Department of Neuroscience and Addiction Studies, School of Advanced Technologies in Medicine, Tehran University of Medical Sciences, Tehran, Iran.
Department of Medical Sciences, School of Medicine, Iran University of Medical Sciences, Tehran, Iran.
Brain Behav. 2023 Nov;13(11):e3262. doi: 10.1002/brb3.3262. Epub 2023 Sep 24.
Obstructive sleep apnea (OSA) is a common sleep disorder that causes intermittent hypoxia and sleep fragmentation, leading to attention impairment and other cognitive deficits. Magnetic resonance imaging (MRI) is a powerful modality that can reveal the structural and functional brain alterations associated with attention impairment in OSA patients. The objective of this systematic review is to identify and synthesize the evidence on MRI biomarkers and neuropsychological assessments of attention deficits in OSA patients.
We searched the Scopus and PubMed databases for studies that used MRI to measure biomarkers related to attention alteration in OSA patients and reported qualitative and quantitative data on the association between MRI biomarkers and attention outcomes. We also included studies that found an association between neuropsychological assessments and MRI findings in OSA patients with attention deficits.
We included 19 studies that met our inclusion criteria and extracted the relevant data from each study. We categorized the studies into three groups based on the MRI modality and the cognitive domain they used: structural and diffusion tensor imaging MRI findings, functional, perfusion, and metabolic MRI findings, and neuropsychological assessment findings.
We found that OSA is associated with structural, functional, and metabolic brain alterations in multiple regions and networks that are involved in attention processing. Treatment with continuous positive airway pressure can partially reverse some of the brain changes and improve cognitive function in some domains and in some studies. This review suggests that MRI techniques and neuropsychological assessments can be useful tools for monitoring the progression and response to treatment of OSA patients.
阻塞性睡眠呼吸暂停（OSA）是一种常见的睡眠障碍，可导致间歇性缺氧和睡眠碎片化，引起注意力损害和其他认知缺陷。磁共振成像（MRI）是一种强大的模态，可以揭示与 OSA 患者注意力损害相关的结构和功能脑改变。本系统综述的目的是确定并综合关于 MRI 生物标志物和 OSA 患者注意力缺陷的神经心理学评估的证据。
我们在 Scopus 和 PubMed 数据库中搜索了使用 MRI 测量与 OSA 患者注意力改变相关的生物标志物并报告 MRI 生物标志物与注意力结果之间关联的定性和定量数据的研究。我们还包括了在 OSA 患者注意力缺陷中发现神经心理学评估与 MRI 发现之间存在关联的研究。
我们纳入了符合纳入标准的 19 项研究，并从每项研究中提取了相关数据。我们根据 MRI 模态和他们使用的认知域将研究分为三组：结构和弥散张量成像 MRI 发现、功能、灌注和代谢 MRI 发现以及神经心理学评估发现。
我们发现 OSA 与多个涉及注意力处理的区域和网络中的结构、功能和代谢性脑改变相关。持续气道正压通气治疗可部分逆转一些大脑变化，并在一些研究中改善某些领域的认知功能。本综述表明，MRI 技术和神经心理学评估可以作为监测 OSA 患者病情进展和治疗反应的有用工具。
