title: Preliminary functional MRI neural correlates of executive functioning and empathy in children with obstructive sleep apnea.
abstract: BACKGROUND
  Pediatric obstructive sleep apnea (OSA) is associated with neurocognitive deficits. However, the neural substrates underlying such deficits remain unknown.
  
  
  METHODS
  To examine executive control and emotional processing in OSA, 10 children age 7 to 11 y with polysomnographically diagnosed OSA and 7 age- and sex-matched controls underwent a color-word Stroop task and an empathy task consisting of dynamic visual scenarios depicting interpersonal harm or neutral actions in a magnetic resonance imaging (MRI) scanner. Functional MRI data were processed using MATLAB 7.12 with SPM8 for region of interest (ROI) analyses, and a general linear model was used with regressors for each trial type in each task.
  
  
  RESULTS
  For the Stroop task, accuracy was similar in the two groups, with no differences in the effect of incongruency on success rates. OSA showed greater neural activity than controls in eight ROI clusters for incongruent versus congruent trials (P < 0.001). Within the a priori ROIs, the anterior cingulate cortex was significantly different between groups (P < 0.05). For perceiving harm versus neutral actions, ROI analysis revealed a significant correlation between apnea-hypopnea index and left amygdala activity in harm versus neutral actions (r = -0.71, P < 0.05).
  
  
  CONCLUSIONS
  These results provide the first functional MRI evidence that cognitive and empathetic processing is influenced by obstructive sleep apnea (OSA) in children. Children with OSA show greater neural recruitment of regions implicated in cognitive control, conflict monitoring, and attentional allocation in order to perform at the same level as children without OSA. When viewing empathy-eliciting scenarios, the severity of OSA predicted less sensitivity to harm in the left amygdala.
authors.affiliation: Department of Pediatrics, Pritzker School of Medicine, Biological Sciences Division, The University of Chicago, Chicago, IL.
authors.forename: Leila
authors.initials: L
authors.lastname: Kheirandish-Gozal
authors.affiliation: Department of Psychology, Social Sciences Division, The University of Chicago, Chicago, IL.
authors.forename: Keith
authors.initials: K
authors.lastname: Yoder
authors.affiliation: Department of Pediatrics, Pritzker School of Medicine, Biological Sciences Division, The University of Chicago, Chicago, IL.
authors.forename: Richa
authors.initials: R
authors.lastname: Kulkarni
authors.affiliation: Department of Pediatrics, Pritzker School of Medicine, Biological Sciences Division, The University of Chicago, Chicago, IL.
authors.forename: David
authors.initials: D
authors.lastname: Gozal
authors.affiliation: Department of Psychology, Social Sciences Division, The University of Chicago, Chicago, IL.
authors.forename: Jean
authors.initials: J
authors.lastname: Decety
mesh_terms: D001288:Attention; D001921:Brain / Q000503:physiopathology*; D001931:Brain Mapping; D016022:Case-Control Studies; D002648:Child; D004644:Emotions; D004645:Empathy; D056344:Executive Function; D005260:Female; D006179:Gyrus Cinguli / Q000503:physiopathology; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D017286:Polysomnography; D020181:Sleep Apnea, Obstructive / Q000503:physiopathology* / Q000523:psychology*; D057190:Stroop Test
keywords: Pediatric sleep apnea; empathy; executive function; fMRI