title: Aberrant Insular Functional Network Integrity in Patients with Obstructive Sleep Apnea.
abstract: Obstructive sleep apnea (OSA) is accompanied by tissue injury to the insular cortices, areas that regulate autonomic pain, dyspnea, and mood, all of which are affected in the syndrome. Presumably, the dysregulation of insular-related functions are mediated by aberrant functional connections with other brain regions; however, the integrity of the functional connectivity (FC) to other sites is undescribed. Our aim was to examine resting-state FC of the insular cortices to other brain areas in OSA, relative to control subjects.
  
  
  
  We collected resting-state functional magnetic resonance imaging (MRI) data from 67 newly diagnosed, treatment-naïve OSA and 75 control subjects using a 3.0-Tesla MRI scanner. After standard processing, data were analyzed for the left and right insular FC.
  
  
  
  OSA subjects showed complex aberrant insular FC to several brain regions, including frontal, parietal, cingulate, temporal, limbic, basal ganglia, thalamus, occipital, cerebellar, and brainstem regions. Areas of altered FC in OSA showed linear relationships with magnitudes of sleep related and neuropsychologic-related variables, whereas control subjects showed no such relationships with those measures.
  
  
  
  Brain functional connections from insular sites to other brain regions in OSA subjects represent abnormal autonomic, affective, sensorimotor, and cognitive control networks that may affect both impaired parasympathetic and sympathetic interactions, as well as abnormal sensorimotor integration, affected in the condition. The functional changes likely result from the previously reported structural changes in OSA subjects, as demonstrated by diverse neuroimaging studies.
authors.affiliation: Department of Anesthesiology, University of California at Los Angeles, Los Angeles, CA.
authors.forename: Bumhee
authors.initials: B
authors.lastname: Park
authors.affiliation: Department of Anesthesiology, University of California at Los Angeles, Los Angeles, CA.
authors.forename: Jose A
authors.initials: JA
authors.lastname: Palomares
authors.affiliation: UCLA School of Nursing, University of California at Los Angeles, Los Angeles, CA.
authors.forename: Mary A
authors.initials: MA
authors.lastname: Woo
authors.affiliation: Department of Medicine, University of California at Los Angeles, Los Angeles, CA.
authors.forename: Daniel W
authors.initials: DW
authors.lastname: Kang
authors.affiliation: UCLA School of Nursing, University of California at Los Angeles, Los Angeles, CA.|The Brain Research Institute, University of California at Los Angeles, Los Angeles, CA.
authors.forename: Paul M
authors.initials: PM
authors.lastname: Macey
authors.affiliation: Department of Neurology, University of California at Los Angeles.
authors.forename: Frisca L
authors.initials: FL
authors.lastname: Yan-Go
authors.affiliation: The Brain Research Institute, University of California at Los Angeles, Los Angeles, CA.|Department of Neurobiology; University of California at Los Angeles, Los Angeles, CA.
authors.forename: Ronald M
authors.initials: RM
authors.lastname: Harper
authors.affiliation: Department of Anesthesiology, University of California at Los Angeles, Los Angeles, CA.|The Brain Research Institute, University of California at Los Angeles, Los Angeles, CA.|Department of Radiological Sciences, University of California at Los Angeles, Los Angeles, CA.|Department of Bioengineering, University of California at Los Angeles, Los Angeles, CA.
authors.forename: Rajesh
authors.initials: R
authors.lastname: Kumar
mesh_terms: D000328:Adult; D000368:Aged; D001341:Autonomic Nervous System / Q000503:physiopathology; D001931:Brain Mapping; D002540:Cerebral Cortex / Q000503:physiopathology*; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D066191:Sensorimotor Cortex / Q000503:physiopathology; D012890:Sleep; D020181:Sleep Apnea, Obstructive / Q000503:physiopathology*
keywords: autonomic regulation; functional magnetic resonance imaging; resting-state functional connectivity; sleep disordered breathing