Cerebral Structural Changes in Severe Obstructive Sleep Apnea

Abstract

Obstructive sleep apnea is associated with abnormalities in neuropsychologic function, and defects in respiratory control may contribute to pathogenesis. Abnormalities may be reflected in structural brain changes. Twenty-seven male untreated patients with severe sleep apnea without comorbidities, and 24 age-matched control subjects, had T1-weighted brain imaging in a high-resolution magnetic resonance scanner. Twenty-three patients with sleep apnea had repeat imaging after 6 months of continuous positive airways pressure treatment. No areas of gray matter volume change were found in patients using an optimized voxel-based morphometry technique, at p < 0.05 adjusted for multiple comparisons (despite the method being sensitive to changes in gray matter fraction of 0.17 or less in all voxels). Furthermore, no differences were seen in bilateral hippocampal, temporal lobe, or whole brain volumes, assessed by manual tracing of anatomical borders. No longitudinal changes were seen in gray matter density or regional volumes after treatment, but whole brain volume decreased slightly. We have found no gray matter volume deficits nor focal structural changes in severe obstructive sleep apnea. Whole brain volume decreases without focal changes after 6 months of continuous positive airways pressure treatment.

Residual sleepiness in obstructive sleep apnoea: phenotype and related symptoms

“…Furthermore, our patients had no morphological abnormalities in the brain imaging, as previously shown in OSA patients [40][41][42]. Hence, we suspect that they suffer from a form of post-hypoxic hypersomnia.…”

Undiagnosed sleep‐related breathing disorders are associated with focal brainstem atrophy in the elderly

“…The hypothesis of a hypoxic stress to the brain is supported by neurochemical changes, such as a decrease in creatinine-containing compounds in the hippocampal areas [Bartlett et al, 2004]. The search for associations between the severity of OSAS and anatomical brain damages has come up with contradictory results ranging from normal structure [O'Donoghue et al, 2005] to scattered defects such as focal gray matter decrease in the left hippocampus [Morrell et al, 2003] or even diffuse gray matter decrease [Macey et al, 2002;Morrell et al, 2003].…”

Emerging co-morbidities of obstructive sleep apnea: cognition, kidney disease, and cancer

“…Historically, a number of voxel based morphometry (VBM) studies have investigated areas of the brain affected in patients with OSA with diverse regions being highlighted as more or less impacted (62)(63)(64)(65)(66). An early study assessing changes in patients with OSA reported diffuse changes in the frontal, temporal and parietal cortices, as well as in the anterior cingulate gyrus, hippocampus, and cerebellum (67).…”