Effects of 3-month CPAP therapy on brain structure in obstructive sleep apnea: A diffusion tensor imaging study.
Effects of 3-month CPAP therapy on brain structure in obstructive sleep apnea: A diffusion tensor imaging study.
复制标题
3 个月的 CPAP 治疗对阻塞性睡眠呼吸暂停患者大脑结构的影响：弥散张量成像研究。
DOI：
10.3389/fneur.2022.913193
复制
发表时间：
2022
影响因子：
3.4
通讯作者：
中科院分区：
文献类型：
--
作者：
阻塞性睡眠呼吸暂停(OSA)患者脑白质(WM)纤维改变与认知功能障碍有关，持续气道正压治疗(CPAP)可减轻认知功能障碍。本研究旨在探讨阻塞性睡眠呼吸暂停综合征(OSA)患者CPAP治疗前(CPAP前)和CPAP治疗后3个月(CPAP后)WM的变化，为了解OSA患者CPAP治疗后WM改变的可逆性变化提供依据。对20例严重未经治疗的阻塞性睡眠呼吸暂停综合征患者和20例睡眠良好者进行了磁共振成像(MRI)检查。使用基于轨迹的空间统计学方法计算WM的分数各向异性(FA)、平均扩散系数、轴向扩散系数和径向扩散系数(RD)。为评价治疗效果，20例CPAP前阻塞性睡眠呼吸暂停综合征患者在3个月后再次行MRI检查。对WM损伤与临床评分的关系进行相关分析。与睡眠良好者相比，阻塞性睡眠呼吸暂停综合征患者丘脑前部放射、钳夹、额枕下束、下纵束、上纵束FA降低，RD增加，钩束、皮质脊髓束、扣带回FA降低(P<；0.05)。CPAP后OSA患者的WM与CPAP前相比无明显变化。未经治疗的阻塞性睡眠呼吸暂停患者的WM异常改变与血氧饱和度、蒙特利尔认知评分和呼吸暂停低通气指数有关。重度阻塞性睡眠呼吸暂停患者WM纤维广泛改变，与认知功能障碍有关。同时，短期CPAP治疗后认知功能恢复并不伴随WM微观结构的可逆性改变。
White matter (WM) fiber alterations in patients with obstructive sleep apnea (OSA) is associated with cognitive impairment, which can be alleviated by continuous positive airway pressure (CPAP). In this study, we aimed to investigate the changes in WM in patients with OSA at baseline (pre-CPAP) and 3 months after CPAP adherence treatment (post-CPAP), and to provide a basis for understanding the reversible changes after WM alteration in this disease. Magnetic resonance imaging (MRI) was performed on 20 severely untreated patients with OSA and 20 good sleepers. Tract-based spatial statistics was used to evaluate the fractional anisotropy (FA), mean diffusion coefficient, axial diffusion coefficient, and radial diffusion coefficient (RD) of WM. To assess the efficacy of treatment, 20 patients with pre-CPAP OSA underwent MRI again 3 months later. A correlation analysis was conducted to evaluate the relationship between WM injury and clinical evaluation. Compared with good sleepers, patients with OSA had decreased FA and increased RD in the anterior thalamic radiation, forceps major, inferior fronto-occipital tract, inferior longitudinal tract, and superior longitudinal tract, and decreased FA in the uncinate fasciculus, corticospinal tract, and cingulate gyrus (P < 0.05). No significant change in WM in patients with post-CPAP OSA compared with those with pre-CPAP OSA. Abnormal changes in WM in untreated patients with OSA were associated with oxygen saturation, Montreal cognitive score, and the apnea hypoventilation index. WM fiber was extensively alteration in patients with severe OSA, which is associated with cognitive impairment. Meanwhile, cognitive recovery was not accompanied by reversible changes in WM microstructure after short-term CPAP therapy.
登录
查看更多内容
频率——短期持续气道正压通气治疗前后阻塞性睡眠呼吸暂停的特定区域均匀性改变和认知功能
影响因子：
3.4
作者：
Li H;Li L;Kong L;Li P;Zeng Y;Li K;Xie W;Shu Y;Liu X;Peng D
通讯作者：
Peng D
影响因子：
3.4
作者：
Lee MH;Lee SK;Thomas RJ;Yoon JE;Yun CH;Shin C
通讯作者：
Shin C
影响因子：
6.3
作者：
Blackwell T;Yaffe K;Laffan A;Redline S;Ancoli-Israel S;Ensrud KE;Song Y;Stone KL;Osteoporotic Fractures in Men Study Group
通讯作者：
Osteoporotic Fractures in Men Study Group
影响因子：
4.7
作者：
Backhaus, J;Junghanns, K;Hohagen, F
通讯作者：
Hohagen, F
影响因子：
6.3
作者：
Chen, Ke-Liang;Xu, Yan;Guo, Qi-Hao
通讯作者：
Guo, Qi-Hao