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

Abstract

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.

The effectiveness of adjustable oral appliance for older adult patients with obstructive sleep apnea syndrome

“…The results of the CBCT examination in this study showed that the palatal and glossopharyngeal air passages of older adult OSAS patients were significantly enlarged. The efficacy of adjustable OAs for older adult OSAS patients is further verified, and the structural stenosis of the palatal and glossopharyngeal has also been confirmed to be a significant cause of OSAS, which was consistent with a previous analysis result of spiral CT and MRI in literature (19).…”

Ağır Derecede Obstrüktif Uyku Apne Sendromu Hastalarında Bilişsel İşlevlerin Değerlendirilmesi

“…OUAS daha önce nörokognitif bozukluklarla ilişkilendirilmiştir. Bilişsel alanlar içinde de en çok yürütücü işlevlerin etkilendiği düşünülmektedir (13). Literatür incelendiğinde ise AVLT ve Stroop değerlendirilmesi birkaç çalışmada kullanılmıştır (14).…”

Τα Επίπεδα Της 25-Υδροξυβιταμίνης D Και Της Ιντερλευκίνης-6 Σε Ενήλικες Ασθενείς Με Σύνδρομο Αποφρακτικής Άπνοιας Ύπνου (ΣΑΑΥ) Και Η Επίδραση Της Θεραπείας Με Συνεχή Θετική Πίεση Αέρα Στα Υποπεδία Των Εκτελεστικών Λειτουργιών Του Εγκεφάλου

“…Συνδέεται επίσης, με την απώλεια νευρο-αξόνων γεγονός που προκαλεί βλάβη στη μυελίνη, τη λευκή ουσία και τον μετωπιαίο λοβό με αποτέλεσμα τη μη αναστρέψιμη βλάβη στα γνωστικά και εκτελεστικά πεδία [220]. Επίσης, η βαρύτητα του ΣΑΑΥ μπορεί να προκαλέσει ελλείμματα στη μνήμη εργασίας, στη χωρητικότητα της μνήμης [221,222,223], στη μειωμένη ταχύτητα επεξεργασίας πληροφοριών, στην έλλειψη προσοχής [224,225,226], στη λήψη απόφασης [227], στην οπτικο-χωρική λειτουργία [228,229] και στη μάθηση [230].…”

“…Η σοβαρότητα του ΣΑΑΥ και κατά συνέπεια των χαρακτηριστικών του συνδέεται με τη βλάβη του εγκεφαλικού ιστού στους διάφορους γνωστικούς τομείς [207,211,219]. Πολλές μελέτες επισημαίνουν πως η βαρύτητα του ΣΑΑΥ μπορεί να προκαλέσει ελλείμματα στη μνήμη εργασίας, στη χωρητικότητα της μνήμης [221,222,223], στη μειωμένη ταχύτητα επεξεργασίας πληροφοριών, στην έλλειψη προσοχής [224,225,226], στη λήψη απόφασης [227], στην οπτικοχωρική λειτουργία [228,229] και στη μάθηση [230]. Τα ευρήματα της τρέχουσας μελέτης συμφωνούν με τη μελέτη των Kong και συν., [198] ότι η θεραπεία με CPAP δεν μειώνει σταθερά τα αυξημένα επίπεδα IL-6.…”