Microstructural changes in normal-appearing white matter in male sleep apnea patients are reversible after treatment: A pilot study,Journal of Neuroscience Research

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Microstructural changes in normal-appearing white matter in male sleep apnea patients are reversible after treatment: A pilot study
Journal of Neuroscience Research ( IF 2.9 ) Pub Date : 2021-07-01 , DOI: 10.1002/jnr.24858
Maria Salsone _{1,

2} , Maria Eugenia Caligiuri ₃ , Vincenza Castronovo _{2,

4} , Nicola Canessa _{5,

6} , Sara Marelli _{2,

4} , Andrea Quattrone ₇ , Aldo Quattrone _{1,

3} , Luigi Ferini-Strambi _{2,

4}

Affiliation

Visually appreciable white matter (WM) changes have been described in obstructive sleep apnea (OSA). However, few data exist on the involvement of silent WM abnormalities. This prospective study investigated the microstructural integrity of normal-appearing white matter (NAWM) in male OSA patients before and after continuous positive airway pressure (CPAP) treatment, using a neuroimaging approach. Magnetic resonance imaging (MRI) was acquired from 32 participants (16 severe never-treated OSA and 16 controls). Diffusion tensor imaging (DTI) and Tract-Based Spatial Statistics (TBSS) were used to assess the microstructural NAWM changes in fractional anisotropy (FA), mean diffusivity (MD), axial diffusivity (AD), and radial diffusivity (RD). In order to evaluate the efficacy of the therapy, OSA patients underwent MRI evaluations at baseline and after 3 months of treatment (follow-up). CPAP treatment significantly increased the FA in NAWM of the brain stem, corpus callosum and bilateral internal capsule of OSA patients at follow-up compared to baseline (p < 0.05, TFCE-corrected). OSA patients also showed increases in AD in the corpus callosum, superior corona radiata, and internal capsule of the right hemisphere (p < 0.05, TFCE-corrected) after CPAP treatment. A significant negative correlation was found between the FA of the corona radiata, corpus callosum, internal capsule, limbic structures, and neuropsychological scores at follow-up evaluation. No significant differences were found in MD and RD of NAWM in our patients after treatment. Our results demonstrate that FA and AD of NAWM in major tracts such as the corpus callosum and the internal capsule increased significantly after CPAP treatment, as a potential beneficial effect of ventilatory therapy. The recovery of NAWM alterations might also be related to the improvement in the neurocognitive profile, suggesting that nonclearly visible WM alterations may contribute to the physiopathology of OSA-related cognitive impairment.

中文翻译：

男性睡眠呼吸暂停患者正常白质的微观结构变化在治疗后是可逆的：一项初步研究

在阻塞性睡眠呼吸暂停 (OSA) 中描述了视觉上可感知的白质 (WM) 变化。然而，很少有关于无症状 WM 异常参与的数据。这项前瞻性研究使用神经影像学方法调查了男性 OSA 患者在持续气道正压通气 (CPAP) 治疗前后外观正常的白质 (NAWM) 的微观结构完整性。从 32 名参与者（16 名从未接受过治疗的严重 OSA 和 16 名对照组）获得磁共振成像 (MRI)。扩散张量成像 (DTI) 和基于轨迹的空间统计 (TBSS) 用于评估分数各向异性 (FA)、平均扩散率 (MD)、轴向扩散率 (AD) 和径向扩散率 (RD) 的微观结构 NAWM 变化。为了评估治疗的效果，OSA 患者在基线和治疗 3 个月后（随访）接受了 MRI 评估。与基线相比，CPAP 治疗显着增加了 OSA 患者随访时脑干、胼胝体和双侧内囊的 NAWM 中的 FA。p < 0.05，TFCE 校正）。OSA 患者还表现出胼胝体、上辐射冠和右半球内囊的 AD 增加（p < 0.05，TFCE 校正）在 CPAP 治疗后。随访评估发现放射冠、胼胝体、内囊、边缘结构的FA与神经心理评分呈显着负相关。我们的患者在治疗后 NAWM 的 MD 和 RD 没有显着差异。我们的研究结果表明，在 CPAP 治疗后，胼胝体和内囊等主要区域的 NAWM 的 FA 和 AD 显着增加，这是通气治疗的潜在有益效果。NAWM 改变的恢复也可能与神经认知状况的改善有关，这表明不清晰可见的 WM 改变可能导致 OSA 相关认知障碍的病理生理学。

更新日期：2021-07-01

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