Yan Xiangbo, Liu Wanqing, Li Danyang, Huang Qiang, Wu Jianlin, Zhang Qing
Imaging Department, Affiliated Zhongshan Hospital Dalian University, Dalian, People's Republic of China.
Faculty of Medicine, Dalian University of Technology, Dalian, People's Republic of China.
Nat Sci Sleep. 2024 Dec 3;16:1869-1880. doi: 10.2147/NSS.S481602. eCollection 2024.
Previous studies have found that obstructive sleep apnea (OSA) can induce cognitive impairment (CI). However, the exact mechanisms of CI development in patients with OSA remains unclear. We investigated the neuropathological basis of CI development by examining changes in cerebral blood perfusion.
Thirty-five patients with untreated OSA (15 with CI and 20 without CI [NCI]) and 15 good sleepers (GS) diagnosed using polysomnography were recruited. All participants underwent resting state brain scans in a Siemens 3.0 Tesla magnetic resonance imaging scanner with a pulsed arterial spin labeling sequence and completed a battery of neuropsychological tests.
Compared to the regional cerebral blood flow (rCBF) values in the GS group, both the CI and NCI groups exhibited lower rCBF values in the bilateral inferior temporal, left lingual, and right medial and paracingulate gyri, as well as higher rCBF values in the bilateral middle frontal gyrus ( < 0.05 in all cases). Compared to the rCBF values in the NCI group, the CI group had lower rCBF values in the bilateral inferior temporal and left lingual gyri, and higher rCBF values in the right rectus and right middle orbital frontal gyri ( < 0.05 in all cases). In the CI group, rCBF values in the bilateral inferior temporal (right, = 0.025; left, = 0.005) and left lingual gyri ( = 0.018) were positively associated with the delayed memory scores, and rCBF values in the left inferior temporal gyrus positively correlated with the attention scores ( = 0.011).
Regions with abnormal perfusion in the NCI and CI groups were mostly memory-related. Blood perfusion in the bilateral inferior temporal and left lingual gyri decreased in the following order: GS > OSA-NCI > OSA-CI. These findings provide blood perfusion-level insights into the neuropathological basis of OSA-CI development.
既往研究发现阻塞性睡眠呼吸暂停（OSA）可诱发认知障碍（CI）。然而，OSA患者发生CI的确切机制仍不清楚。我们通过检查脑血流灌注变化来研究CI发生的神经病理学基础。
招募了35例未经治疗的OSA患者（15例有CI，20例无CI [NCI]）以及15例经多导睡眠图诊断为睡眠良好者（GS）。所有参与者在西门子3.0特斯拉磁共振成像扫描仪中采用脉冲动脉自旋标记序列进行静息态脑扫描，并完成一系列神经心理学测试。
与GS组的局部脑血流量（rCBF）值相比，CI组和NCI组在双侧颞下回、左侧舌回、右侧内侧和扣带旁回的rCBF值均较低，而在双侧额中回的rCBF值较高（所有情况均P<0.05）。与NCI组的rCBF值相比，CI组在双侧颞下回和左侧舌回的rCBF值较低，而在右侧直回和右侧眶额中回的rCBF值较高（所有情况均P<0.05）。在CI组中，双侧颞下回（右侧，P = 0.025；左侧，P = 0.005）和左侧舌回（P = 0.018）的rCBF值与延迟记忆评分呈正相关，左侧颞下回的rCBF值与注意力评分呈正相关（P = 0.011）。
NCI组和CI组灌注异常的区域大多与记忆相关。双侧颞下回和左侧舌回的血流灌注按以下顺序降低：GS>OSA-NCI>OSA-CI。这些发现为OSA-CI发生的神经病理学基础提供了血流灌注水平的见解。
