Department of Neurology, Seoul Metropolitan Government Seoul National University Boramae Medical Center, Seoul National University College of Medicine, Seoul, South Korea.
Department of Neurology, USC Stevens Neuroimaging and Informatics Institute, Keck School of Medicine, University of Southern California, Los Angeles, California, USA.
Hum Brain Mapp. 2023 Jun 1;44(8):3045-3056. doi: 10.1002/hbm.26261. Epub 2023 Mar 10.
Obstructive sleep apnea (OSA) may lead to white mater (WM) disruptions and cognitive deficits. However, no studies have investigated the full extent of the brain WM, and its associations with cognitive deficits in OSA remain unclear. We thus applied diffusion tensor imaging (DTI) tractography with multi-fiber models and used atlas-based bundle-specific approach to investigate the WM abnormalities for various tracts of the cerebral cortex, thalamus, brainstem, and cerebellum in patients with untreated OSA. We enrolled 100 OSA patients and 63 healthy controls. Fractional anisotropy (FA) and mean diffusivity (MD) values mapped on 33 regions of interest including WM tracts of cortex, thalamus, brainstem, and cerebellum were obtained from tractography-based reconstructions. We compared FA/MD values between groups and correlated FA/MD with clinical data in the OSA group after controlling for age and body mass index. OSA patients showed significantly lower FA values in multiple WM fibers including corpus callosum, inferior fronto-occipital fasciculus, middle/superior longitudinal fasciculi, thalamic radiations, and uncinate (FDR <0.05). Higher FA values were found in medial lemniscus of patients compared to controls (FDR <0.05). Lower FA values of rostrum of corpus callosum correlated with lower visual memory performance in OSA group (p < .005). Our quantitative DTI analysis demonstrated that untreated OSA could negatively impact the integrity of pathways more broadly, including brainstem structures such as medial lemniscus, in comparison to previous findings. Fiber tract abnormalities of the rostral corpus callosum were associated with impaired visual memory in untreated OSA may provide insights into the related pathomechanism.
阻塞性睡眠呼吸暂停（OSA）可能导致白质（WM）中断和认知功能障碍。然而，目前还没有研究调查脑 WM 的全部范围，以及其与 OSA 认知缺陷的关系仍不清楚。因此，我们应用扩散张量成像（DTI）纤维束追踪技术和基于图谱的束特异性方法，研究了未经治疗的 OSA 患者大脑皮质、丘脑、脑干和小脑的各种脑 WM 异常。我们纳入了 100 名 OSA 患者和 63 名健康对照者。从基于纤维束追踪的重建中获得了包括皮质、丘脑、脑干和小脑 WM 束在内的 33 个感兴趣区的各向异性分数（FA）和平均弥散度（MD）值。我们比较了两组间的 FA/MD 值，并在控制年龄和体重指数后，在 OSA 组中比较了 FA/MD 值与临床数据的相关性。OSA 患者在包括胼胝体、下额枕束、中/上纵束、丘脑辐射和钩束在内的多个 WM 纤维中的 FA 值显著降低（FDR<0.05）。与对照组相比，患者的内侧丘系 FA 值更高（FDR<0.05）。与对照组相比，OSA 组患者胼胝体嘴部的 FA 值较低与视觉记忆功能较差有关（p<0.005）。我们的定量 DTI 分析表明，与之前的研究相比，未经治疗的 OSA 可能会对更广泛的通路完整性产生负面影响，包括内侧丘系等脑干结构。未治疗的 OSA 患者的胼胝体前部纤维束异常与视觉记忆受损有关，这可能为相关的病理机制提供了一些见解。
