title: Increased Muscle Sympathetic Nerve Activity and Impaired Executive Performance Capacity in Obstructive Sleep Apnea.
abstract: OBJECTIVE
  To investigate muscle sympathetic nerve activity (MSNA) response and executive performance during mental stress in obstructive sleep apnea (OSA).
  
  
  METHODS
  Individuals with no other comorbidities (age = 52 ± 1 y, body mass index = 29 ± 0.4, kg/m2) were divided into two groups: (1) control (n = 15) and (2) untreated OSA (n = 20) defined by polysomnography. Mini-Mental State of Examination (MMSE) and Inteligence quocient (IQ) were assessed. Heart rate (HR), blood pressure (BP), and MSNA (microneurography) were measured at baseline and during 3 min of the Stroop Color Word Test (SCWT). Sustained attention and inhibitory control were assessed by the number of correct answers and errors during SCWT.
  
  
  RESULTS
  Control and OSA groups (apnea-hypopnea index, AHI = 8 ± 1 and 47 ± 1 events/h, respectively) were similar in age, MMSE, and IQ. Baseline HR and BP were similar and increased similarly during SCWT in control and OSA groups. In contrast, baseline MSNA was higher in OSA compared to controls. Moreover, MSNA significantly increased in the third minute of SCWT in OSA, but remained unchanged in controls (P < 0.05). The number of correct answers was lower and the number of errors was significantly higher during the second and third minutes of SCWT in the OSA group (P < 0.05). There was a significant correlation (P < 0.01) between the number of errors in the third minute of SCWT with AHI (r = 0.59), arousal index (r = 0.55), and minimum O2 saturation (r = -0.57).
  
  
  CONCLUSIONS
  As compared to controls, MSNA is increased in patients with OSA at rest, and further significant MSNA increments and worse executive performance are seen during mental stress.
  
  
  BACKGROUND
  URL: http://www.clinicaltrials.gov, registration number: NCT002289625.
authors.affiliation: Master Program in Experimental Physiopathology, HCFMUSP, São Paulo, Brazil.
authors.forename: Thiago T
authors.initials: TT
authors.lastname: Goya
authors.affiliation: School of Arts Sciences and Humanities, USP, São Paulo, Brazil.
authors.forename: Rosyvaldo F
authors.initials: RF
authors.lastname: Silva
authors.affiliation: InCor-HCFMUSP, São Paulo, Brazil.
authors.forename: Renan S
authors.initials: RS
authors.lastname: Guerra
authors.affiliation: InCor-HCFMUSP, São Paulo, Brazil.
authors.forename: Marta F
authors.initials: MF
authors.lastname: Lima
authors.affiliation: InCor-HCFMUSP, São Paulo, Brazil.
authors.forename: Eline R F
authors.initials: ER
authors.lastname: Barbosa
authors.affiliation: Laboratory of Psychiatric Neuroimaging, Department of Psychiatry, HCFMUSP, São Paulo, Brazil.|Center for Interdisciplinary Research on Applied Neurosciences (NAPNA, USP), São Paulo, Brazil.
authors.forename: Paulo Jannuzzi
authors.initials: PJ
authors.lastname: Cunha
authors.affiliation: InCor-HCFMUSP, São Paulo, Brazil.
authors.forename: Denise M L
authors.initials: DM
authors.lastname: Lobo
authors.affiliation: Institute of Radiology, HCFMUSP, São Paulo, Brazil.
authors.forename: Carlos A
authors.initials: CA
authors.lastname: Buchpiguel
authors.affiliation: Laboratory of Psychiatric Neuroimaging, Department of Psychiatry, HCFMUSP, São Paulo, Brazil.|Center for Interdisciplinary Research on Applied Neurosciences (NAPNA, USP), São Paulo, Brazil.
authors.forename: Geraldo
authors.initials: G
authors.lastname: Busatto-Filho
authors.affiliation: InCor-HCFMUSP, São Paulo, Brazil.|School of Physical Education and Sport, USP, São Paulo, Brazil.
authors.forename: Carlos E
authors.initials: CE
authors.lastname: Negrão
authors.affiliation: InCor-HCFMUSP, São Paulo, Brazil.
authors.forename: Geraldo
authors.initials: G
authors.lastname: Lorenzi-Filho
authors.affiliation: School of Arts Sciences and Humanities, USP, São Paulo, Brazil.|Center for Interdisciplinary Research on Applied Neurosciences (NAPNA, USP), São Paulo, Brazil.
authors.forename: Linda M
authors.initials: LM
authors.lastname: Ueno-Pardi
mesh_terms: D000328:Adult; D000368:Aged; D001143:Arousal; D001288:Attention; D001794:Blood Pressure; D016022:Case-Control Studies; D056344:Executive Function; D005260:Female; D006339:Heart Rate; D006801:Humans; D007266:Inhibition, Psychological; D008297:Male; D008875:Middle Aged; D009132:Muscles / Q000294:innervation*; D017286:Polysomnography; D012146:Rest; D020181:Sleep Apnea, Obstructive / Q000150:complications / Q000503:physiopathology* / Q000523:psychology; D013315:Stress, Psychological / Q000150:complications / Q000503:physiopathology; D057190:Stroop Test; D013564:Sympathetic Nervous System / Q000503:physiopathology*
keywords: executive performance; mental stress; muscle sympathetic nerve activity; obstructive sleep apnea