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）是一种在睡眠期间发生上呼吸道反复阻塞的疾病。这发生在易受影响的患者中，当通常保持上呼吸道开放的肌肉随着睡眠开始而放松时。在这些呼吸中断（呼吸暂停）期间，氧气水平可能会显着下降，并导致反复从睡眠中醒来。患有睡眠呼吸暂停的患者通常在白天昏昏欲睡，并且难以集中精力完成复杂或无聊的任务。磁共振成像（MRI）技术的最新改进允许靶向大脑的非常小的区域，例如脑干，控制上呼吸道肌肉的大脑区域。MRI可以检测到脑细胞损伤的细微迹象，并可以评估由任务（如移动舌头）引起的大脑激活。AIM 1.通过MRI扫描确定OSA患者脑细胞损伤的存在和模式。2.检查最严重损伤模式的患者是否也是最难入睡和集中注意力的患者。3.确定这些大脑异常是否在OSA治疗6个月后得到改善。4.评估OSA患者清醒时的脑干活动，并将其与非OSA受试者的活动进行比较。意义：这个项目将促进我们对阻塞性睡眠呼吸暂停的原因的理解。我们预计这将为研究这种疾病对脑细胞的损伤提供一种新的方法。它还将为调查OSA的原因和评估旨在增强上呼吸道肌肉活动和预防睡眠期间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.