比较了这些组之间的WM完整性、PSG数据和神经认知评估得分。
在呼吸暂停低通气指数（AHI）、阻塞性呼吸暂停低通气指数（OAHI）、觉醒指数、最低血氧饱和度（SpO nadir）和注意力方面，SG组比MG组和HC组差，MG组比HC组差。在基线血氧饱和度（SpO）和智力方面，SG组比MG组和HC组差，MG组和HC组之间无显著差异。仅SG组与HC组相比，在双侧丘脑前辐射、双侧额枕下束、双侧下纵束、右侧上纵束、右侧海马、左侧扣带回、右侧钩束、胼胝体主要钳和胼胝体次要钳观察到WM完整性受损。仅SG组的WM完整性与OSA严重程度和神经认知评估得分显著相关，而MG组则不然。
仅在SG组观察到基线SpO降低、WM损伤和智力下降，而MG组未观察到，这意味着SpO降低、WM损伤和WM损伤之间存在关联。因此，对于SG组，需要额外评估脑损伤和认知功能下降，以进行OSA的预后评估。
