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dc.contributor.authorO'Donoghue, Fergal Jen
dc.contributor.authorWellard, R Marken
dc.contributor.authorRochford, Peter Den
dc.contributor.authorDawson, Andrewen
dc.contributor.authorBarnes, Mareeen
dc.contributor.authorRuehland, Warren Ren
dc.contributor.authorJackson, Melinda Len
dc.contributor.authorHoward, Mark Een
dc.contributor.authorPierce, Robert Jen
dc.contributor.authorJackson, Graeme Den
dc.identifier.citationSleep 2012; 35(1): 41-8en
dc.description.abstractTo 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.en
dc.subject.othersleep disordered breathingen
dc.subject.otherCase-Control Studiesen
dc.subject.otherContinuous Positive Airway Pressureen
dc.subject.otherMagnetic Resonance Imaging.methodsen
dc.subject.otherNeuropsychological Testsen
dc.subject.otherSleep Apnea, Obstructive.metabolism.therapyen
dc.titleMagnetic resonance spectroscopy and neurocognitive dysfunction in obstructive sleep apnea before and after CPAP treatment.en
dc.typeJournal Articleen
dc.identifier.affiliationInstitute for Breathing and Sleep, Austin Health, Heidelberg, Victoria, Australiaen
dc.type.austinJournal Articleen, Maree
item.openairetypeJournal Article-
item.fulltextNo Fulltext-
item.openairecristype and Sleep Medicine- for Breathing and Sleep- and Sleep Medicine- for Breathing and Sleep- for Breathing and Sleep- for Breathing and Sleep- and Sleep Medicine- for Breathing and Sleep- for Breathing and Sleep- Florey Institute of Neuroscience and Mental Health-
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