Aberrant spontaneous low-frequency brain activity in male patients with severe obstructive sleep apnea revealed by resting-state functional MRI.
Aberrant spontaneous low-frequency brain activity in male patients with severe obstructive sleep apnea revealed by resting-state functional MRI.
复制标题
静息态功能 MRI 显示患有严重阻塞性睡眠呼吸暂停的男性患者异常自发低频脑活动
DOI：
10.2147/ndt.s73730
复制
发表时间：
2015
影响因子：
3.2
通讯作者：
Peng DC
中科院分区：
文献类型：
--
作者：
Li HJ;Dai XJ;Gong HH;Nie X;Zhang W;Peng DC
背景：以往大多数神经影像学研究表明阻塞性睡眠呼吸暂停（OSA）患者存在结构和功能异常。然而，很少有研究集中在区域强度的自发波动在休息状态下，异常属性和行为表现之间的关系。本研究应用低频波动幅度（ALFF）方法探讨阻塞性睡眠呼吸暂停（OSA）患者脑自发活动的局部特征。方法25例未接受治疗的重度睡眠呼吸暂停综合征患者和25例年龄和受教育年限相匹配的睡眠良好者（GS）。ALFF方法用于评估自发脑活动的局部特征。用受试者工作特征曲线分析ALFF改变区的平均信号值。采用偏相关分析探讨不同区域的平均ALFF值与行为表现之间的关系。结果与GS组相比，OSA组的体重指数、呼吸暂停低通气指数、动脉血氧饱和度<90%、觉醒指数、埃普沃思嗜睡量表（ESS）评分均显著升高，而快动眼睡眠和蒙特利尔认知评定量表（莫卡）评分显著降低。与GS相比，OSAs在右侧楔前叶和双侧扣带回后部的ALFF区明显降低，在左侧额下回的ALFF区明显升高。较低和较高ALFF面积的曲线下面积值分别为0.90和0.93。进一步的诊断分析表明，这两个聚类的敏感性和特异性分别为80%和92%。低ALFF组的平均信号值与最低血氧饱和度（r=0.447，P=0.025）和莫卡评分（r =0.405，P=0.045）呈显著正相关。结论阻塞性睡眠呼吸暂停综合征可能与额叶默认模式网络功能障碍和适应性代偿反应有关，反映了认知功能障碍的病理生理机制。
Background The majority of previous neuroimaging studies have demonstrated both structural and functional abnormalities in obstructive sleep apnea (OSA). However, few studies have focused on the regional intensity of spontaneous fluctuations during the resting state and the relationship between the abnormal properties and the behavioral performances. In the present study, we employed the amplitude of low-frequency fluctuation (ALFF) method to explore the local features of spontaneous brain activity in OSA patients (OSAs). Methods Twenty-five untreated male severe OSAs and 25 age-matched and years-of-education-matched male good sleepers (GSs) were included in this study. The ALFF method was used to assess the local features of spontaneous brain activity. The mean signal values of the altered ALFF areas were analyzed with receiver operating characteristic curve. Partial correlation analysis was used to explore the relationship between the observed mean ALFF values of the different areas and the behavioral performances. Results Compared with GSs, OSAs had significantly higher scores for body mass index, apnea–hypopnea index, arterial oxygen saturation <90%, arousal index, and Epworth Sleepiness Scale (ESS) score; furthermore, OSAs had significantly lower scores for rapid eye movement sleep and in the Montreal Cognitive Assessment (MoCA). Compared with GSs, OSAs showed significant lower-ALFF areas in the cluster of the right precuneus and bilateral posterior cingulate gyrus, as well as a higher-ALFF area in the left inferior frontal gyrus. The area under the curve values of the lower- and higher-ALFF areas were 0.90 and 0.93, respectively. Further diagnostic analysis exhibited that the sensibility and specificity of the two clusters were 80% and 92%, respectively. The mean signal value of the lower-ALFF cluster displayed significant positive correlations with lowest oxygen saturation (r=0.447, P=0.025) and MoCA score (r =0.405, P=0.045). Conclusion OSAs may involve in a dysfunction in the default mode network and an adaptive compensatory response in the frontal lobe, which reflect the underlying pathophysiology of cognitive impairment.