Shuan Ke, Tianjing Luo, Yi Ding, Chia-Jung Tang, Zhijun Jie, Joseph Zongen Shen, Danhong Wu, Yong Du
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引用次数: 0
Abstract
Background: Obstructive sleep apnea (OSA) is a neglected global health issue and when left untreated could lead to cognitive impairment (CI), one of the most burdensome outcomes of OSA. Enlarged perivascular spaces (EPVS), an imaging feature as well as a subtype of cerebral small vessel disease and integral part of CSVD, are associated with cognitive function, but the relationship between EPVS and CI is not well understood and by extension the correlation between OSA and EPVS, how CI develops under the joint impact of OSA and EPVS remains unclear. It is the goal of This study to explore the associations among OSA, EPVS, and CI.
Methods: This cross-sectional study included 175 older adults with imaging features of EPVS with or without other CSVD subtype features by cranial magnetic resonance imaging between January 2021 and June 2023 at the Shanghai Fifth People's Hospital. We assessed OSA using polysomnography. Blood samples were collected to determine vascular risk factor indices. Cognitive scoring modalities included the Mini-Mental State Examination (MMSE) and Montreal Cognitive Assessment (MOCA). To explore the relationship among OSA, EPVS, and CI, we used single-factor analysis, multifactorial analysis, and receiver operating characteristic (ROC) curves.
Results: A total of 136 participants were analyzed. In our statistical process, MMSE showed a more distinguished performance than MoCA. Participants with OSA had greater EPVS burdens in the midbrain (p < 0.001) and hippocampus (p < 0.001) and more serious CI (p = 0.001). OSA positively influenced EPVS in the midbrain (β = 0.052; 95% confidence interval [CI]: 0.006, 0.097; p = 0.026) and hippocampus (β = 0.190, 95% CI: 0.104, 0.275, p < 0.001). Moreover, the apnea-hypopnea index (AHI; β = -0.514; 95% CI: -0.077, -0.031; p < 0.001) negatively affected cognitive e function. With each increase in the AHI by 1 unit, the risk of CI increased by 12.0% (odds ratio = 1.120; 95%CI: 1.062, 1.181; p < 0.001). The AHI (sensitivity, 67.20%; specificity, 92.20%; area under the ROC curve, 0.828; p < 0.001) had a certain degree of accuracy in ruling out CI in the EPVS population, as calculated using the ROC curve.
Conclusions: We identified significant relations among OSA, EPVS, and CI. The AHI is a potential marker for estimating cognitive function in patients with EPVS.
期刊介绍：
The journal Sleep and Breathing aims to reflect the state of the art in the international science and practice of sleep medicine. The journal is based on the recognition that management of sleep disorders requires a multi-disciplinary approach and diverse perspectives. The initial focus of Sleep and Breathing is on timely and original studies that collect, intervene, or otherwise inform all clinicians and scientists in medicine, dentistry and oral surgery, otolaryngology, and epidemiology on the management of the upper airway during sleep.
Furthermore, Sleep and Breathing endeavors to bring readers cutting edge information about all evolving aspects of common sleep disorders or disruptions, such as insomnia and shift work. The journal includes not only patient studies, but also studies that emphasize the principles of physiology and pathophysiology or illustrate potentially novel approaches to diagnosis and treatment. In addition, the journal features articles that describe patient-oriented and cost-benefit health outcomes research. Thus, with peer review by an international Editorial Board and prompt English-language publication, Sleep and Breathing provides rapid dissemination of clinical and clinically related scientific information. But it also does more: it is dedicated to making the most important developments in sleep disordered breathing easily accessible to clinicians who are treating sleep apnea by presenting well-chosen, well-written, and highly organized information that is useful for patient care.
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