Contribution of hypercapnia to cognitive impairment in severe sleep-disordered breathing

Beaudin, Andrew E.; Raneri, Jill K.; Ayas, Najib; Skomro, Robert; Smith, Eric E.; Hanly, Patrick J.

doi:10.5664/jcsm.9558

Cited by 12 publications

(4 citation statements)

References 38 publications

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“…The dAI is considered an influential functional center of the human brain and is often described as a “cognitive” area ( Uddin et al, 2014 ). Growing evidence suggests that respiratory and sleep disorders in OSA patients lead to cognitive impairment, encompassing language, attention, executive control and so on ( Beaudin et al, 2021 ). Newly emerging evidence has demonstrated that damage to the cerebellar cortex, including among abnormally connected brain regions, leads to cognitive impairment ( Ramnani, 2012 ).…”

Section: Discussionmentioning

confidence: 99%

“…Obstructive sleep apnea (OSA) is a sleep-related breathing disorder characterized by recurrent complete or partial pharyngeal collapse during sleep ( Jordan et al, 2014 ). These episodes bring about intermittent nocturnal apnea and hypoxia, hypercapnia, and sleep fragmentation, negatively impacting cognitive, neuropsychological, sensorimotor, and affective functioning ( Vanek et al, 2020 ; Beaudin et al, 2021 ; Lee et al, 2021 ). Evidence has displayed that the occurrence of OSA is related to abnormal structure and function in the central nervous system, especially impairments in the insular cortex ( Li et al, 2014 ; Rosenzweig et al, 2014 ).…”

Section: Introductionmentioning

confidence: 99%

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Aberrant Resting-State Functional Brain Connectivity of Insular Subregions in Obstructive Sleep Apnea

Kong

Shu

et al. 2022

Front. Neurosci.

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The insular cortex is a cortical regulatory area involved in dyspnea, cognition, emotion, and sensorimotor function. Previous studies reported that obstructive sleep apnea (OSA) shows insular tissue damage and abnormal functional connections for the whole insula. The insula can be divided into different subregions with distinct functional profiles, including the ventral anterior insula (vAI) participating in affective processing, dorsal anterior insula (dAI) involved in cognitive processing, and posterior insula (PI) involved in the processing of sensorimotor information. However, the functional connectivity (FC) of these insular subregions in OSA has yet to be established. Hence, the purpose of this study was to explore the resting-state FC of the insular subregions with other brain areas and its relationship with clinical symptoms of OSA. Resting-state functional magnetic resonance imaging data from 83 male OSA patients and 84 healthy controls were analyzed by whole-brain voxel-based FC using spherical seeds from six insular subregions, namely, the bilateral vAI, dAI, and PI, to identify abnormalities in the insular subregions network and related brain regions. Ultimately, the Pearson correlation analysis was carried out between the dysfunction results and the neuropsychological tests. Compared with the healthy control group, the OSA patients exhibited disturbed FC from the dAI to areas relevant to cognition, such as the bilateral cerebellum posterior lobe, superior frontal gyrus, right middle frontal gyrus and middle temporal gyrus; decreased FC from the vAI to areas linked with emotion, such as the bilateral fusiform gyrus, superior parietal lobule, precuneus and cerebellum posterior lobe; and abnormal FC from the PI to the brain regions involved in sensorimotor such as the bilateral precentral gyrus, right superior/middle temporal gyrus and left superior frontal gyrus. The linear regression result showed that the apnea-hypopnea index was positively correlated with the increased FC between the right PI and the right precuneus (after Bonferroni correlation, P < 0.001) In conclusion, the abnormal FC between insular subregions and other brain regions were related to cognitive, emotional and sensorimotor networks in OSA patients. These results may provide a new imaging perspective for further understanding of OSA-related cognitive and affective disorders.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Aberrant Resting-State Functional Brain Connectivity of Insular Subregions in Obstructive Sleep Apnea

Kong

Shu

et al. 2022

Front. Neurosci.

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“…Indeed, MoCA was designed to screen for dementia ( 3 ) and does not replace a comprehensive cognitive assessment. However, aside from the fact that it has been used in patients who require overnight respiratory support ( 4 , 5 ), it allows a multidimensional assessment of cognitive function, unlike other cognitive tests like the Trail Making Test. To illustrate this, we performed a domain-by-domain analysis of MoCA results before and after the initiation of home NIV.…”

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confidence: 99%

Reply to Esquinas et al.

Patout,

Razakamanantsoa,

D’Cruz

et al. 2023

Am J Respir Crit Care Med

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“…While sleep disturbances have been observed in adults with MetS, there is limited research on their occurrence in children and adolescents [2].Obesity contributes to sleep apnea by causing intermittent hypoxia and fragmented sleep [3]. The repeated micro-arousals refer to the disruption of normal sleep architecture, resulting in poor sleep quality, contributing to excessive daytime sleepiness and may lead to neurocognitive and behavioural problems [4]. The Autonomous Arousal Index (AAI) is a sleep-related index that reflects the frequency of awakenings or arousals during sleep.…”

mentioning

confidence: 99%

Cardiorespiratory Monitoring of Children and Adolescents With Metabolic Syndrome Aged 10-17 Years: A Cross-Sectional Descriptive Study

Aliusef,

Churylina,

Mitiuriaeva

et al. 2023

EUMJ

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Study objectives. This study aims to investigate potential differences in sleep parameters between children with metabolic syndrome (MetS) and their healthy counterparts using the portable cardiorespiratory monitoring device SOMNOcheck micro CARDIO. Methods. The study included 71 children and adolescents aged 10 to 17 years, with 39 in the MetS group and 32 in the control group. The main anthropometric parameters were: neck circumference (NC), waist circumference (WC) and waist-to-height ratio (WHtR). All children were assessed using the Friedman tongue position (FTP) scale. Children completed the Epworth Sleepiness Scale for Children and Adolescents (ESS-CHAD) and the Montreal Cognitive Assessment (MoCA). Salivary cortisol was collected in the morning immediately after waking up. The sleep study was performed using a portable SOMNOcheck micro CARDIO device with a special cardiaс sensor. Statistical analysis of the data was performed using EZR version 1.61. Results. Significant differences in cardiorespiratory sleep monitoring were observed between between the MetS and non-MetS groups. Patients with MetS had higher daytime sleepiness scores and lower MoCA scores compared to the control group. Cortisol levels in morning saliva showed a marked increase among children with obstructive apnea/hypopnea index ≥ 1. A logistic regression model established a link between FTP stages III and IV and the autonomous arousal index. Conclusions. These findings highlight the differences (p < 0.05) in sleep-related parameters between the MetS and non-MetS groups, which may indicate an increased risk of sleep-disordered breathing and cognitive impairment in such children.

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Contribution of hypercapnia to cognitive impairment in severe sleep-disordered breathing

Cited by 12 publications

References 38 publications

Aberrant Resting-State Functional Brain Connectivity of Insular Subregions in Obstructive Sleep Apnea

Aberrant Resting-State Functional Brain Connectivity of Insular Subregions in Obstructive Sleep Apnea

Reply to Esquinas et al.

Cardiorespiratory Monitoring of Children and Adolescents With Metabolic Syndrome Aged 10-17 Years: A Cross-Sectional Descriptive Study

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