Association of Polysomnographic Sleep Parameters With Neuroimaging Biomarkers of Cerebrovascular Disease in Older Adults With Sleep Apnea

Carvalho, Diego Z.; McCarter, Stuart J.; St Louis, Erik K.; Przybelski, Scott A.; Johnson Sparrman, Kohl L.; Somers, Virend K.; Boeve, Bradley F.; Petersen, Ronald C.; Jack, Clifford R.; Graff-Radford, Jonathan; Vemuri, Prashanthi

doi:10.1212/wnl.0000000000207392

Cited by 15 publications

(3 citation statements)

References 51 publications

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“…The relationship between OSA and cerebral infarction remains controversial. Studies have suggested that OSA can lead to an adverse prognosis in cerebral infarction, impair brain function, exacerbate cognitive dysfunction, and increase mortality risk (30)(31)(32)(33). The main mechanisms underlying these adverse outcomes include chronic intermittent hypoxia, sympathetic activation, changes in cerebral blood flow, oxidative stress, systemic inflammation, hypercoagulability, and endothelial dysfunction (34,35).…”

Section: Discussionmentioning

confidence: 99%

Correlation between obstructive sleep apnea and hypoperfusion in patients with acute cerebral infarction

Zhou,

Jin,

Liu

et al. 2024

Front. Neurol.

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PurposeTo explore the relationship between obstructive sleep apnea (OSA) and hypoperfusion during ultra-early acute cerebral infarction.Patients and methodsData were retrospectively collected from patients admitted to our hospital with acute cerebral infarction between January 2020 and January 2022, who underwent comprehensive whole-brain computed tomography perfusion imaging and angiography examinations within 6 h of onset. The F-stroke software automatically assessed and obtained relevant data (Tmax). The patients underwent an initial screening for sleep apnea. Based on their Apnea-Hypopnea Index (AHI), patients were categorized into an AHI ≤15 (n = 22) or AHI >15 (n = 25) group. The pairwise difference of the time-to-maximum of the residue function (Tmax) > 6 s volume was compared, and the correlation between AHI, mean pulse oxygen saturation (SpO2), oxygen desaturation index (ODI), percentage of time with oxygen saturation < 90% (T90%), and the Tmax >6 s volume was analyzed.ResultsThe Tmax >6 s volume in the AHI > 15 group was significantly larger than that in the AHI ≤ 15 group [109 (62–157) vs. 59 (21–106) mL, p = 0.013]. Spearman’s correlation analysis revealed Tmax >6 s volume was significantly correlated with AHI, mean SpO2, ODI, and T90% in the AHI > 15 group, however, no significant correlations were observed in the AHI ≤ 15 group. Controlling for the site of occlusion and Multiphase CT angiography (mCTA) score, AHI (β = 0.919, p < 0.001), mean SpO2 (β = −0.460, p = 0.031), ODI (β = 0.467, p = 0.032), and T90% (β =0.478, p = 0.026) remained associated with early hypoperfusion in the AHI > 15 group.ConclusionIn patients with acute cerebral infarction and AHI > 15, AHI, mean SpO2, ODI and T90% were associated with early hypoperfusion. However, no such relationship exists among patients with AHI ≤ 15.

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Section: Discussionmentioning

confidence: 99%

Correlation between obstructive sleep apnea and hypoperfusion in patients with acute cerebral infarction

Zhou,

Jin,

Liu

et al. 2024

Front. Neurol.

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“…A confounder in sleep disruption studies might be the (unknown) presence of obstructive sleep apnoea (OSA). Multiple studies in populations with OSA investigated its relationship with AD through vascular damage, because people with OSA have higher cardiovascular risk and has increased oxidative stress due to their nocturnal hypoxemia, possibly exacerbating neurovascular damage [64][65][66][67], as described in detail in the review by Daulatzai (2015) [68]. Indeed, the meta-analysis by Bubu et al revealed that among sleep disorders, OSA carries the greatest relative risk (RR) for AD [4].…”

Section: Discussionmentioning

confidence: 99%

The effect of long-term sleep disruption on the brain – looking beyond amyloid

Mentink,

van Osch,

Bakker

et al. 2023

Preprint

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The mechanism underlying the possible causal association between long-term sleep disruption and Alzheimer’s disease remains unclear [1]. A hypothesised pathway through increased brain amyloid load was not confirmed in previous work in our cohort of maritime pilots with long-term work-related sleep disruption [2]. Here, using functional MRI, T2-FLAIR and Arterial Spin Labeling MRI scans, we explored alternative neuroimaging biomarkers related to both sleep disruption and AD: resting-state network co-activation and between-network connectivity of the default mode network (DMN), salience network (SAL) and frontoparietal network (FPN), vascular damage and cerebral blood flow (CBF).We acquired data of 16 maritime pilots (56 ± 2.3 years old) with work-related long-term sleep disruption (23 ± 4.8 working years) and 16 healthy controls (59 ± 3.3 years old), with normal sleep patterns (Pittsburgh Sleep Quality Index ≤ 5). Maritime pilots did not show altered co-activation in either the DMN, FPN, or SAL and no differences in between-network connectivity. We did not detect increased markers of vascular damage in maritime pilots, and additionally, maritime pilots did not show altered CBF-patterns compared to healthy controls.In summary, maritime pilots with long-term sleep disruption did not show neuroimaging markers indicative of preclinical AD compared to healthy controls. These findings do not resemble those of short-term sleep deprivation studies. This could be due to resiliency to sleep disruption or selection bias, as participants have already been exposed to and were able to deal with sleep disruption for multiple years, or to compensatory mechanisms [3]. This suggests the relationship between sleep disruption and AD is not as strong as previously implied in studies on short-term sleep deprivation, which would be beneficial for all shift workers suffering from work-related sleep disruptions.

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“…Obstructive sleep apnea (OSA) is a prevalent sleep disorder characterized by recurrent episodes of upper airway collapse during sleep, leading to intermittent hypoxia and sleep fragmentation (Bhuniya et al., 2022 ; Carvalho et al., 2023 ; Ji et al., 2022 ; Lal et al., 2021 ; Martins & Conde, 2021 ; Slowik et al., 2023 ). It affects millions of people worldwide (Benjafield et al., 2019 ; Lyons et al., 2020 ).…”

Section: Introductionmentioning

confidence: 99%

Obstructive sleep apnea and attention deficits: A systematic review of magnetic resonance imaging biomarkers and neuropsychological assessments

Ghaderi,

Mohammadi,

Mohammadi

2023

Brain and Behavior

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Background and objectiveObstructive sleep apnea (OSA) is a common sleep disorder that causes intermittent hypoxia and sleep fragmentation, leading to attention impairment and other cognitive deficits. Magnetic resonance imaging (MRI) is a powerful modality that can reveal the structural and functional brain alterations associated with attention impairment in OSA patients. The objective of this systematic review is to identify and synthesize the evidence on MRI biomarkers and neuropsychological assessments of attention deficits in OSA patients.MethodsWe searched the Scopus and PubMed databases for studies that used MRI to measure biomarkers related to attention alteration in OSA patients and reported qualitative and quantitative data on the association between MRI biomarkers and attention outcomes. We also included studies that found an association between neuropsychological assessments and MRI findings in OSA patients with attention deficits.ResultsWe included 19 studies that met our inclusion criteria and extracted the relevant data from each study. We categorized the studies into three groups based on the MRI modality and the cognitive domain they used: structural and diffusion tensor imaging MRI findings, functional, perfusion, and metabolic MRI findings, and neuropsychological assessment findings.ConclusionsWe found that OSA is associated with structural, functional, and metabolic brain alterations in multiple regions and networks that are involved in attention processing. Treatment with continuous positive airway pressure can partially reverse some of the brain changes and improve cognitive function in some domains and in some studies. This review suggests that MRI techniques and neuropsychological assessments can be useful tools for monitoring the progression and response to treatment of OSA patients.

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Association of Polysomnographic Sleep Parameters With Neuroimaging Biomarkers of Cerebrovascular Disease in Older Adults With Sleep Apnea

Cited by 15 publications

References 51 publications

Correlation between obstructive sleep apnea and hypoperfusion in patients with acute cerebral infarction

Correlation between obstructive sleep apnea and hypoperfusion in patients with acute cerebral infarction

The effect of long-term sleep disruption on the brain – looking beyond amyloid

Obstructive sleep apnea and attention deficits: A systematic review of magnetic resonance imaging biomarkers and neuropsychological assessments

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