阻塞性睡眠呼吸暂停患者的脑微观结构异常及相关神经认知功能障碍：一项基于扩散峰度成像的初步研究。

Microstructural brain abnormalities and associated neurocognitive dysfunction in obstructive sleep apnea: a pilot study with diffusion kurtosis imaging.

机构信息

Department of Radiology, The Sixth Hospital of Shanxi Medical University (General Hospital of TISCO), Taiyuan, People's Republic of China.

GE Healthcare, Beijing, People's Republic of China.

出版信息

J Clin Sleep Med. 2024 Oct 1;20(10):1571-1578. doi: 10.5664/jcsm.11184.

DOI:10.5664/jcsm.11184

PMID:38656791

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11446125/

Abstract

STUDY OBJECTIVES

We assessed possible brain abnormalities in adult patients with moderate and severe obstructive sleep apnea using the mean kurtosis (MK) from diffusion kurtosis imaging and analyzed the correlation between MK and cognitive function.

METHODS

A total of 30 patients with moderate or severe obstructive sleep apnea and 30 healthy controls evaluated by the Montreal Cognitive Assessment scale were enrolled. All participants underwent diffusion kurtosis imaging and 3-dimensional T1-weighted imaging on a 3.0T magnetic resonance scanner. The MK values of gray and white matter brain regions were compared. Partial correlation analysis was used to analyze the correlation between respiratory sleep parameters/cognitive score and MK values in different brain regions.

RESULTS

Compared with the healthy controls, the MK of 20 brain regions (13 after false discovery rate correction) and cognitive scores in the obstructive sleep apnea group were significantly lower. In the obstructive sleep apnea group, apnea-hypopnea index was negatively correlated with the MK in the white matter of the right occipital lobe; lowest oxygen saturation was positively correlated with the MK in the bilateral parietal, precentral, and right postcentral cortex; total score on the Montreal Cognitive Assessment scale was positively correlated with MK in the left hippocampus; language function was positively correlated with MK in the white matter of the left parietal lobe; and delayed recall was positively correlated with the MK in right insula cortex and bilateral cingulate. After false discovery rate correction, only the correlations of lowest oxygen saturation with right precentral gyrus cortex and bilateral parietal cortex were significant.

CONCLUSIONS

MK values of diffusion kurtosis imaging may provide valuable information in assessing the neurological impacts of obstructive sleep apnea.

CITATION

Zhang N, Peng K, Guo J-X, Liu Q, Xiao A-L, Jing H. Microstructural brain abnormalities and associated neurocognitive dysfunction in obstructive sleep apnea: a pilot study with diffusion kurtosis imaging. 2024;20(10):1571-1578.

摘要

研究目的

我们通过扩散峰度成像中的平均峰度（MK）评估了中重度阻塞性睡眠呼吸暂停患者的大脑可能存在的异常，并分析了 MK 与认知功能之间的相关性。

方法

共纳入 30 例经蒙特利尔认知评估量表评估为中重度阻塞性睡眠呼吸暂停的患者和 30 例健康对照者。所有参与者均在 3.0T 磁共振扫描仪上接受扩散峰度成像和三维 T1 加权成像。比较了灰质和白质脑区的 MK 值。采用偏相关分析，分析不同脑区的呼吸睡眠参数/认知评分与 MK 值之间的相关性。

结果

与健康对照组相比，阻塞性睡眠呼吸暂停组 20 个脑区（经假发现率校正后为 13 个）的 MK 值和认知评分均显著降低。在阻塞性睡眠呼吸暂停组中，呼吸暂停低通气指数与右侧枕叶白质的 MK 值呈负相关；最低血氧饱和度与双侧顶叶、中央前回和右侧中央后回皮质的 MK 值呈正相关；蒙特利尔认知评估量表总分与左侧海马体的 MK 值呈正相关；语言功能与左侧顶叶白质的 MK 值呈正相关；延迟回忆与右侧岛叶皮质和双侧扣带回的 MK 值呈正相关。经假发现率校正后，仅最低血氧饱和度与右侧中央前回和双侧顶叶皮质的相关性具有统计学意义。