Gender Differences in Neural Deficits Associated with Obstructive Sleep Apnea

描述（由申请人提供）：阻塞性睡眠呼吸暂停（OSA）困扰着美国2000万成年人，并与发病率和死亡率增加有关。男性和女性在发病率和合并症方面的主要差异知之甚少。然而，在初步研究中，我们发现与OSA相关的神经损伤的位置和范围存在性别差异。由于大脑的变化发生与阻塞性睡眠呼吸暂停可能有助于生理和神经心理学特征，男性和女性的差异可以解释一些性别差异的障碍。在尝试将神经变化与健康状况的综合指标联系起来之前，我们的目标是验证与OSA相关的神经损伤的性别差异。我们将评估64名患有和不患有OSA的受试者，男性和女性平均分配;所有OSA受试者将最近被诊断为睡眠障碍并未接受治疗。我们将评估全脑结构与扩散张量成像指数（分数各向异性和平均扩散率），T2弛豫时间，和区域灰质体积的措施，由性别和OSA状态建模，和其他潜在的显着影响（性别，年龄，体重指数）和双向相互作用。我们还将通过贝克抑郁量表II和OSA严重程度（呼吸暂停低通气指数）评估抑郁症状对神经的影响。研究结果将确定哪些大脑区域在与OSA相关的神经损伤中表现出较大的男女差异;受影响的特定结构的功能作用将用于未来的研究，以选择相关的健康状况测量。例如，如果抑郁症相关区域受到影响，后续研究将包括对心理健康状况的全面评估。了解性别在OSA脑损伤中的作用对于了解综合征进展和共病的发展以及考虑男性和女性患者的不同治疗策略非常重要。公共卫生相关性：这项研究将比较患有阻塞性睡眠呼吸暂停（OSA）的男性和女性之间的脑损伤，OSA是一种导致健康状况不佳和过早死亡的睡眠疾病。我们将使用磁共振成像来观察男性的脑损伤是否多于女性。我们将研究与患有OSA的女性而不是男性的问题有关的特定大脑区域，例如抑郁症。如果性别之间在损伤量和大脑中受影响的部位方面存在重要差异，我们未来的研究将着眼于这些大脑变化是否可以解释我们在OSA中看到的男女健康差异。

DESCRIPTION (provided by applicant): Obstructive sleep apnea (OSA) afflicts 20 million adults in the United States, and is associated with increased morbidity and mortality. Major male-female differences in the incidence and co-morbidities of the disorder are poorly understood. However, in preliminary studies, we found gender differences in the location and extend of neural injury associated with OSA. Since brain changes occurring with OSA may contribute to physiologic and neuropsychological characteristics, male-female differences could explain some of the gender differences in the disorder. Before attempting to related neural changes to comprehensive measures of health status, we aim to verify the gender differences in neural injury associated with OSA. We will assess 64 subjects with and without OSA, split evenly between males and females; all OSA subjects will be recently diagnosed and untreated for the sleep disorder. We will assess whole-brain structure with diffusion tensor imaging indices (fractional anisotropy and mean diffusivity), T2 relaxation time, and regional gray matter volume measures, modeled by gender and OSA status, and other potentially significant effects (sex, age, body mass index) and two-way interactions. We will additionally assess neural influences of depressive symptoms as measure by the Beck Depression Inventory-II, and OSA severity (apnea-hypopnea index). The findings will establish which brain areas show large male-female differences in neural injury associated with OSA; the functional roles of the particular structures affected will be used in future studies to select relevant health status measurements. For example, if depression-related regions are affected, follow-on studies will include comprehensive assessment of mental health status. Understanding the role of gender in brain injury occurring with OSA is important for understanding syndrome progression and development of co-morbidities, and for considering different treatment strategies for male and female patients. PUBLIC HEALTH RELEVANCE: This study will compare the brain damage between men and women with Obstructive Sleep Apnea (OSA), a sleep illness that leads to poor health and early death. We will use magnetic resonance imaging to see whether there is more or less brain injury in males than females. We will look at specific brain regions that are related to the problems that women but not men with OSA have, such as depression. If there are important differences between the sexes in the amount of damage, and places in the brain that are affected, our future studies will look to see if those brain changes explain the male-female health differences we see in OSA.