High Field Magnetic Resonance Evaluation of Cerebral and Brainstem Dysfunction in Obstructive Sleep Apnea.

背景：阻塞性睡眠呼吸暂停（OSA）是一种睡眠期间反复发生上呼吸道阻塞的情况。这种情况发生在易受影响的病人身上，通常保持上呼吸道开放的肌肉随着睡眠的开始而放松。在这些呼吸中断（呼吸暂停）期间，氧气水平会显著下降，并导致从睡眠中反复醒来。患有睡眠呼吸暂停的患者在白天常常感到困倦，并且在复杂或无聊的任务上难以集中注意力。磁共振成像（MRI）技术的最新改进使得可以瞄准大脑的非常小的区域，例如脑干，大脑中控制上呼吸道肌肉的区域。核磁共振成像可以检测到脑细胞受损的细微迹象，并可以评估由任务引起的大脑激活，比如移动舌头。目的1。通过MRI扫描确定OSA患者脑细胞损伤的存在和模式。2. 为了检查那些受伤最严重的病人是否也有最严重的困倦和注意力不集中的问题。3. 以确定这些脑部异常是否在OSA治疗6个月后有所改善。4. 评估阻塞性睡眠呼吸暂停患者清醒时的脑干活动，并将其与非阻塞性睡眠呼吸暂停患者的活动进行比较。意义：本项目将促进我们对阻塞性睡眠呼吸暂停的病因的理解。我们期望这将为研究这种疾病的脑细胞损伤提供一种新的方法。这也将为研究阻塞性睡眠呼吸暂停的原因和评估旨在增强上气道肌肉活动和防止睡眠阻塞的新疗法提供新的手段。

BACKGROUND: Obstructive Sleep Apnea (OSA) is a condition where repetitive obstruction of the upper airway occurs during sleep. This occurs in susceptible patients when the muscles which normally hold the upper airway open relax with sleep onset. During these interruptions to breathing (apneas) oxygen levels can fall significantly and repetitive awakenings from sleep result. Patients with sleep apnea are often sleepy during the day and experience difficulties with concentration on complex or boring tasks. Recent improvements in magnetic resonance imaging (MRI) technology allow targeting very small areas of the brain, such as the brainstem, the region of the brain which contols the upper airway muscles. MRI can detect subtle signs of damage to brain cells, and can assess brain activation induced by a task, such as moving the tongue . AIM 1. To identify the presence and patterns of damage to brain cells in patients with OSA by MRI scanning. 2. To examine whether patients with the most severe patterns of injury are also those with the greatest difficulties with sleepiness and concentration. 3. To determine whether these brain abnormalities improve after 6 months of treatment of OSA. 4. To assess activity of the brainstem in wakefulness in OSA patients and compare this to the activity in subjects without OSA. SIGNIFICANCE: This project will advance our understanding of the causes of obstructive sleep apnea. We anticipate it will provide a new method for investigating injury to brain cells in this disease. It will also provide a new means for investigating the causes of OSA and for evaluating novel therapies aimed at enhancing the activity of upper airway muscles and preventing obstruction during sleep.