Purpose of Review

Obstructive sleep apnea is extremely prevalent in the elderly and may precipitate dementia. We review recent advances on gray and white matter structure in obstructive sleep apnea, the impact of treatment, and potential pathological and neurodegenerative processes underlying brain structural changes.

Recent Findings

Two opposite patterns are observed in neuroimaging studies of obstructive sleep apnea. One may indicate cellular damage (gray matter atrophy, higher white matter hyperintensity burden, lower white matter fractional anisotropy, higher water diffusivities), while the other (gray matter hypertrophy, restricted white matter diffusivities) may reflect transitory responses, such as intracellular edema, reactive gliosis or compensatory structural changes. Treating obstructive sleep apnea could partly reverse these structural changes.

Summary

Structural alterations related to obstructive sleep apnea may follow a multi-determined biphasic pattern depending on numerous factors (e.g. severity, symptomatology, age) that could tip the scale toward neurodegeneration and need to be investigated by longitudinal studies.

中文翻译：

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阻塞性睡眠呼吸暂停和大脑：以灰色和白色物质结构为重点

审查目的

阻塞性睡眠呼吸暂停在老年人中极为普遍，并可能导致痴呆。我们回顾了阻塞性睡眠呼吸暂停中灰色和白色物质结构的最新进展，治疗的影响以及潜在的病理和神经退行性过程，它们是大脑结构变化的基础。

最近的发现

在阻塞性睡眠呼吸暂停的神经影像学研究中观察到两种相反的模式。一种可能表示细胞损伤（灰质萎缩，白质过度紧张负担增加，白质分数各向异性降低，水扩散率较高），另一种可能表示细胞损伤（灰质肥大，白质扩散受限）可能反映了短暂反应，例如细胞内水肿，反应性神经胶质变性或代偿性结构改变。治疗阻塞性睡眠呼吸暂停可以部分逆转这些结构变化。

概括

与阻塞性睡眠呼吸暂停有关的结构改变可能遵循多种确定的双相模式，这取决于多种因素（例如严重程度，症状，年龄），这些因素可能会导致神经退行性变，需要通过纵向研究进行研究。