Please use this identifier to cite or link to this item: http://ahro.austin.org.au/austinjspui/handle/1/11411
Title: Magnetic resonance spectroscopy and neurocognitive dysfunction in obstructive sleep apnea before and after CPAP treatment.
Authors: O'Donoghue, Fergal J;Wellard, R Mark;Rochford, Peter D;Dawson, Andrew;Barnes, Maree;Ruehland, Warren R;Jackson, Melinda L;Howard, Mark E;Pierce, Robert J;Jackson, Graeme D
Affiliation: Institute for Breathing and Sleep, Austin Health, Heidelberg, Australia. Fergal.ODonoghue@austin.org.au
Issue Date: 1-Jan-2012
Citation: Sleep 2012; 35(1): 41-8
Abstract: To determine whether cerebral metabolite changes may underlie abnormalities of neurocognitive function and respiratory control in OSA.Observational, before and after CPAP treatment.Two tertiary hospital research institutes.30 untreated severe OSA patients, and 25 age-matched healthy controls, all males free of comorbidities, and all having had detailed structural brain analysis using voxel-based morphometry (VBM).Single voxel bilateral hippocampal and brainstem, and multivoxel frontal metabolite concentrations were measured using magnetic resonance spectroscopy (MRS) in a high resolution (3T) scanner. Subjects also completed a battery of neurocognitive tests. Patients had repeat testing after 6 months of CPAP. There were significant differences at baseline in frontal N-acetylaspartate/choline (NAA/Cho) ratios (patients [mean (SD)] 4.56 [0.41], controls 4.92 [0.44], P = 0.001), and in hippocampal choline/creatine (Cho/Cr) ratios (0.38 [0.04] vs 0.41 [0.04], P = 0.006), (both ANCOVA, with age and premorbid IQ as covariates). No longitudinal changes were seen with treatment (n = 27, paired t tests), however the hippocampal differences were no longer significant at 6 months, and frontal NAA/Cr ratios were now also significantly different (patients 1.55 [0.13] vs control 1.65 [0.18] P = 0.01). No significant correlations were found between spectroscopy results and neurocognitive test results, but significant negative correlations were seen between arousal index and frontal NAA/Cho (r = -0.39, corrected P = 0.033) and between % total sleep time at SpO(2) < 90% and hippocampal Cho/Cr (r = -0.40, corrected P = 0.01).OSA patients have brain metabolite changes detected by MRS, suggestive of decreased frontal lobe neuronal viability and integrity, and decreased hippocampal membrane turnover. These regions have previously been shown to have no gross structural lesions using VBM. Little change was seen with treatment with CPAP for 6 months. No correlation of metabolite concentrations was seen with results on neurocognitive tests, but there were significant negative correlations with OSA severity as measured by severity of nocturnal hypoxemia.
Internal ID Number: 22215917
URI: http://ahro.austin.org.au/austinjspui/handle/1/11411
DOI: 10.5665/sleep.1582
URL: http://www.ncbi.nlm.nih.gov/pubmed/22215917
Type: Journal Article
Subjects: Neuroimaging
hypoxia
neuropsychological
sleep disordered breathing
Adult
Brain.metabolism
Case-Control Studies
Continuous Positive Airway Pressure
Humans
Magnetic Resonance Imaging.methods
Male
Neuroimaging.methods
Neuropsychological Tests
Sleep Apnea, Obstructive.metabolism.therapy
Appears in Collections:Journal articles

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