The association between sleepiness and cognitive dysfunction and brain micro-morphological change in obstructive sleep apnea syndrome

我们测量了严重阻塞性睡眠呼吸暂停综合征（sOSAS）患者的认知和情绪障碍，并研究了这些认知和情绪障碍与睡眠期间呼吸指数之间的相关性。此外，我们应用基于体素的统计方法，通过SPM 8-回归的FA/ADC图和灰色/白色物质图像来估计睡眠期间sOSAS的脑微结构变化与呼吸指数之间的相关性。因此，主观白天嗜睡只与动机相关，只有最低的SpO 2影响认知障碍。影像学研究中，最低SpO 2与FA/ADC图和白色像中对较高认知功能起重要作用的额内侧区和额下区以及含有许多维持觉醒功能核团的脑干呈正相关。海马旁区灰质浓度与最低SpO 2呈正相关。结论：低氧入侵引起的低SpO 2可能是认知功能损害的原因，低氧入侵引起的神经轴突微结构改变可能是认知功能损害的主要原因。

We measured cognitive and emotional impairment of the patients suffered severe obstructive sleep apnea syndrome(sOSAS), and investigated the correlation between these cognitive and emotional impairment and respiratory index during sleep. Additionally, we applied the voxel-based statistic approach by SPM8-regression for FA/ADC maps and gray/white matter images to estimate the correlation between brain microstructural changes of sOSAS and respiratory index during sleep. As a results, subjective daytime sleepiness was only associated with motivation and only lowest SpO2 affected on cognitive impairment. In imaging study, lowest SpO2 showed positive correlation with medial and inferior frontal area where are important for higher cognitive function and brain-stem containing many nuclei for arousal maintaining function in FA/ADC maps and white matter image. The gray matter concentration in parahippocampal area was also affected positive correlation with lowest SpO2. As a conclusion, lower SpO2 (hypoxia invasion) might cause the cognitive impairment and this impairment would be caused by neural axonal microstructural changes by hypoxia invasion.