title: Desperately seeking grey matter volume changes in sleep apnea: A methodological review of magnetic resonance brain voxel-based morphometry studies.
abstract: Cognitive impairment related to obstructive sleep apnea might be explained by subtle changes in brain anatomy. This has been mainly investigated using magnetic resonance brain scans coupled with a voxel-based morphometry analysis. However, this approach is prone to several methodological pitfalls that may explain the large discrepancy in the results reported in the literature. We critically reviewed twelve papers addressing grey matter volume modifications in association with obstructive sleep apnea. Finally, based on strict methodological criteria, only three studies reported robust, but conflicting, results. No clear evidence has emerged and exploring brain alteration due to obstructive sleep apnea should thus be considered as an open field. We provide recommendations for designing additional robust voxel-based morphometry studies, notably the use of larger cohorts, which is the only way to solve the underpowered issue and the underestimated role of confounders in neuroimaging studies.
authors.affiliation: EA 4607 SNA-EPIS, Service de Physiologie Clinique et de l'Exercice, Pole NOL, CHU Nord, 42055 Saint-Étienne, France; Faculté de Médecine Jacques Lisfranc, Université Jean Monnet, 42023 Saint-Étienne, COMUE Lyon-Saint-Étienne, France. Electronic address: sebastien.celle@univ-st-etienne.fr.
authors.forename: Sébastien
authors.initials: S
authors.lastname: Celle
authors.affiliation: Inserm, U836, F-38000 Grenoble, France; Université Grenoble Alpes, GIN, F-38000 Grenoble, France.
authors.forename: Chantal
authors.initials: C
authors.lastname: Delon-Martin
authors.affiliation: EA 4607 SNA-EPIS, Service de Physiologie Clinique et de l'Exercice, Pole NOL, CHU Nord, 42055 Saint-Étienne, France; Faculté de Médecine Jacques Lisfranc, Université Jean Monnet, 42023 Saint-Étienne, COMUE Lyon-Saint-Étienne, France.
authors.forename: Frédéric
authors.initials: F
authors.lastname: Roche
authors.affiliation: EA 4607 SNA-EPIS, Service de Physiologie Clinique et de l'Exercice, Pole NOL, CHU Nord, 42055 Saint-Étienne, France; Faculté de Médecine Jacques Lisfranc, Université Jean Monnet, 42023 Saint-Étienne, COMUE Lyon-Saint-Étienne, France.
authors.forename: Jean-Claude
authors.initials: JC
authors.lastname: Barthélémy
authors.affiliation: Université Grenoble Alpes, GIN, F-38000 Grenoble, France; Inserm, U 1042, F-38000 Grenoble, France.
authors.forename: Jean-Louis
authors.initials: JL
authors.lastname: Pépin
authors.affiliation: Inserm, U836, F-38000 Grenoble, France; Université Grenoble Alpes, GIN, F-38000 Grenoble, France.
authors.forename: Michel
authors.initials: M
authors.lastname: Dojat
mesh_terms: D001921:Brain / Q000473:pathology*; D003072:Cognition Disorders / Q000473:pathology; D066128:Gray Matter / Q000473:pathology*; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods*; D020181:Sleep Apnea, Obstructive / Q000473:pathology*
keywords: Anatomy; Neuroimaging; Obstructive sleep apnea; Registration; Segmentation; Voxel-based morphometry