Brain morphology associated with obstructive sleep apnea
Brain morphology associated with obstructive sleep apnea
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DOI：
10.1164/rccm.200201-050oc
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发表时间：
2002-11-15
影响因子：
24.7
通讯作者：
Harper, RM
中科院分区：
文献类型：
--
作者：
Macey, PM;Henderson, LA;Harper, RM
阻塞性睡眠呼吸暂停(OSA)的特征是反复出现低氧、高碳酸血症和一过性血压升高，这些发作可能损害或改变神经结构。大脑结构不发达或先前存在的脑区损伤也可能是导致该综合征的原因之一。使用高分辨率T1加权磁共振成像评估了21名阻塞性睡眠呼吸暂停综合征患者和21名对照受试者的脑形态。以大约1毫米(3)的体素获得三维脑图像。图像被空间归一化并分割为灰质、白质和脑脊液。对于每个节段，使用基于体素的形态计量学，确定与年龄、利手和组(OSA患者和对照组)相关的局部体积差异，并根据疾病严重程度加权OSA影响。在对照组中，年龄对总灰质有显著的影响，而在阻塞性睡眠呼吸暂停综合征患者中则没有。阻塞性睡眠呼吸暂停综合征患者大脑的多个部位，包括额叶和顶叶皮质、颞叶、前扣带回、海马体和小脑，局部灰质丢失明显减少，通常是单侧灰质丢失。单侧血流灌注良好的结构丢失提示阻塞性睡眠呼吸暂停综合征早期出现神经功能障碍。灰质丢失发生在参与上呼吸道运动调节的部位以及有助于认知功能的区域。
Obstructive sleep apnea (OSA) is characterized by repeated occurrences of hypoxic, hypercapnic, and transient blood pressure elevation episodes that may damage or alter neural structures. Underdeveloped structures or pre-existing damage in brain areas may also contribute to the genesis of the syndrome. Brain morphology in 21 patients with OSA and in 21 control subjects was assessed using high-resolution T1-weighted magnetic resonance imaging. Three-dimensional brain images were obtained with voxels of approximately 1 mm(3). Images were spatially normalized and segmented into gray matter, white matter, and cerebrospinal fluid. For each segment, regional volumetric differences were determined relative to age, handedness, and group (patients with OSA versus control subjects), using voxel-based morphometry, with OSA effects weighted by disease severity. A significant age effect on total gray matter was found in control subjects but not in patients with OSA. Diminished regional and often unilateral gray matter loss was apparent in multiple sites of the brain in patients with OSA, including the frontal and parietal cortex, temporal lobe, anterior cingulate, hippocampus, and cerebellum. Unilateral loss in well-perfused structures suggests onset of neural deficits early in the OSA syndrome. The gray matter loss occurs within sites involved in motor regulation of the upper airway as well as in areas contributing to cognitive function.