title: Effect of continuous positive airway pressure on regional cerebral blood flow during wakefulness in obstructive sleep apnea.
abstract: BACKGROUND
  The alteration of regional cerebral blood flow (rCBF) during wakefulness after the treatment for obstructive sleep apnea syndrome (OSA) using continuous positive airway pressure (CPAP) has not been elucidated. The aim of this study was to investigate rCBF characteristics and the effects of nasal CPAP in OSA patients.
  
  
  METHODS
  Fifteen severe OSA patients (apnea-hypopnea index, 62.7 ± 22.4/h), when awake, underwent Technetium-99m ethyl cysteinate dimer single photon emission computed tomography before and after CPAP treatment, and the findings were compared to those of nine healthy controls matched for age and sex.
  
  
  RESULTS
  Compared to controls, patients with OSA before CPAP treatment showed a significantly lower rCBF in the frontal lobe. After the treatment, no difference in rCBF was observed between the good CPAP compliance group and the controls. In the former group, there was a positive correlation between the 3% oxygen desaturation index on diagnostic polysomnogram and the increase of rCBF after CPAP treatment in the frontal lobe.
  
  
  CONCLUSIONS
  When awake, patients with severe OSA were shown to have reversible decreases in rCBF, especially in the frontal lobe, and an appropriate CPAP treatment was thought to improve rCBF in this area. Our results support the importance of appropriate CPAP treatment for severe OSA patients.
authors.affiliation: Department of Respiratory Medicine, Juntendo University Graduate School of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo, 162-0814, Japan, sshiota@juntendo.ac.jp.
authors.forename: Satomi
authors.initials: S
authors.lastname: Shiota
authors.forename: Yuichi
authors.initials: Y
authors.lastname: Inoue
authors.forename: Hidenori
authors.initials: H
authors.lastname: Takekawa
authors.forename: Masaki
authors.initials: M
authors.lastname: Kotajima
authors.forename: Mami
authors.initials: M
authors.lastname: Nakajyo
authors.forename: Chie
authors.initials: C
authors.lastname: Usui
authors.forename: Yasuko
authors.initials: Y
authors.lastname: Yoshioka
authors.forename: Tatsuo
authors.initials: T
authors.lastname: Koga
authors.forename: Kazuhisa
authors.initials: K
authors.lastname: Takahashi
mesh_terms: D000328:Adult; D000368:Aged; D045422:Continuous Positive Airway Pressure; D005260:Female; D005625:Frontal Lobe / Q000098:blood supply*; D006801:Humans; D008297:Male; D008875:Middle Aged; D017286:Polysomnography; D012016:Reference Values; D012039:Regional Blood Flow / Q000502:physiology; D020181:Sleep Apnea, Obstructive / Q000503:physiopathology* / Q000628:therapy; D015899:Tomography, Emission-Computed, Single-Photon; D014851:Wakefulness / Q000502:physiology*
references.citation: Acta Neurobiol Exp (Wars). 2011;71(2):233-43
references.pmid: 21731077
references.citation: Acta Neurol Belg. 1997 Jun;97(2):96-107
references.pmid: 9246377
references.citation: Sleep. 1987 Jun;10(3):254-62
references.pmid: 3629088
references.citation: Sleep Breath. 2009 May;13(2):127-36
references.pmid: 18830731
references.citation: Eur Respir J. 2004 Dec;24(6):980-6
references.pmid: 15572542
references.citation: Am J Respir Crit Care Med. 2003 Jun 1;167(11):1548-53
references.pmid: 12615622
references.citation: Proc Am Thorac Soc. 2008 Feb 15;5(2):136-43
references.pmid: 18250205
references.citation: J Neurosci. 2002 Feb 1;22(3):612-3
references.pmid: 11826087
references.citation: Sleep. 2004 Dec 15;27(8):1512-7
references.pmid: 15683142
references.citation: Respir Med. 2004 May;98(5):421-7
references.pmid: 15139571
references.citation: Sleep. 2006 Mar;29(3):381-401
references.pmid: 16553025
references.citation: Obesity (Silver Spring). 2011 May;19(5):1095-7
references.pmid: 21311507
references.citation: Am J Respir Crit Care Med. 2002 Nov 15;166(10):1382-7
references.pmid: 12421746
references.citation: Sleep Med. 2011 Apr;12(4):335-40
references.pmid: 21398177
references.citation: Hum Brain Mapp. 2000 Jul;10(3):120-31
references.pmid: 10912591
references.citation: Surg Neurol. 2003 Jun;59(6):455-60; discussion 460-3
references.pmid: 12826338
references.citation: J Int Neuropsychol Soc. 2004 Sep;10(5):772-85
references.pmid: 15327723
references.citation: Pneumologie. 1997 Sep;51(9):926-30
references.pmid: 9411446
references.citation: Am J Respir Crit Care Med. 2011 May 15;183(10):1419-26
references.pmid: 21037021
references.citation: J Alzheimers Dis. 2012;32(3):633-42
references.pmid: 22842868
references.citation: J Nucl Med Technol. 2009 Sep;37(3):191-5
references.pmid: 19692453
references.citation: J Clin Exp Neuropsychol. 1993 Mar;15(2):330-41
references.pmid: 8491855
references.citation: Am J Respir Crit Care Med. 2005 May 15;171(10):1185-90
references.pmid: 15699018
references.citation: Sleep. 2007 Nov;30(11):1515-20
references.pmid: 18041484
references.citation: Neuroscience. 2004;126(2):313-23
references.pmid: 15207349
references.citation: J Sleep Res. 2000 Sep;9(3):207-31
references.pmid: 11012860
references.citation: Sleep. 1992 Dec;15(6 Suppl):S17-9
references.pmid: 1470802
references.citation: Chest. 1986 Nov;90(5):686-90
references.pmid: 3769569
references.citation: Acta Neurobiol Exp (Wars). 2010;70(3):279-87
references.pmid: 20871647
references.citation: Arthritis Res Ther. 2010;12(2):R64
references.pmid: 20374641