Functional Connectivity Changes in the Insular Subregions of Patients with Obstructive Sleep Apnea after 6 Months of Continuous Positive Airway Pressure Treatment

Long, Ting; Li, Haijun; Shu, Yongqiang; Li, Kunyao; Xie, Wei; Zeng, Yaping; Huang, Ling; Zeng, Li; Liu, Xiang; Peng, Dechang

doi:10.1155/2023/5598047

Cited by 6 publications

(2 citation statements)

References 78 publications

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“…CPAP treatment was shown to modulate FC or activation in some regions and improve behavioral performance in some studies, but not in others. These inconsistent results may be due to different fMRI paradigms, analysis methods, or baseline characteristics (Khazaie et al., 2017 ; Li et al., 2022 ; Long et al., 2023 ; Prilipko et al., 2012 ; Prilipko et al., 2014 ; Sun et al., 2023 ). Moreover, OSA triggers compensatory or adaptive responses in the brain, such as increased activation or deactivation in specific regions or networks, increased connectivity or plasticity in others, or higher brain volume or metabolism in some areas.…”

Section: Discussionmentioning

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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Section: Discussionmentioning

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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“…However, the results of large multicenter studies are still mixed (87)(88)(89). Interestingly, some studies suggest that CPAP treatment may increase FC in adults with OSA, notably in DMN regions such as the PCC and precuneus (82,90). Taken together, the potential beneficial effects of CPAP treatment to preserve brain and cognitive integrity still need to be confirmed in older populations.…”

Section: Discussionmentioning

confidence: 99%

Altered resting-state functional connectivity patterns in late middle-aged and older adults with obstructive sleep apnea

et al. 2023

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IntroductionObstructive sleep apnea (OSA) is increasingly recognized as a risk factor for cognitive decline, and has been associated with structural brain alterations in regions relevant to memory processes and Alzheimer’s disease. However, it is unclear whether OSA is associated with disrupted functional connectivity (FC) patterns between these regions in late middle-aged and older populations. Thus, we characterized the associations between OSA severity and resting-state FC between the default mode network (DMN) and medial temporal lobe (MTL) regions. Second, we explored whether significant FC changes differed depending on cognitive status and were associated with cognitive performance.MethodsNinety-four participants [24 women, 65.7 ± 6.9 years old, 41% with Mild Cognitive Impairment (MCI)] underwent a polysomnography, a comprehensive neuropsychological assessment and a resting-state functional magnetic resonance imaging (MRI). General linear models were conducted between OSA severity markers (i.e., the apnea-hypopnea, oxygen desaturation and microarousal indices) and FC values between DMN and MTL regions using CONN toolbox. Partial correlations were then performed between OSA-related FC patterns and (i) OSA severity markers in subgroups stratified by cognitive status (i.e., cognitively unimpaired versus MCI) and (ii) cognitive scores in the whole sample. All analyzes were controlled for age, sex and education, and considered significant at a p < 0.05 threshold corrected for false discovery rate.ResultsIn the whole sample, a higher apnea-hypopnea index was significantly associated with lower FC between (i) the medial prefrontal cortex and bilateral hippocampi, and (ii) the left hippocampus and both the posterior cingulate cortex and precuneus. FC patterns were not associated with the oxygen desaturation index, or micro-arousal index. When stratifying the sample according to cognitive status, all associations remained significant in cognitively unimpaired individuals but not in the MCI group. No significant associations were observed between cognition and OSA severity or OSA-related FC patterns.DiscussionOSA severity was associated with patterns of lower FC in regions relevant to memory processes and Alzheimer’s disease. Since no associations were found with cognitive performance, these FC changes could precede detectable cognitive deficits. Whether these FC patterns predict future cognitive decline over the long-term needs to be investigated.

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The Effect of Obstructive Sleep Apnea on Cognition: A Focus on Decision-Making

Cini,

Salabelle,

Salsone

et al. 2024

Curr Treat Options Neurol

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Functional Connectivity Changes in the Insular Subregions of Patients with Obstructive Sleep Apnea after 6 Months of Continuous Positive Airway Pressure Treatment

Cited by 6 publications

References 78 publications

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

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

Altered resting-state functional connectivity patterns in late middle-aged and older adults with obstructive sleep apnea

The Effect of Obstructive Sleep Apnea on Cognition: A Focus on Decision-Making

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