Sleep and respiratory stimulus specific dampening of cortical responsiveness in OSAS
Sleep and respiratory stimulus specific dampening of cortical responsiveness in OSAS
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DOI：
10.1016/s1569-9048(03)00084-3
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发表时间：
2003-07-16
影响因子：
2.3
通讯作者：
Colrain, IM
中科院分区：
文献类型：
--
作者：
Afifi, L;Guilleminault, C;Colrain, IM
吸气闭塞刺激的应用会产生称为呼吸相关诱发电位(RREPs)的皮质反应。在清醒时，RREP波形由早期的P1和NF成分、N1和P300组成。在非REM睡眠中，主要成分是N550，最明显的是诱发的K-复合体的平均值。阻塞性睡眠呼吸暂停综合征(OSAS)患者此前已被证明觉醒RREP正常，但N550波幅降低，K-复合体诱发比例较小。本研究通过评估OSAS患者和对照组清醒和非REM睡眠期间的呼吸和听觉诱发电位(AEP)，检验了这一假设，即这反映了与吸气努力相关的刺激所特有的睡眠特异性抑制。听觉音调在清醒时以奇怪的顺序呈现，而在第二阶段睡眠时呈现为单调的序列。在清醒和第二阶段睡眠中，每隔三到五次呼吸，也会出现吸气性闭塞，通过nCPAP面罩进行500毫秒的封堵。数据来自10名OSAS患者和10名对照。觉醒时听觉N1、P3和呼吸P1、Nf、N1、P3成分的波幅无显著差异。对于第二阶段睡眠中出现的听觉刺激，听觉N550的幅度和诱发的K-复合体的比例在不同组之间没有差异。OSAS组呼吸N550和K-复合体诱发率均显著降低，而面罩阻断压反应无明显差异。结果证实，对吸气性闭塞的大脑皮质反应迟钝，这是睡眠特有的。在对听觉刺激的反应方面没有显著的群体差异，这突出表明OSAS患者中与睡眠相关的差异是与吸气努力相关刺激的处理有关的。(C)2003 Elsevier Science B.V.保留所有权利。
The application of inspiratory occlusion stimuli produces cortical responses called respiratory-related evoked potentials (RREPs). During wakefulness the RREP waveform consists of early P1 and Nf components, an N1 and a P300. During non-REM sleep the predominant component is an N550, best seen in the averages of elicited K-complexes. Obstructive sleep apnea syndrome (OSAS) patients have been previously shown to have a normal wake RREP but to have a reduced amplitude N550 and a smaller proportion of elicited K-complexes than controls. The present study tested the hypothesis that this reflects a sleep-specific dampening peculiar to inspiratory effort-related stimuli, by assessing both respiratory and auditory evoked potentials (AEPs) during wakefulness and non-REM sleep in OSAS patients and controls. Auditory tones were presented in an oddball sequence during wakefulness and as a monotonous series during stage 2 sleep. Inspiratory occlusions, delivered for 500 msec via an nCPAP mask were also presented during wakefulness and stage 2 sleep, every three to five breaths. Data were collected from ten OSAS patients and ten controls. There were no significant differences in the amplitudes of the auditory N1 and P3 or the respiratory P1, Nf, N1 or P3 components during wakefulness. The amplitude of the auditory N550 and the proportion of elicited K-complexes did not differ between groups for auditory stimuli presented during stage 2 sleep. The respiratory N550 and K-complex elicitation rate were both significantly reduced in the OSAS group, despite there being no differences in the mask occlusion pressure response to the occlusion. The results confirm a blunted cortical response to inspiratory occlusions that is specific to sleep. The absence of significant group differences in the responses to auditory stimuli highlight that the sleep-related differences seen in OSAS patients are specific to the processing of inspiratory effort related stimuli. (C) 2003 Elsevier Science B.V. All rights reserved.