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IF 2.1 4区医学 Q3 CLINICAL NEUROLOGY

Sleep and Breathing Pub Date : 2025-03-14 DOI:10.1007/s11325-025-03291-6

Shuan Ke, Tianjing Luo, Yi Ding, Chia-Jung Tang, Zhijun Jie, Joseph Zongen Shen, Danhong Wu, Yong Du

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引用次数: 0

摘要

背景：阻塞性睡眠呼吸暂停（OSA）是一个被忽视的全球性健康问题，如果不及时治疗，可能会导致认知功能障碍（CI），这是 OSA 最严重的后果之一。血管周围间隙增大（EPVS）是一种影像学特征，也是脑小血管疾病的一种亚型，是 CSVD 的组成部分，与认知功能有关，但 EPVS 与 CI 之间的关系以及 OSA 与 EPVS 之间的相关性尚不清楚，CI 在 OSA 和 EPVS 的共同影响下是如何发展的也尚不清楚。本研究旨在探讨 OSA、EPVS 和 CI 之间的关联：这项横断面研究纳入了 2021 年 1 月至 2023 年 6 月期间在上海市第五人民医院接受头颅磁共振成像检查的 175 名具有 EPVS 影像特征并伴有或不伴有其他 CSVD 亚型特征的老年人。我们使用多导睡眠图评估 OSA。采集血样以确定血管风险因素指数。认知评分方法包括迷你精神状态检查（MMSE）和蒙特利尔认知评估（MOCA）。为了探讨 OSA、EPVS 和 CI 之间的关系，我们使用了单因素分析、多因素分析和接收器操作特征曲线（ROC）：共对 136 名参与者进行了分析。在我们的统计过程中，MMSE的表现比MoCA更为突出。OSA患者的中脑EPVS负担更大（P 结论：我们发现OSA、MoCA和EPVS之间存在显著关系：我们发现了 OSA、EPVS 和 CI 之间的重要关系。AHI 是估计 EPVS 患者认知功能的潜在标志。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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Does Obstructive sleep apnea mediate the risk of cognitive impairment by expanding the perivascular space?

Background: Obstructive sleep apnea (OSA) is a neglected global health issue and when left untreated could lead to cognitive impairment (CI), one of the most burdensome outcomes of OSA. Enlarged perivascular spaces (EPVS), an imaging feature as well as a subtype of cerebral small vessel disease and integral part of CSVD, are associated with cognitive function, but the relationship between EPVS and CI is not well understood and by extension the correlation between OSA and EPVS, how CI develops under the joint impact of OSA and EPVS remains unclear. It is the goal of This study to explore the associations among OSA, EPVS, and CI.

Methods: This cross-sectional study included 175 older adults with imaging features of EPVS with or without other CSVD subtype features by cranial magnetic resonance imaging between January 2021 and June 2023 at the Shanghai Fifth People's Hospital. We assessed OSA using polysomnography. Blood samples were collected to determine vascular risk factor indices. Cognitive scoring modalities included the Mini-Mental State Examination (MMSE) and Montreal Cognitive Assessment (MOCA). To explore the relationship among OSA, EPVS, and CI, we used single-factor analysis, multifactorial analysis, and receiver operating characteristic (ROC) curves.

Results: A total of 136 participants were analyzed. In our statistical process, MMSE showed a more distinguished performance than MoCA. Participants with OSA had greater EPVS burdens in the midbrain (p < 0.001) and hippocampus (p < 0.001) and more serious CI (p = 0.001). OSA positively influenced EPVS in the midbrain (β = 0.052; 95% confidence interval [CI]: 0.006, 0.097; p = 0.026) and hippocampus (β = 0.190, 95% CI: 0.104, 0.275, p < 0.001). Moreover, the apnea-hypopnea index (AHI; β = -0.514; 95% CI: -0.077, -0.031; p < 0.001) negatively affected cognitive e function. With each increase in the AHI by 1 unit, the risk of CI increased by 12.0% (odds ratio = 1.120; 95%CI: 1.062, 1.181; p < 0.001). The AHI (sensitivity, 67.20%; specificity, 92.20%; area under the ROC curve, 0.828; p < 0.001) had a certain degree of accuracy in ruling out CI in the EPVS population, as calculated using the ROC curve.

Conclusions: We identified significant relations among OSA, EPVS, and CI. The AHI is a potential marker for estimating cognitive function in patients with EPVS.

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来源期刊

Sleep and Breathing 医学-呼吸系统

CiteScore

5.20

自引率

4.00%

发文量

222

审稿时长

3-8 weeks

期刊介绍： The journal Sleep and Breathing aims to reflect the state of the art in the international science and practice of sleep medicine. The journal is based on the recognition that management of sleep disorders requires a multi-disciplinary approach and diverse perspectives. The initial focus of Sleep and Breathing is on timely and original studies that collect, intervene, or otherwise inform all clinicians and scientists in medicine, dentistry and oral surgery, otolaryngology, and epidemiology on the management of the upper airway during sleep. Furthermore, Sleep and Breathing endeavors to bring readers cutting edge information about all evolving aspects of common sleep disorders or disruptions, such as insomnia and shift work. The journal includes not only patient studies, but also studies that emphasize the principles of physiology and pathophysiology or illustrate potentially novel approaches to diagnosis and treatment. In addition, the journal features articles that describe patient-oriented and cost-benefit health outcomes research. Thus, with peer review by an international Editorial Board and prompt English-language publication, Sleep and Breathing provides rapid dissemination of clinical and clinically related scientific information. But it also does more: it is dedicated to making the most important developments in sleep disordered breathing easily accessible to clinicians who are treating sleep apnea by presenting well-chosen, well-written, and highly organized information that is useful for patient care.