title: Cognitive profile and brain morphological changes in obstructive sleep apnea.
abstract: Obstructive sleep apnea (OSA) is accompanied by neurocognitive impairment, likely mediated by injury to various brain regions. We evaluated brain morphological changes in patients with OSA and their relationship to neuropsychological and oximetric data. Sixteen patients affected by moderate-severe OSA (age: 55.8±6.7 years, 13 males) and fourteen control subjects (age: 57.6±5.1 years, 9 males) underwent 3.0 Tesla brain magnetic resonance imaging (MRI) and neuropsychological testing evaluating short- and long-term memory, executive functions, language, attention, praxia and non-verbal learning. Volumetric segmentation of cortical and subcortical structures and voxel-based morphometry (VBM) were performed. Patients and controls differed significantly in Rey Auditory-Verbal Learning test (immediate and delayed recall), Stroop test and Digit span backward scores. Volumes of cortical gray matter (GM), right hippocampus, right and left caudate were smaller in patients compared to controls, with also brain parenchymal fraction (a normalized measure of cerebral atrophy) approaching statistical significance. Differences remained significant after controlling for comorbidities (hypertension, diabetes, smoking, hypercholesterolemia). VBM analysis showed regions of decreased GM volume in right and left hippocampus and within more lateral temporal areas in patients with OSA. Our findings indicate that the significant cognitive impairment seen in patients with moderate-severe OSA is associated with brain tissue damage in regions involved in several cognitive tasks. We conclude that OSA can increase brain susceptibility to the effects of aging and other clinical and pathological occurrences.
authors.affiliation: Center for Neurological Imaging, Brigham & Women's Hospital, Harvard Medical School, Boston, MA 02115, USA. ftorelli@bwh.harvard.edu
authors.forename: Federico
authors.initials: F
authors.lastname: Torelli
authors.forename: Nicola
authors.initials: N
authors.lastname: Moscufo
authors.forename: Girolamo
authors.initials: G
authors.lastname: Garreffa
authors.forename: Fabio
authors.initials: F
authors.lastname: Placidi
authors.forename: Andrea
authors.initials: A
authors.lastname: Romigi
authors.forename: Silvana
authors.initials: S
authors.lastname: Zannino
authors.forename: Marco
authors.initials: M
authors.lastname: Bozzali
authors.forename: Fabrizio
authors.initials: F
authors.lastname: Fasano
authors.forename: Giovanni
authors.initials: G
authors.lastname: Giulietti
authors.forename: Ina
authors.initials: I
authors.lastname: Djonlagic
authors.forename: Atul
authors.initials: A
authors.lastname: Malhotra
authors.forename: Maria Grazia
authors.initials: MG
authors.lastname: Marciani
authors.forename: Charles R G
authors.initials: CR
authors.lastname: Guttmann
mesh_terms: D001921:Brain / Q000473:pathology / Q000503:physiopathology; D003072:Cognition Disorders / Q000209:etiology* / Q000473:pathology* / Q000503:physiopathology; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D020181:Sleep Apnea, Obstructive / Q000150:complications* / Q000473:pathology* / Q000503:physiopathology