title: Assessment of neural alterations in obstructive sleep apnoea syndrome: can apparent diffusion coefficient measurements be useful?
abstract: OBJECTIVE
  Our aim was to investigate whether neurological alteration in patients with obstructive sleep apnoea syndrome (OSAS) with apparently normal cerebral and cerebellar structures can be assessed by means of apparent diffusion coefficient (ADC) measurement and to investigate the association between OSAS severity and ADC values.
  
  
  METHODS
  Following the acquisition of diffusion-weighted cranial magnetic resonance imaging, ADC measurements were performed in 24 different apparently normal cerebral and cerebellar structures, including the bilateral frontal and parietal cortices, insulae, cingulate gyri, hippocampi, frontal and parieto-occipital periventricular white matter (PWM), caudate nuclei, putamen, thalami, cerebellar hemispheres, pons and mesencephalon in 47 OSAS patients and 20 control subjects. The ADC values of the patients and the control group were compared. The association between the apnoea-hypopnoea index (AHI) and the ADC values of the patients were investigated.
  
  
  RESULTS
  The ADC values in the bilateral frontal PWM were lower in the patient group than those in the control subjects (P < 0.05). The measurements in the right cingulate gyri of the OSAS patients exhibited significantly higher ADC values than those of the control group (P = 0.002). Bilateral thalamic ADC values in severe OSAS patients were significantly higher than those in mild and moderate OSAS patients (P < 0.05).
  
  
  CONCLUSIONS
  The ADC measurement is a simple and effective technique to evaluate neural alteration of the brain in patients with OSAS. ADC measurements can also be useful in the evaluation of the association between the AHI and the degree of neural alteration in the central nervous system.
authors.affiliation: Department of Radiology, School of Medicine, Afyon Kocatepe University, Afyonkarahisar, Turkey.
authors.forename: Emre
authors.initials: E
authors.lastname: Kacar
authors.affiliation: Department of Pulmonary Medicine, School of Medicine, Afyon Kocatepe University, Afyonkarahisar, Turkey.
authors.forename: Sevinc
authors.initials: S
authors.lastname: Sarinc Ulasli
authors.affiliation: Department of Pulmonary Medicine, School of Medicine, Afyon Kocatepe University, Afyonkarahisar, Turkey.
authors.forename: Ersin
authors.initials: E
authors.lastname: Günay
authors.affiliation: Department of Radiology, School of Medicine, Afyon Kocatepe University, Afyonkarahisar, Turkey.
authors.forename: Gülay
authors.initials: G
authors.lastname: Güngör
authors.affiliation: Department of Radiology, School of Medicine, Afyon Kocatepe University, Afyonkarahisar, Turkey.
authors.forename: Ebru
authors.initials: E
authors.lastname: Ünlü
authors.affiliation: Department of Radiology, School of Medicine, Afyon Kocatepe University, Afyonkarahisar, Turkey.
authors.forename: Mehtap
authors.initials: M
authors.lastname: Beker Acay
authors.affiliation: Department of Pulmonary Medicine, School of Medicine, Afyon Kocatepe University, Afyonkarahisar, Turkey.
authors.forename: Tülay
authors.initials: T
authors.lastname: Koyuncu
authors.affiliation: Department of Pulmonary Medicine, School of Medicine, Afyon Kocatepe University, Afyonkarahisar, Turkey.
authors.forename: Mehmet
authors.initials: M
authors.lastname: Ünlü
authors.affiliation: Department of Radiology, School of Medicine, Afyon Kocatepe University, Afyonkarahisar, Turkey.
authors.forename: Alpay
authors.initials: A
authors.lastname: Haktanir
mesh_terms: D000328:Adult; D000368:Aged; D001921:Brain / Q000000981:diagnostic imaging* / Q000473:pathology; D016022:Case-Control Studies; D038524:Diffusion Magnetic Resonance Imaging / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D017286:Polysomnography; D011446:Prospective Studies; D020181:Sleep Apnea, Obstructive / Q000000981:diagnostic imaging* / Q000473:pathology
keywords: Apparent Diffusion Coefficient measurement; Obstructive Sleep Apnoea Syndrome; brain; diffusion weighted MRI