title: Association of Obstructive Sleep Apnea with Episodic Memory and Cerebral Microvascular Pathology: A Preliminary Study.
abstract: OBJECTIVE
  To evaluate the impact of obstructive sleep apnea (OSA) on neurocognitive function and brain morphology in older adults with depression and cognitive impairment.
  
  
  METHODS
  We prospectively screened OSA with the STOP-Bang questionnaire in the last 25 patients enrolled into the Donepezil Treatment of Cognitive Impairment and Depression (DOTCODE) trial. High and low probability of OSA were defined as a STOP-Bang score of ≥5 (h-OSA) and of <5 (l-OSA), respectively. Baseline magnetic resonance imaging (MRI) was used to evaluate brain morphology. The initial 16 weeks of antidepressant treatment were part of the DOTCODE trial.
  
  
  RESULTS
  After 16 weeks of antidepressant treatment, the h-OSA group performed significantly worse on the Selective Reminding Test delayed recall task than the l-OSA group, controlling for baseline performance (F = 19.1, df = 1,22, p < 0.001). In 19 of 25 participants who underwent brain MRI, the h-OSA group had significantly greater volumes of MRI hyperintensities in deep white matter, periventricular white matter, and subcortical gray matter compared with the l-OSA group. There was no significant association between OSA and hippocampal or entorhinal cortex volumes in our sample, even after controlling for intracranial volume.
  
  
  CONCLUSIONS
  OSA is associated with impaired verbal episodic memory and microvascular damage in older adults with depression and cognitive impairment. One possibility is that by contributing to cerebral microvascular damage, OSA may exacerbate progressive memory decline.
authors.affiliation: Department of Psychiatry, College of Physicians and Surgeons of Columbia University / Columbia University Medical Center, New York, NY; The Late-life Depression Clinic and the Memory Disorders Clinic, Division of Geriatric Psychiatry, New York State Psychiatric Institute, New York, NY. Electronic address: nak2120@cumc.columbia.edu.
authors.forename: Nancy A
authors.initials: NA
authors.lastname: Kerner
authors.affiliation: Department of Psychiatry, College of Physicians and Surgeons of Columbia University / Columbia University Medical Center, New York, NY; The Late-life Depression Clinic and the Memory Disorders Clinic, Division of Geriatric Psychiatry, New York State Psychiatric Institute, New York, NY.
authors.forename: Steven P
authors.initials: SP
authors.lastname: Roose
authors.affiliation: Department of Psychiatry, College of Physicians and Surgeons of Columbia University / Columbia University Medical Center, New York, NY; Department of Neurology, Taub Institute for Research in Alzheimer's Disease and the Aging Brain, Gertrude H. Sergievsky Center, Columbia University College of Physicians and Surgeons, New York, NY; The Late-life Depression Clinic and the Memory Disorders Clinic, Division of Geriatric Psychiatry, New York State Psychiatric Institute, New York, NY.
authors.forename: Gregory H
authors.initials: GH
authors.lastname: Pelton
authors.affiliation: Division of Biostatistics, Department of Psychiatry, College of Physicians and Surgeons of Columbia University, Columbia University Medical Center, New York, NY.
authors.forename: Adam
authors.initials: A
authors.lastname: Ciarleglio
authors.affiliation: Division of Biostatistics, Department of Psychiatry, College of Physicians and Surgeons of Columbia University, Columbia University Medical Center, New York, NY.
authors.forename: Jennifer
authors.initials: J
authors.lastname: Scodes
authors.affiliation: Department of Psychiatry, College of Physicians and Surgeons of Columbia University / Columbia University Medical Center, New York, NY.
authors.forename: Cody
authors.initials: C
authors.lastname: Lentz
authors.affiliation: Department of Psychiatry, College of Physicians and Surgeons of Columbia University / Columbia University Medical Center, New York, NY; The Late-life Depression Clinic and the Memory Disorders Clinic, Division of Geriatric Psychiatry, New York State Psychiatric Institute, New York, NY; Queens College, City University of New York, New York, NY.
authors.forename: Joel R
authors.initials: JR
authors.lastname: Sneed
authors.affiliation: Department of Psychiatry, College of Physicians and Surgeons of Columbia University / Columbia University Medical Center, New York, NY; Department of Neurology, Taub Institute for Research in Alzheimer's Disease and the Aging Brain, Gertrude H. Sergievsky Center, Columbia University College of Physicians and Surgeons, New York, NY; The Late-life Depression Clinic and the Memory Disorders Clinic, Division of Geriatric Psychiatry, New York State Psychiatric Institute, New York, NY.
authors.forename: D P
authors.initials: DP
authors.lastname: Devanand
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D059345:Cerebral Small Vessel Diseases / Q000000981:diagnostic imaging* / Q000453:epidemiology; D060825:Cognitive Dysfunction / Q000453:epidemiology / Q000503:physiopathology*; D017507:Comoros; D003863:Depression / Q000453:epidemiology / Q000503:physiopathology*; D005260:Female; D066128:Gray Matter / Q000000981:diagnostic imaging*; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D061212:Memory, Episodic; D020181:Sleep Apnea, Obstructive / Q000453:epidemiology / Q000503:physiopathology*; D066127:White Matter / Q000000981:diagnostic imaging*
keywords: MRI; Obstructive sleep apnea; depression; hippocampus; memory; older adults; white matter