Glymphatic system dysfunction in obstructive sleep apnea evidenced by DTI-ALPS

Lee, Ho‐Joon; Lee, Dong Ah; Shin, Kyoungsoon; Park, Kang Min

doi:10.1016/j.sleep.2021.12.013

Cited by 60 publications

(30 citation statements)

References 35 publications

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“…In this study, the ALPS-index was calculated, which shows the influence of the water diffusion along the perivascular space and reflects activity of the glymphatic system. The results of our study were able to confirm with large number of subjects again with the findings of previous study (Lee et al, 2022) and show glymphatic system is dysfunctional in OSA subjects, with decreased ratio in OSA over healthy controls. Our results indicate that the ALPS-index is close to 1, which represents that the water diffusion along the perivascular space is minimal.…”

Section: Diffusion and Analysis Along The Perivascular Space Indices ...supporting

confidence: 91%

“…Although a recent pilot study showed altered glymphatic system in limited number of OSA patients (Lee et al, 2022), but without examination of interactions between transverse, vertical, and longitudinal fiber directions, as well as correlations of glymphatic system indices with sleep symptoms. Therefore, in the present study, our aim was to examine the glymphatic system activity in newly diagnosed, treatment-naïve OSA patients compared to healthy control subjects, assess relationships between OSA disease severity, sleep symptoms, and glymphatic system indices in OSA patients, as well as correlations between diffusivity components and disease severity and sleep symptoms in OSA subjects.…”

Section: Introductionmentioning

confidence: 95%

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Impaired Glymphatic System Actions in Obstructive Sleep Apnea Adults

et al. 2022

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Study ObjectivesObstructive sleep apnea (OSA) is accompanied by sleep fragmentation and altered sleep architecture, which can potentially hinder the glymphatic system, increasing risks for Alzheimer’s disease (AD), but the status is unclear in OSA. Our aim was to investigate the glymphatic system in OSA subjects and examine the relationships between OSA disease severity, sleep symptoms, and glymphatic system indices in OSA using diffusion tensor imaging (DTI).MethodsWe acquired DTI data from 59 OSA and 62 controls using a 3.0-Tesla MRI and examined OSA disease severity and sleep symptoms with the Pittsburgh Sleep Quality Index (PSQI) and Epworth Sleepiness Scale (ESS). Diffusivity maps in the x-axis (Dxx), y-axis (Dyy), and z-axis (Dzz), as well as in x-y axis (Dxy), y-z axis (Dyz), and x-z axis (Dxz) were calculated, diffusion values for the projection and association fibers extracted, and the DTI analyses along the perivascular space (DTI-ALPS index) were performed. The glymphatic system indices were compared between groups and correlated with disease severity and sleep symptoms in OSA subjects.ResultsDzz values, derived from projection fiber areas, Dyy and Dzz values from association fiber areas, as well as ALPS and Dyzmean values were significantly reduced in OSA over controls. Significant correlations emerged between disease severity, sleep symptoms, and Dxy, Dxx, and Dzz values in OSA subjects.ConclusionOSA patients show abnormal glymphatic system function that may contribute to increased risks for AD. The findings suggest that the APLS method can be used to assess the glymphatic system in OSA patients.

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Section: Diffusion and Analysis Along The Perivascular Space Indices ...supporting

confidence: 91%

Section: Introductionmentioning

confidence: 95%

Impaired Glymphatic System Actions in Obstructive Sleep Apnea Adults

et al. 2022

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“…Dr. Ho-Joon Lee and colleagues describe the glymphatic system dysfunction in obstructive sleep apnea (OSA) patients using the DTI-ALPS index as a MRI marker [ 1 ]. DTI-ALPS index was significantly correlated with apnea-hypopnea (AHI, r = −0.427; p = 0.042) and oxygen desaturation index (ODI, r = −0.497; p = 0.036).…”

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confidence: 99%

Sleep body position correlates with cognitive performance in middle-old obstructive sleep apnea subjects

et al. 2022

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“…These studies suggest the promise of the DTI-ALPS index as an imaging marker for assessing cognitive impairment. Two other researches on sleep disorders found that the DTI-ALPS index was significantly lower in patients with obstructive sleep apnea (OSA) and isolated rapid eye movement sleep behavior disorder (iRBD) than in healthy controls ( 94 , 95 ).…”

Section: Imaging Of Brain Glymphatic Systemmentioning

confidence: 99%

Perivascular Spaces, Glymphatic System and MR

et al. 2022

Front. Neurol.

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The importance of the perivascular space (PVS) as one of the imaging markers of cerebral small vessel disease (CSVD) has been widely appreciated by the neuroradiologists. The PVS surrounds the small blood vessels in the brain and has a signal consistent with the cerebrospinal fluid (CSF) on MR. In a variety of physio-pathological statuses, the PVS may expand. The discovery of the cerebral glymphatic system has provided a revolutionary perspective to elucidate its pathophysiological mechanisms. Research on the function and pathogenesis of this system has become a prevalent topic among neuroradiologists. It is now believed that this system carries out the similar functions as the lymphatic system in other parts of the body and plays an important role in the removal of metabolic waste and the maintenance of homeostatic fluid circulation in the brain. In this article, we will briefly describe the composition of the cerebral glymphatic system, the influencing factors, the MR manifestations of the PVS and the related imaging technological advances. The aim of this research is to provide a reference for future clinical studies of the PVS and glymphatic system.

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Glymphatic system dysfunction in obstructive sleep apnea evidenced by DTI-ALPS

Cited by 60 publications

References 35 publications

Impaired Glymphatic System Actions in Obstructive Sleep Apnea Adults

Impaired Glymphatic System Actions in Obstructive Sleep Apnea Adults

Sleep body position correlates with cognitive performance in middle-old obstructive sleep apnea subjects

Perivascular Spaces, Glymphatic System and MR

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