Obstructive Sleep Apnea Risk Is Associated with Cognitive Impairment after Controlling for Mild Traumatic Brain Injury History: A Chronic Effects of Neurotrauma Consortium Study.
Obstructive Sleep Apnea Risk Is Associated with Cognitive Impairment after Controlling for Mild Traumatic Brain Injury History: A Chronic Effects of Neurotrauma Consortium Study.
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DOI：
10.1089/neu.2019.6916
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发表时间：
2020-12-01
影响因子：
4.2
通讯作者：
Nakase-Richardson R
中科院分区：
文献类型：
--
作者：
Garcia A;Reljic T;Pogoda TK;Kenney K;Agyemang A;Troyanskaya M;Belanger HG;Wilde EA;Walker WC;Nakase-Richardson R
睡眠障碍对轻度创伤性脑损伤（mTBI）后持续认知症状的影响尚不清楚。阻塞性睡眠呼吸暂停 (OSA) 非常常见，但其发生 OSA 的危险因素与有 mTBI 病史的认知能力之间的关系尚未得到研究。目前的研究对参加神经创伤慢性影响联盟 (CENC) 前瞻性多中心研究的 391 名经历过战斗的 911 事件后退伍军人和现役军人（中位年龄≥37 岁）进行了 OSA 风险水平及其与认知表现的关联。参与者包括患有和不患有 mTBI 的人（n = 分别为 326 和 65）。当使用临床临界点时，有 mTBI 病史的人更有可能被归类为 OSA 高风险（mTBI 阳性 = 65% vs. mTBI 阴性 = 51%）。在调整 TBI 状态和人口统计学变量后，OSA 风险的增加与复杂处理速度和执行功能（韦克斯勒成人智力量表第四版编码，跟踪测试，B 部分）测量的较差表现以及更大的症状负担（神经行为症状清单）显着相关。因此，OSA 作为一种可改变的行为健康因素，可能有助于 mTBI 后的认知表现。因此，OSA 可作为改善损伤后临床和认知结果的潜在干预点。
The contribution of sleep disturbance to persistent cognitive symptoms following a mild traumatic brain injury (mTBI) remains unclear. Obstructive sleep apnea (OSA) is very common, yet its relationship between risk factors for developing OSA and cognitive performance in those with history of mTBI has not been investigated. The current study examined OSA risk levels and its association with cognitive performance in 391 combat-exposed, post-911 veterans and service members (median age = 37 years) enrolled in the Chronic Effects of Neurotrauma Consortium (CENC) prospective multi-center study. Participants included those with and without mTBI (n = 326 and 65, respectively). When using clinical cut-offs, those with history of mTBI were more likely to be categorized as high risk for OSA (mTBI positive = 65% vs. mTBI negative = 51%). After adjustment for TBI status and demographic variables, increased OSA risk was significantly associated with worse performance on measures of complex processing speed and executive functioning (Wechsler Adult Intelligence Scale Fourth Edition Coding, Trail Making Test, part B) and greater symptom burden (Neurobehavioral Symptom Inventory). Thus, OSA, a modifiable behavioral health factor, likely contributes to cognitive performance following mTBI. Accordingly, OSA serves as a potential point of intervention to improve clinical and cognitive outcomes after injury.
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