OBSTRUCTIVE SLEEP-APNEA SYNDROME - PATHOGENESIS OF NEUROPSYCHOLOGICAL DEFICITS
OBSTRUCTIVE SLEEP-APNEA SYNDROME - PATHOGENESIS OF NEUROPSYCHOLOGICAL DEFICITS
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DOI：
10.1080/01688639108405110
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发表时间：
1991-11-01
影响因子：
2.2
通讯作者：
MALO, J
中科院分区：
文献类型：
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作者：
BEDARD, MA;MONTPLAISIR, J;MALO, J
阻塞性睡眠呼吸暂停综合征（OSAS）患者存在神经心理学缺陷。夜间低氧血症和白天警觉性受损已被认为是这些缺陷的发病机制，但它仍然很难找到良好的认知缺陷和这些生理参数之间的相关性。在本研究中，10名正常对照组与10名中度和10名重度呼吸暂停患者进行了比较，所有患者均在睡眠实验室连续两晚记录，并在干预期间进行了警惕性和神经心理学评估。与对照组相比，中度和重度OSAS患者在许多认知功能方面存在差异，但重度OSAS患者的差异更大。此外，在后一组中发现正常的测试中，重度呼吸暂停也比中度呼吸暂停更糟糕。这表明随着阻塞性睡眠呼吸暂停综合征的进展，神经心理缺陷的出现是不连续的。进一步的分析显示，一般智力指标以及执行和精神任务的减少都归因于低氧血症的严重程度，而其他注意力和记忆力缺陷则与警惕性受损有关。因此，警觉性障碍和夜间低氧血症可能对OSAS中发现的认知功能障碍有不同的贡献。
Neuropsychological deficits have been documented in patients with obstructive sleep apnea syndrome (OSAS). Both nocturnal hypoxemia and impairment of daytime vigilance have been suggested as the pathogenesis of these deficits, yet it remains difficult to find good correlations between cognitive deficits and either of these physiological parameters. In the present study, 10 normal controls were compared to 10 moderately and 10 severely apneic patients, all recorded in a sleep laboratory for two consecutive nights, with a vigilance and neuropsychological assessment made during the intervening day. Relative to the controls, moderate and severe OSAS showed differences in many cognitive functions, although the severely affected showed the greater differences. Moreover, severe apneics were also worse than moderate apneics on tests that were found to be normal in the latter group. This suggests a discontinuity in the appearance of neuropsychological deficits as OSAS progresses. Further analyses revealed that reductions in general intellectual measures, as well as in executive and psychomotor tasks were all attributable to the severity of hypoxemia, while other attention and memory deficits were related to vigilance impairment. Therefore, both vigilance impairment and nocturnal hypoxemia may differentially contribute to the cognitive dysfunctions found in OSAS.