Cerebral Structural Changes in Severe Obstructive Sleep Apnea

• Published in: American journal of respiratory and critical care medicine Vol. 171; no. 10; pp. 1185 - 1190
• Main Authors: O'Donoghue, Fergal J, Briellmann, Regula S, Rochford, Peter D, Abbott, David F, Pell, Gaby S, Chan, Chow Huat Patrick, Tarquinio, Natalie, Jackson, Graeme D, Pierce, Robert J
• Format: Journal Article
• Language: English
• Published: New York, NY Am Thoracic Soc 15.05.2005; American Lung Association; American Thoracic Society
• Subjects: Adult; Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy; Biological and medical sciences; Brain Diseases - etiology; Brain Diseases - pathology; Chronic obstructive pulmonary disease, asthma; Continuous Positive Airway Pressure; Humans; Intensive care medicine; Investigative techniques, diagnostic techniques (general aspects); Male; Medical sciences; Middle Aged; Nervous system; Organ Size; Pneumology; Radiodiagnosis. Nmr imagery. Nmr spectrometry; Sensitivity and Specificity; Sleep Apnea, Obstructive - complications; Sleep Apnea, Obstructive - therapy; Telencephalon - pathology; obstructive sleep apnea; Nervous system diseases; Sleep apnea syndrome; Intensive care; Respiratory disease; Central nervous system; cerebral morphology; Resuscitation; Encephalon; neuroimaging
• ISSN: 1073-449X; 1535-4970
• DOI: 10.1164/rccm.200406-738OC

Obstructive sleep apnea is associated with abnormalities in neuropsychologic function, and defects in respiratory control may contribute to pathogenesis. Abnormalities may be reflected in structural brain changes. Twenty-seven male untreated patients with severe sleep apnea without comorbidities, and 24 age-matched control subjects, had T1-weighted brain imaging in a high-resolution magnetic resonance scanner. Twenty-three patients with sleep apnea had repeat imaging after 6 months of continuous positive airways pressure treatment. No areas of gray matter volume change were found in patients using an optimized voxel-based morphometry technique, at p < 0.05 adjusted for multiple comparisons (despite the method being sensitive to changes in gray matter fraction of 0.17 or less in all voxels). Furthermore, no differences were seen in bilateral hippocampal, temporal lobe, or whole brain volumes, assessed by manual tracing of anatomical borders. No longitudinal changes were seen in gray matter density or regional volumes after treatment, but whole brain volume decreased slightly. We have found no gray matter volume deficits nor focal structural changes in severe obstructive sleep apnea. Whole brain volume decreases without focal changes after 6 months of continuous positive airways pressure treatment.