title: Changes in cerebral metabolites in obstructive sleep apnea: a systemic review and meta-analysis.
abstract: Cognitive impairment is associated with changes in cerebral metabolites in patients with obstructive sleep apnea (OSA). Several studies have used magnetic resonance spectroscopy (MRS) to detect variations in cerebral metabolites; however, the results have been inconsistent. This meta-analysis summarizes the differences in cerebral metabolites between patients with OSA and controls. Two electronic databases, PubMed and Embase, were searched for articles (published before March 31, 2016) describing studies that used MRS to evaluate the cerebral metabolite changes. The overall effects were measured using the weighted mean difference with a 95% confidence interval. Subgroup analysis and sensitivity analysis were used to explore the sources of between-study heterogeneity and the stability of the results. Publication bias was also evaluated. Thirteen studies were ultimately included. In the hippocampus, the N-acetylaspartate (NAA)/creatine ratio was lower in patients with OSA. In the frontal lobe, only the NAA/choline ratio was lower in patients with OSA. Cerebral metabolites are significantly altered in the hippocampus in patients with OSA. Further clinical studies are needed to explore the underlying mechanisms between OSA and the changes in cerebral metabolites in the brain.
authors.affiliation: Department of Otolaryngology Head and Neck Surgery &Center of Sleep Medicine, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Yishan Road 600, Shanghai, 200233, China.|Otolaryngological Institute of Shanghai Jiao Tong University, Yishan Road 600, Shanghai, 200233, China.|Clinical Research Center, Shanghai Jiao Tong University School of Medicine, South Chongqing Road 225, Shanghai, 200020, China.
authors.forename: Yunyan
authors.initials: Y
authors.lastname: Xia
authors.affiliation: Department of Otolaryngology Head and Neck Surgery &Center of Sleep Medicine, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Yishan Road 600, Shanghai, 200233, China.|Otolaryngological Institute of Shanghai Jiao Tong University, Yishan Road 600, Shanghai, 200233, China.|Clinical Research Center, Shanghai Jiao Tong University School of Medicine, South Chongqing Road 225, Shanghai, 200020, China.
authors.forename: Yiqun
authors.initials: Y
authors.lastname: Fu
authors.affiliation: Department of Otolaryngology Head and Neck Surgery &Center of Sleep Medicine, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Yishan Road 600, Shanghai, 200233, China.|Otolaryngological Institute of Shanghai Jiao Tong University, Yishan Road 600, Shanghai, 200233, China.|Clinical Research Center, Shanghai Jiao Tong University School of Medicine, South Chongqing Road 225, Shanghai, 200020, China.
authors.forename: Huajun
authors.initials: H
authors.lastname: Xu
authors.affiliation: Department of Otolaryngology Head and Neck Surgery &Center of Sleep Medicine, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Yishan Road 600, Shanghai, 200233, China.|Otolaryngological Institute of Shanghai Jiao Tong University, Yishan Road 600, Shanghai, 200233, China.|Clinical Research Center, Shanghai Jiao Tong University School of Medicine, South Chongqing Road 225, Shanghai, 200020, China.
authors.forename: Jian
authors.initials: J
authors.lastname: Guan
authors.affiliation: Department of Otolaryngology Head and Neck Surgery &Center of Sleep Medicine, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Yishan Road 600, Shanghai, 200233, China.|Otolaryngological Institute of Shanghai Jiao Tong University, Yishan Road 600, Shanghai, 200233, China.|Clinical Research Center, Shanghai Jiao Tong University School of Medicine, South Chongqing Road 225, Shanghai, 200020, China.
authors.forename: Hongliang
authors.initials: H
authors.lastname: Yi
authors.affiliation: Department of Otolaryngology Head and Neck Surgery &Center of Sleep Medicine, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Yishan Road 600, Shanghai, 200233, China.|Otolaryngological Institute of Shanghai Jiao Tong University, Yishan Road 600, Shanghai, 200233, China.|Clinical Research Center, Shanghai Jiao Tong University School of Medicine, South Chongqing Road 225, Shanghai, 200020, China.
authors.forename: Shankai
authors.initials: S
authors.lastname: Yin
mesh_terms: D001921:Brain / Q000378:metabolism*; D001923:Brain Chemistry; D005260:Female; D006801:Humans; D009682:Magnetic Resonance Spectroscopy; D008297:Male; D020181:Sleep Apnea, Obstructive / Q000378:metabolism*