Microstructural Changes in the Cerebral White Matter After 12 Months of CPAP Treatment for Moderate to Severe Obstructive Sleep Apnoea: A TBSS Study

IF 3 2区医学 Q2 CLINICAL NEUROLOGY

Nature and Science of Sleep Pub Date : 2024-05-27 DOI:10.2147/nss.s460919

Xiang Liu, Zhipeng Wei, Long Ting, Xuming Liu, Yongqiang Shu, Huang Ling, Lifeng Li, Yumeng Liu, Guojin Xia, Dechang Peng, Haijun Li

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引用次数: 0

Abstract

Introduction: Continuous positive airway pressure (CPAP) therapy improves clinical symptoms in patients with obstructive sleep apnea (OSA); however, the mechanism of this clinical improvement and how it may be associated with the restoration of white matter (WM) structures in the brain is unclear. Therefore, this study investigated the relationship between the structural recovery of brain WM and improvements in cognitive function and emotion after long-term (12 months) CPAP treatment in patients with OSA.
Methods: We collected data from 17 patients with OSA before and 12 months after CPAP treatment, including sleep monitoring, clinical assessment, and diffusion tensor imaging (DTI) magnetic resonance imaging.
Results: We observed a partial reversible recovery of brain WM (mean and radial diffusion coefficients) after treatment. This recovery involved the commissural fibers (cingulum, body of corpus callosum), projection fibers (retrolenticular part of the internal capsule, posterior thalamic radiation, posterior limb of the internal capsule, superior corona radiata, posterior corona radiata), association fibers (external capsule, superior longitudinal fasciculus, inferior longitudinal fasciculus), and other regions. In addition, the improvements in WM fibers in one part of the brain significantly were correlated with the Hamilton Anxiety Scale and Hamilton Depression Scale scores.
Discussion: Our results suggest that reversible recovery of reduced brain WM integrity due to OSA may require longer CPAP treatment. Moreover, changes in the integrity of the commissural fibers were associated with emotion regulation. These restored WM areas may explain the cognitive and mood improvements observed after OSA treatment.

Keywords: obstructive sleep apnea, continuous positive airway pressure, diffusion tensor imaging, tract-based spatial statistics

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中度至重度阻塞性睡眠呼吸暂停患者接受 12 个月 CPAP 治疗后大脑白质的微结构变化：TBSS 研究

简介：持续气道正压（CPAP）疗法可改善阻塞性睡眠呼吸暂停（OSA）患者的临床症状；然而，这种临床症状改善的机制及其与脑白质（WM）结构恢复之间的关系尚不清楚。因此，本研究调查了 OSA 患者经过长期（12 个月）CPAP 治疗后大脑 WM 结构恢复与认知功能和情绪改善之间的关系：我们收集了 17 名 OSA 患者在 CPAP 治疗前和治疗 12 个月后的数据，包括睡眠监测、临床评估和弥散张量成像（DTI）磁共振成像：我们观察到治疗后大脑 WM（平均扩散系数和径向扩散系数）的部分可逆性恢复。这种恢复涉及神经元纤维（齿状体、胼胝体主体）、投射纤维（内囊后部、丘脑后辐射、内囊后肢、放射状上冠、放射状后冠）、关联纤维（外囊、上纵筋束、下纵筋束）和其他区域。此外，大脑某一部分WM纤维的改善与汉密尔顿焦虑量表和汉密尔顿抑郁量表的评分显著相关：我们的研究结果表明，OSA导致的大脑WM完整性降低的可逆恢复可能需要更长时间的CPAP治疗。此外，神经纤维完整性的变化与情绪调节有关。关键词：阻塞性睡眠呼吸暂停；持续气道正压；弥散张量成像；基于束的空间统计学

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来源期刊

Nature and Science of Sleep Neuroscience-Behavioral Neuroscience

CiteScore

5.70

自引率

5.90%

发文量

245

审稿时长

16 weeks

期刊介绍： Nature and Science of Sleep is an international, peer-reviewed, open access journal covering all aspects of sleep science and sleep medicine, including the neurophysiology and functions of sleep, the genetics of sleep, sleep and society, biological rhythms, dreaming, sleep disorders and therapy, and strategies to optimize healthy sleep. Specific topics covered in the journal include: The functions of sleep in humans and other animals Physiological and neurophysiological changes with sleep The genetics of sleep and sleep differences The neurotransmitters, receptors and pathways involved in controlling both sleep and wakefulness Behavioral and pharmacological interventions aimed at improving sleep, and improving wakefulness Sleep changes with development and with age Sleep and reproduction (e.g., changes across the menstrual cycle, with pregnancy and menopause) The science and nature of dreams Sleep disorders Impact of sleep and sleep disorders on health, daytime function and quality of life Sleep problems secondary to clinical disorders Interaction of society with sleep (e.g., consequences of shift work, occupational health, public health) The microbiome and sleep Chronotherapy Impact of circadian rhythms on sleep, physiology, cognition and health Mechanisms controlling circadian rhythms, centrally and peripherally Impact of circadian rhythm disruptions (including night shift work, jet lag and social jet lag) on sleep, physiology, cognition and health Behavioral and pharmacological interventions aimed at reducing adverse effects of circadian-related sleep disruption Assessment of technologies and biomarkers for measuring sleep and/or circadian rhythms Epigenetic markers of sleep or circadian disruption.