Decoupling of global signal and cerebrospinal fluid inflow is associated with cognitive decline in patients with obstructive sleep apnoea

IF 3.8 2区医学 Q1 CLINICAL NEUROLOGY

Sleep medicine Pub Date : 2025-03-12 DOI:10.1016/j.sleep.2025.03.009

Ying Li , Shiwei Lin , Zheng Guo , Qunjun Liang , Yanyu Zhang , Xiaoshan Lin , Shengli Chen , Fajian Wei , Li Zhu , Shuo Li , Yingwei Qiu

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引用次数: 0

Abstract

Objectives

The role of cortical glymphatic dysfunction in the cognitive impairment of the obstructive sleep apnea (OSA) requires further study. To compare the coupling between the resting-state blood-oxygen-level-dependent (BOLD) signals and cerebrospinal fluid (CSF) signals (BOLD-CSF coupling), a proxy for the cortical glymphatic function, across patients with differing severities of OSA and relate them with disease characteristics and treatment.

Methods

A total of 153 participants (89 OSA patients and 64 matched controls) were prospectively included. OSA patients were classified into three groups (mild, moderate, and severe OSA) according to the apnea-hypopnea index (AHI). All participants underwent neuropsychological assessment and BOLD functional magnetic resonance imaging. BOLD-CSF coupling was assessed at global and regional levels and correlated with the cognitive impairment. Alterations in BOLD-CSF coupling and cognitive performance after treatment were assessed in OSA patients.

Result

Severe OSA patients exhibited weaker global and anterior BOLD-CSF coupling than mild OSA patients, moderate OSA patients, and healthy controls (HCs). Furthermore, the weaker global and anterior BOLD-CSF coupling was associated with poor cognitive performance in all OSA patients. Notably, cognitive performance and cortical glymphatic function improved significantly in patients with OSA after treatment.

Conclusion

Our findings demonstrated cortical glymphatic dysfunction in severe OSA patients, especially in the anterior region of the brain. Cortical glymphatic dysfunction may underlie the cognitive impairment in OSA patients, both of which would improve in OSA patients after treatment.

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来源期刊

Sleep medicine 医学-临床神经学

CiteScore

8.40

自引率

6.20%

发文量

1060

审稿时长

49 days

期刊介绍： Sleep Medicine aims to be a journal no one involved in clinical sleep medicine can do without. A journal primarily focussing on the human aspects of sleep, integrating the various disciplines that are involved in sleep medicine: neurology, clinical neurophysiology, internal medicine (particularly pulmonology and cardiology), psychology, psychiatry, sleep technology, pediatrics, neurosurgery, otorhinolaryngology, and dentistry. The journal publishes the following types of articles: Reviews (also intended as a way to bridge the gap between basic sleep research and clinical relevance); Original Research Articles; Full-length articles; Brief communications; Controversies; Case reports; Letters to the Editor; Journal search and commentaries; Book reviews; Meeting announcements; Listing of relevant organisations plus web sites.