Volumetric brain magnetic resonance imaging analysis in children with obstructive sleep apnea

Musso, Mary Frances; Lindsey, Hannah M.; Wilde, Elisabeth A.; Hunter, Jill V.; Glaze, Daniel G.; Goodrich-Hunsaker, Naomi J.; Wu, Trevor C.; Black, Garrett; Biekman, Brian; Zhang, Wei; Zhu, Huirong; Anand, Grace Shebha; Friedman, Ellen M.

doi:10.1016/j.ijporl.2020.110369

Cited by 20 publications

(19 citation statements)

References 45 publications

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“…Unlike our study, a recent review identified that SDB was associated with changes in the brain using MRI in children with normal weight [34]. Likewise, using polysomnography, recent studies determined that normal-weight children (7-11 years) with OSA had smaller regional GMV [32] and WMV [63] than children without OSA. Furthermore, Walter and Horne [33] concluded in a review that previous MRI studies found significant structural changes (i.e., reduced white and gray matter of particular brain areas, including the hippocampus) in children with SDB.…”

Section: Discussioncontrasting

confidence: 62%

Does sleep-disordered breathing add to impairments in academic performance and brain structure usually observed in children with overweight/obesity?

et al. 2022

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Approximately 4–11% of children suffer from sleep-disordered breathing (SDB), and children with obesity are at increased risk. Both obesity and SDB have been separately associated with poorer brain health, yet whether SDB severity affects brain health in children with obesity remains unanswered. This study aimed to examine associations of SDB severity with academic performance and brain structure (i.e., total brain and gray and white matter volumes and gray matter volume in the hippocampus) in children with overweight/obesity. One hundred nine children aged 8–12 years with overweight/obesity were included. SDB severity and its subscales (i.e., snoring, daytime sleepiness, and inattention/hyperactivity) were evaluated via the Pediatric Sleep Questionnaire (PSQ), and academic performance was evaluated with the Woodcock-Muñoz standardized test and school grades. Brain structure was assessed by magnetic resonance imaging. SDB severity was not associated with academic performance measured by the standardized test (all |β|> 0.160, P > 0.076), yet it was associated with the school grade point average (β = -0.226, P = 0.007) and natural and social science grades (β = -0.269, P = 0.024). Intention/hyperactivity seemed to drive these associations. No associations were found between SDB severity and the remaining school grades (all β < -0.188, P > 0.065) or brain volumes (all P > 0.05).Conclusion: Our study shows that SDB severity was associated with lower school grades, yet it was not associated with the standardized measurement of academic performance or with brain volumes in children with overweight/obesity. SDB severity may add to academic problems in children beyond the effects contributed by overweight/obesity status alone. What is Known:• Sleep-disordered breathing (SDB) may affect brain structure and academic performance in children.• Children with overweight/obesity are at higher risk for the development of SDB, yet the comorbid obesity-SDB relationship with brain health has not been investigated thus far. What is New:• To our knowledge, this is the first study examining the associations of comorbid obesity-SDB severity with brain volumes and academic performance in children.• SDB symptoms may adversely affect academic performance at school in children with overweight/obesity, beyond the effects of weight status alone.

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Section: Discussioncontrasting

confidence: 62%

Does sleep-disordered breathing add to impairments in academic performance and brain structure usually observed in children with overweight/obesity?

et al. 2022

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“…Of note, functional MRI‐imaging data have shown that children with OSAS require greater neural recruitment of regions of the brain involved in cognitive control, conflict monitoring, and attentional allocation to perform at the same level as control subjects 20 . However, that is not the whole story as multiple regions of cortical thinning as well as changes in gray and white matter regional brain volumes have been described in children with OSAS, though here again the severity of OSAS did not correlate with the extent of these alterations 21,22 …”

Section: Osas In Otherwise Healthy Childrenmentioning

confidence: 75%

“…20 However, that is not the whole story as multiple regions of cortical thinning as well as changes in gray and white matter regional brain volumes have been described in children with OSAS, though here again the severity of OSAS did not correlate with the extent of these alterations. 21,22 Inflammatory factors seem to explain some of the individual variability seen. Children with OSAS and neurocognitive dysfunction have been reported to have higher plasma CRP levels compared to children with OSAS without neurocognitive dysfunction.…”

Section: Neurocognitive and Behavioral Consequencesmentioning

confidence: 99%

Phenotypic variance in pediatric obstructive sleep apnea

Tan

Kaditis

2021

Pediatric Pulmonology

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It is crucial that clinicians understand what underpins the considerable phenotypic variance in pediatric obstructive sleep apnea syndrome (OSAS), if they are to implement individually tailored phenotype-based approaches to diagnosis and management.This review summarizes the current literature on how disease severity, comorbidities, genetic and environmental/lifestyle factors interact to determine the overall OSAS phenotype. The first part discusses the impact of these factors on OSAS-related morbidity in the context of otherwise healthy children, whilst the second half details children with complex conditions, particularly focusing on the anatomical and functional abnormalities predisposing to upper airway obstruction unique to each condition. One can then understand the need for a multidimensional assessment strategy for pediatric OSAS; one that incorporates the history, physical examination, sleep study results, and biomarkers to enable precise stratification, so vital for effective determination of the timing and the nature of the therapeutic interventions required.

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“…In adolescents, weekend shifts in sleep schedules, reduced sleep efficiency, and shorter weekday sleep durations have all been shown to be associated with smaller gray matter volumes ( Lapidaire et al, 2021 , Teicher et al, 2018 , Urrila et al, 2017 ). Research examining specific regions suggests that sleep disturbances, including shorter weekday sleep durations and obstructive sleep apnea, are associated with reduced regional gray matter volume in the bi-lateral hippocampus ( Taki et al, 2012 ) and across various frontal regions ( Musso et al, 2020 , Philby et al, 2017 ) in children and adolescence. These studies indicate a role of sleep and sleep disturbances in gray matter development across childhood and adolescence, but additional research is clearly needed to further clarify this association.…”

Section: Sleep and Neurodevelopment In Childhoodmentioning

confidence: 99%

Preschool sleep and depression interact to predict gray matter volume trajectories across late childhood to adolescence

Hoyniak

Whalen

Tillman

et al. 2022

Developmental Cognitive Neuroscience

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There is a close relationship between sleep and depression, and certain maladaptive outcomes of sleep problems may only be apparent in individuals with heightened levels of depression. In a sample enriched for preschool depression, we examined how sleep and depression in early childhood interact to predict later trajectories of gray matter volume. Participants ( N = 161) were recruited and assessed during preschool (ages 3–6 years) and were later assessed with five waves of structural brain imaging, spanning from late childhood to adolescence. Sleep and depression were assessed using a semi-structured parent interview when the children were preschool-aged, and total gray matter volume was calculated at each scan wave. Although sleep disturbances alone did not predict gray matter volume/trajectories, preschool sleep and depression symptoms interacted to predict later total gray matter volume and the trajectory of decline in total gray matter volume. Sleep disturbances in the form of longer sleep onset latencies, increased irregularity in the child’s sleep schedule, and higher levels of daytime sleepiness in early childhood were all found to interact with early childhood depression severity to predict later trajectories of cortical gray matter volume. Findings provide evidence of the interactive effects of preschool sleep and depression symptoms on later neurodevelopment.

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Volumetric brain magnetic resonance imaging analysis in children with obstructive sleep apnea

Cited by 20 publications

References 45 publications

Does sleep-disordered breathing add to impairments in academic performance and brain structure usually observed in children with overweight/obesity?

Does sleep-disordered breathing add to impairments in academic performance and brain structure usually observed in children with overweight/obesity?

Phenotypic variance in pediatric obstructive sleep apnea

Preschool sleep and depression interact to predict gray matter volume trajectories across late childhood to adolescence

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