Sangal R B, Sangal J M
Wayne State University School of Medicine, USA.
Clin Electroencephalogr. 1997 Jan;28(1):16-25. doi: 10.1177/155005949702800104.
This study was conducted to evaluate cognitive abnormalities in obstructive sleep apnea (OSA) using cognitive evoked potentials (P300), and to clarify if such cognitive dysfunction is related to the OSA itself or to the hypersomnolence in OSA. Subjects were administered a polysomnogram, auditory and visual P300 testing using 31 scalp electrodes, and the multiple sleep latency test. There were 40 normal subjects ages 26 to 75. Of 143 consecutive OSA patients ages 26 to 75, 56 had severe OSA (Respiratory Disturbance Index or RDI 40-80/h sleep) with objective somnolence (Mean Sleep Latency < 5 min). Thirty-three had severe OSA without objective somnolence. Fifty-four had profound OSA (RDI > 80/h sleep) with or without objective somnolence. The normals and the three OSA groups did not differ in age. Patients with profound OSA or with severe OSA without somnolence had longer visual P300 latency than normals. The groups also differed in visual P300 latency topography. OSA patients had significantly longer latencies frontally than normals. Thus, OSA, even in the absence of hypersomnolence, is associated with abnormalities in cognitive evoked potentials. Visual P300 latency at frontal electrodes seems to be a neurophysiological index of dysfunction in OSA that is independent of tests of sleepiness.
本研究旨在使用认知诱发电位（P300）评估阻塞性睡眠呼吸暂停（OSA）患者的认知异常情况，并阐明这种认知功能障碍是与OSA本身相关，还是与OSA患者的嗜睡症状相关。研究对象接受了多导睡眠图监测、使用31个头皮电极进行的听觉和视觉P300测试以及多次睡眠潜伏期测试。共有40名年龄在26至75岁之间的正常受试者。在143名年龄在26至75岁之间的连续OSA患者中，56名患有严重OSA（呼吸紊乱指数或RDI为40 - 80次/小时睡眠）且有客观嗜睡症状（平均睡眠潜伏期<5分钟）。33名患有严重OSA但无客观嗜睡症状。54名患有重度OSA（RDI>80次/小时睡眠），伴有或不伴有客观嗜睡症状。正常组与三个OSA组在年龄上无差异。患有重度OSA或患有严重OSA但无嗜睡症状的患者，其视觉P300潜伏期比正常受试者更长。这些组在视觉P300潜伏期地形图上也存在差异。OSA患者额叶部位的潜伏期明显长于正常受试者。因此，即使没有嗜睡症状，OSA也与认知诱发电位异常有关。额叶电极处的视觉P300潜伏期似乎是OSA功能障碍的一个神经生理指标，且独立于嗜睡测试。
