Evaluation of brain white matter changes on MRI in patients newly diagnosed with obstructive sleep apnea compared with the control group

Abstract

Obstructive sleep apnea (OSA) is nowadays introduced as a risk factor for white matter brain changes. Research on OSA and white matter changes provides contradictory evidence for the contextual link between the two conditions. This study aimed to determine the prevalence and severity of OSA and changes in the brain's white matter and the relationship between severity levels of both diseases. This was a cross-sectional study in which 40 patients with OSA and 40 patients without OSA underwent polysomnography to determine the severity of OSA and MRI for detecting white matter changes. The severity of white matter changes was classified according to the age-related white matter change (ARWMC) score, and the severity of OSA based on the apnea–hypopnea index (AHI). To evaluate the independent effect of OSA on white matter changes, a multivariate regression model, including the severity of OSA and risk factors, was used. 76.5% of affected people did not show any changes, and from 13 (32.5%) patients with OSA who experienced white matter changes, 10% were mild, and 22.5% were moderate to severe changes. The white matter changes score increased with increasing OSA severity. The univariate analysis also showed a significant positive correlation between OSA severity and ARWMC score. Our major finding was that moderate to severe OSA was independently associated with the prevalence of white matter changes. We also observed a higher prevalence of moderate to severe OSA associated with increasing white matter changes, suggesting that the severity of the disease affects brain structural modification.