Cerebral metabolic impairment in patients with obstructive sleep apnoea: an independent association of obstructive sleep apnoea with white matter change
Cerebral metabolic impairment in patients with obstructive sleep apnoea: an independent association of obstructive sleep apnoea with white matter change
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DOI：
10.1136/jnnp.71.3.334
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发表时间：
2001-09-01
影响因子：
11
通讯作者：
Chen, W
中科院分区：
文献类型：
--
作者：
Kamba, M;Inoue, Y;Chen, W
目的探讨阻塞性睡眠呼吸暂停（OSA）的严重程度与脑代谢损害程度之间的关系。方法55例习惯性打鼾和白天过度嗜睡的患者分别接受标准的夜间多导睡眠图和磁共振波谱检查。用二维化学位移成像（重复时间; 1500 ms，回波时间; 135 ms）测量质子AIR谱。通过大脑皮层和白色物质的N-乙酰天冬氨酸（NAA）/胆碱比值评估脑代谢障碍的严重程度。通过呼吸暂停低通气指数（ABI）和外周血氧饱和度最小值评估OSA的严重程度。对所有患者是否存在合并症进行评价，包括高血压、心脏病、糖尿病和糖尿病。结果单因素方差分析显示AHI、年龄、有无高血压对脑白色物质NAA/胆碱比值有显著影响（分别为p = 0.011、p = 0.028、p = 0.0496）。在最终的多变量回归模型中，AHI与大脑白色物质的NAA/胆碱比值呈显著负相关，与年龄和是否存在心脏病无关（标准化偏回归系数=-0.417，p < 0.001）。OSA的严重程度与大脑皮质NAA/胆碱比值无明显关系。单变量方差分析显示年龄对大脑皮层的NAA/胆碱比率有显著影响（p < 0.001），回归模型显示年龄与大脑皮层的TNAA/胆碱比率呈显著负相关（r =-0.552，p < 0.001）。
Objectives To determine the relation between severity of obstructive sleep apnoea (OSA) and degree of cerebral metabolic impairment.Methods-Fifty five patients with habitual snoring and excessive daytime sleepiness underwent standard overnight polysomnography and magnetic resonance spectroscopy separately. Proton AIR spectra were measured with two dimensional chemical shift imaging (repetition time; 1500 ms, echo time; 135 ms). Severity of cerebral metabolic impairment was assessed by the N-acetylaspartate, (NAA)/choline ratios for the cerebral cortex and white matter. Severity of OSA was assessed by the apnoea-hypopnoea index (ABI) and the minimum value of peripheral oxyhaemoglobin saturation. All patients were evaluated for the presence or absence of comobidities including hypertension, cardiac disease, diabetes mellitus, and hyperlipidaemia. Univariate analysis of variance (ANOVA) and mulitple linear regression analysis were used for statistical analyses.Results-Univariate ANOVA disclosed significant effects of AHI, age, and the presence or absence of hypertension on the NAA/choline ratio for cerebral white matter (p = 0.011, p = 0.028, p = 0.0496, respectively). The AHI had a significant negative association with the NAA/choline ratio for cerebral white matter, independent of age and the presence or absence of cardiac disease, in the final multivariate regression model (standardised partial regression coefficient = -0.417, p < 0.001). No significant relation was found between severity of OSA and the NAA/choline ratio for the cerebral cortex. Age alone had a significant effect on the NAA/choline ratio for the cerebral cortex on univariate ANOVA (p < 0.001) and a significant negative association with the TNAA/choline ratio for the cerebral cortex in the regression model (r = -0.552, p < 0.001).Conclusions-A significant relation exists between AM and the degree of metabolic impairment in cerebral white matter in patients with OSA.