Li Kunyao, Shu Yongqiang, Liu Xiang, Xie Wei, Li Panmei, Kong Linghong, Yu Pengfei, Zeng Yaping, Huang Ling, Long Ting, Zeng Li, Li Haijun, Peng Dechang
Medical Imaging Center, The First Affiliated Hospital of Nanchang University, Nanchang, China.
Science and Technology Division, Big Data Research Center, The Second Affiliated Hospital of Nanchang University, Nanchang, China.
Front Neurosci. 2022 Aug 26;16:940721. doi: 10.3389/fnins.2022.940721. eCollection 2022.
Previous studies have found that abnormal local spontaneous brain activity in patients with obstructive sleep apnea (OSA) was associated with cognitive impairment, and dynamic functional connections can capture the time changes of functional connections during magnetic resonance imaging acquisition. The purpose of this study was to investigate the dynamic characteristics of regional brain connectivity and its relationship with cognitive function in patients with OSA and to explore whether the dynamic changes can be used to distinguish them from healthy controls (HCs).
Seventy-nine moderate and severe male OSA patients without any treatment and 84 HCs with similar age and education were recruited, and clinical data and resting functional magnetic resonance imaging data were collected. The dynamic regional homogeneity (dReHo) was calculated using a sliding window technique, and a double-sample -test was used to test the difference in the dReHo map between OSA patients and HCs. We explored the relationship between dReHo and clinical and cognitive function in OSA patients using Pearson correlation analysis. A support vector machine was used to classify the OSA patients and HCs based on abnormal dReHo.
Compared with HCs, OSA patients exhibited higher dReHo values in the right medial frontal gyrus and significantly lower dReHo values in the right putamen, right superior temporal gyrus, right cingulate gyrus, left insula and left precuneus. The correlation analysis showed that the abnormal dReHo values in multiple brain regions in patients with OSA were significantly correlated with nadir oxygen saturation, the oxygen depletion index, sleep period time, and Montreal cognitive assessment score. The support vector machine classification accuracy based on the dReHo difference in brain regions was 81.60%, precision was 81.01%, sensitivity was 81.01%, specificity was 82.14%, and area under the curve was 0.89.
The results of this study suggested that there was abnormal dynamic regional spontaneous brain activity in patients with OSA, which was related to clinical and cognitive evaluation and can be used to distinguish OSA patients from HCs. The dReHo is a potential objective neuroimaging marker for patients with OSA that can further the understanding of the neuropathological mechanism of patients with OSA.
既往研究发现，阻塞性睡眠呼吸暂停（OSA）患者局部脑自发活动异常与认知功能障碍有关，动态功能连接能够捕捉磁共振成像采集过程中功能连接的时间变化。本研究旨在探讨OSA患者脑区连接的动态特征及其与认知功能的关系，并探索动态变化是否可用于将其与健康对照（HCs）区分开来。
招募79例未经任何治疗的中重度男性OSA患者和84例年龄及教育程度相近的HCs，收集临床资料和静息态功能磁共振成像数据。采用滑动窗口技术计算动态局部一致性（dReHo），并使用双样本检验来检验OSA患者和HCs之间dReHo图谱的差异。我们采用Pearson相关分析探讨OSA患者dReHo与临床及认知功能之间的关系。基于异常dReHo，使用支持向量机对OSA患者和HCs进行分类。
与HCs相比，OSA患者右侧额内侧回的dReHo值较高，而右侧壳核、右侧颞上回、右侧扣带回、左侧岛叶和左侧楔前叶的dReHo值显著较低。相关分析表明，OSA患者多个脑区的异常dReHo值与最低血氧饱和度、氧耗竭指数、睡眠时间和蒙特利尔认知评估得分显著相关。基于脑区dReHo差异的支持向量机分类准确率为81.60%，精确率为81.01%，灵敏度为81.01%，特异性为82.14%，曲线下面积为0.89。
本研究结果表明，OSA患者存在异常的动态局部脑自发活动，这与临床及认知评估相关，且可用于将OSA患者与HCs区分开来。dReHo是OSA患者潜在的客观神经影像学标志物，有助于进一步理解OSA患者的神经病理机制。
