Executive functioning in obstructive sleep apnea syndrome patients without comorbidities: Focus on the fractionation of executive functions

Borges, Juliane Goldoni; Ginani, Giuliano Emerenciano; Hachul, Helena; Cintra, Fátima Dumas; Tufik, Sérgio; Pompéia, Sabine

doi:10.1080/13803395.2013.858661

Cited by 31 publications

(26 citation statements)

References 61 publications

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“…In a review by Bucks et al (2013), five published articles were analyzed and disease severity was not associated with cognitive functions in three of them. Also, in another study by Borges et al (2013), no significant correlation was found between AHI and executive performance. These findings are also consistent with our study findings.…”

Section: Discussionmentioning

confidence: 82%

Factors affecting executive functions in obstructive sleep apnea syndrome and volumetric changes in the prefrontal cortex

et al. 2016

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Purpose Obstructive sleep apnea syndrome (OSAS) is associated with cognitive changes and executive functions are among the cognitive domains most affected. However, it is not completely understood which of the factor(s) among hypoxemia, repeated arousal, and sleepiness affect the executive functions. This study aims to evaluate the possible relationship between the executive functions and nocturnal parameters, Epworth Sleepiness Scale (ESS) scores, and prefrontal cortex (PFC) volumes. Patients and methodsA total of 28 patients aged between 18 and 60 years who were newly diagnosed with OSAS were included in this study. The Wisconsin Card Sorting Test (WCST) and Stroop test which were used in the evaluation of executive functions were applied to all patients. Cranial magnetic resonance imaging (MRI) and volumetric measurements of the PFC were performed. Polysomnography (PSG), WCST, Stroop test, and cranial MRI were also applied to the control group which consisted of age- and education status-matched 15 healthy subjects. The correlation of WCST and Stroop tests and PFC volume, PSG parameters, and ESS scale was examined.ResultsThe WCST-6 test scores were statistically significantly higher in the patient group (p = 0.022; p < 0.05). Additionally, the Stroop test 5 (p = 0.043) and Stroop test-5 correction (p = 0.005) measurements were statistically significantly higher in the patient group (p < 0.05). A negative and statistically significant correlation was found between the WCST-4 and WCST-10 and ESS measurements in the patient group (r −0.452; p 0.016; p < 0.05; r −0.437; p 0.020; p < 0.05). However, there was no correlation between the PSG parameters and WCST and Stroop test scores. No statistically significant differences in the MRI volumetric measurements of the PFC were found between the patient and control groups.ConclusionsImpairment in the attentive and executive functions in OSAS is evident. The most influential factor is excessive daytime sleepiness, rather than hypoxemia and severity of the disease.Electronic supplementary materialThe online version of this article (doi:10.1186/s40064-016-3609-z) contains supplementary material, which is available to authorized users.

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Section: Discussionmentioning

confidence: 82%

Factors affecting executive functions in obstructive sleep apnea syndrome and volumetric changes in the prefrontal cortex

et al. 2016

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“…Such inconsistent findings are a challenge for the field, and call in to question the proposed models of cognitive harm in OSA. These have led some authors to argue that OSA does not cause cognitive impairment, ipsum . Rather, they propose, the co‐morbidities commonly present in OSA such as hypertension, hyperlipidaemia, obesity with associated inflammation, diabetes or metabolic syndrome, are the primary causes of the neurological damage.…”

Section: The Role Of Co‐morbiditiesmentioning

confidence: 99%

“…Rather, they propose, the co‐morbidities commonly present in OSA such as hypertension, hyperlipidaemia, obesity with associated inflammation, diabetes or metabolic syndrome, are the primary causes of the neurological damage. In support of this view, one study that recruited individuals with OSA without co‐morbidities failed to find differences in cognitive performance between individuals with OSA and non‐OSA controls . Individuals with OSA without co‐morbidities, however, may not represent the norm in OSA, as increased co‐morbidity may itself be a consequence of the disorder, and vice versa .…”

Section: The Role Of Co‐morbiditiesmentioning

confidence: 99%

Reviewing the relationship between OSA and cognition: Where do we go from here?

et al. 2017

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Obstructive sleep apnoea (OSA) is a disorder of breathing during sleep resulting in temporary reduction in cerebral oxygenation and sleep disruption. A growing body of research reveals a relatively consistent pattern of deficits in cognition, particularly in attention, episodic memory, and executive function, which are partially remediated by treatment. This is where the consensus ends. Despite a number of competing explanations regarding how OSA affects cognition, reliable evidence is hard to find, which may relate to the many, common conditions co-morbid with OSA or to the methodological challenges in this field. This paper reviews the evidence for cognitive impairment in OSA, the proposed models of cognitive harm, the impact of comorbidities and the many methodological and theoretical challenges of exploring the effect of OSA on cognition. To overcome some of these challenges, we end by proposing a number of future directions for the field, including suggesting some core design elements for future studies.

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“…Dual-task performance-the ability to perform simultaneously two tasks that load on different storage domains-also constitutes a separable type of executive function (see Logie et al, 2004), as does planning, or the ability to organize behavior toward a specific goal that must be achieved through intermediate stages (Jurado and Rosselli, 2007;Oosterman et al, 2013), and the efficiency of access to long-term memory (see Fisk and Sharp, 2004). Updating, shifting and inhibiting are correlated but distinguishable abilities (see Miyake et al, 2000;Friedman and Miyake, 2004;Miyake and Friedman, 2012), and all six types of executive functions can be assessed separately in the same experimental setting (e.g., see Vaz et al, 2011;Ginani et al, 2011;Borges et al, 2013). Evaluation of one's own performance (metacognition) is also related to executive control (e.g., Fernandez-Duque et al, 2000) and has been little investigated in the caffeine literature.…”

Section: Introductionmentioning

confidence: 99%

Acute personalized habitual caffeine doses improve attention and have selective effects when considering the fractionation of executive functions

Lanini

Galduróz

Pompéia

2015

Hum. Psychopharmacol Clin Exp

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Caffeine is widely used, often consumed with food, and improves simple and complex/executive attention under fasting conditions. We investigated whether these cognitive effects are observed when personalized habitual doses of caffeine are ingested by caffeine consumers, whether they are influenced by nutriments and if various executive domains are susceptible to improvement. This was a double-blind, placebo-controlled study including 60 young, healthy, rested males randomly assigned to one of four treatments: placebo fasting, caffeine fasting, placebo meal and caffeine meal. Caffeine doses were individualized for each participant based on their self-reported caffeine consumption at the time of testing (morning). The test battery included measures of simple and sustained attention, executive domains (inhibiting, updating, shifting, dual tasking, planning and accessing long-term memory), control measures of subjective alterations, glucose and insulin levels, skin conductance, heart rate and pupil dilation. Regardless of meal intake, acute habitual doses of caffeine decreased fatigue, and improved simple and sustained attention and executive updating. This executive effect was not secondary to the habitual weekly dose consumed, changes in simple and sustained attention, mood, meal ingestion and increases in cognitive effort. We conclude that the morning caffeine "fix" has positive attentional effects and selectively improved executive updating whether or not caffeine is consumed with food.

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Executive functioning in obstructive sleep apnea syndrome patients without comorbidities: Focus on the fractionation of executive functions

Abstract: OSAS without comorbidities did not lead to cognitive impairment.

Cited by 31 publications

References 61 publications

Factors affecting executive functions in obstructive sleep apnea syndrome and volumetric changes in the prefrontal cortex

Factors affecting executive functions in obstructive sleep apnea syndrome and volumetric changes in the prefrontal cortex

Reviewing the relationship between OSA and cognition: Where do we go from here?

Acute personalized habitual caffeine doses improve attention and have selective effects when considering the fractionation of executive functions

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