Obstructive sleep apnea (OSA) involves intermittent cessations of breathing during sleep. People with OSA can experience memory deficits and have reduced hippocampal volume; these features are also characteristic of Alzheimer's disease (AD), where they are accompanied by neurofibrillary tangles (NFTs) and amyloid beta (Aβ) plaques in the hippocampus and brainstem. We have recently shown reduced hippocampal volume to be related to OSA severity, and although OSA may be a risk factor for AD, the hippocampus and brainstems of clinically-verified OSA cases have not yet been examined for NFTs and Aβ plaques. The present study used quantitative immunohistochemistry to investigate post-mortem hippocampi of 34 people with OSA (18 females, 16 males; mean age 67 years) and brainstems of 24 people with OSA for the presence of NFTs and Aβ plaques. OSA severity was a significant predictor of Aβ plaque burden in the hippocampus after controlling for age, sex, BMI and CPAP use. OSA severity also predicted NFT burden in the hippocampus, but not after controlling for age. Although 71% of brainstems contained NFTs and 21% contained Aβ plaques, their burdens were not correlated with OSA severity. These results indicate that OSA accounts for some of the 'cognitively normal' individuals who have been found to have substantial Aβ burdens, and are currently considered to be at a prodromal stage of AD.

中文翻译：

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阻塞性睡眠呼吸暂停患者海马和脑干的阿尔茨海默病神经病理学

阻塞性睡眠呼吸暂停 (OSA) 涉及睡眠期间呼吸的间歇性停止。患有 OSA 的人可能会出现记忆障碍和海马体积减少；这些特征也是阿尔茨海默病 (AD) 的特征，在海马和脑干中伴有神经原纤维缠结 (NFT) 和淀粉样蛋白 (Aβ) 斑块。我们最近发现海马体积减少与 OSA 严重程度有关，尽管 OSA 可能是 AD 的危险因素，但尚未对经临床验证的 OSA 病例的海马和脑干进行 NFT 和 Aβ 斑块检查。本研究使用定量免疫组织化学来调查 34 名 OSA 患者（18 名女性，16 名男性；平均年龄 67 岁）的死后海马和 24 名 OSA 患者的脑干中是否存在 NFT 和 Aβ 斑块。在控制年龄、性别、BMI 和 CPAP 使用后，OSA 严重程度是海马 Aβ 斑块负荷的重要预测因子。OSA 严重程度也预测了海马体的 NFT 负担，但不是在控制年龄之后。尽管 71% 的脑干含有 NFT，21% 含有 Aβ 斑块，但它们的负担与 OSA 严重程度无关。这些结果表明 OSA 是一些“认知正常”个体的原因，这些个体被发现具有大量 Aβ 负担，目前被认为处于 AD 的前驱阶段。他们的负担与 OSA 严重程度无关。这些结果表明 OSA 是一些“认知正常”个体的原因，这些个体被发现具有大量 Aβ 负担，目前被认为处于 AD 的前驱阶段。他们的负担与 OSA 严重程度无关。这些结果表明 OSA 是一些“认知正常”个体的原因，这些个体被发现具有大量 Aβ 负担，目前被认为处于 AD 的前驱阶段。