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Liu X, Wei Z, Ting L, Liu X, Shu Y, Ling H, Li L, Liu Y, Xia G, Peng D, Li H. Microstructural Changes in the Cerebral White Matter After 12 Months of CPAP Treatment for Moderate to Severe Obstructive Sleep Apnoea: A TBSS Study. Nat Sci Sleep 2024; 16:531-542. [PMID: 38827391 PMCID: PMC11141711 DOI: 10.2147/nss.s460919] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2024] [Accepted: 05/14/2024] [Indexed: 06/04/2024] Open
Abstract
Introduction Continuous positive airway pressure (CPAP) therapy improves clinical symptoms in patients with obstructive sleep apnea (OSA); however, the mechanism of this clinical improvement and how it may be associated with the restoration of white matter (WM) structures in the brain is unclear. Therefore, this study investigated the relationship between the structural recovery of brain WM and improvements in cognitive function and emotion after long-term (12 months) CPAP treatment in patients with OSA. Methods We collected data from 17 patients with OSA before and 12 months after CPAP treatment, including sleep monitoring, clinical assessment, and diffusion tensor imaging (DTI) magnetic resonance imaging. Results We observed a partial reversible recovery of brain WM (mean and radial diffusion coefficients) after treatment. This recovery involved the commissural fibers (cingulum, body of corpus callosum), projection fibers (retrolenticular part of the internal capsule, posterior thalamic radiation, posterior limb of the internal capsule, superior corona radiata, posterior corona radiata), association fibers (external capsule, superior longitudinal fasciculus, inferior longitudinal fasciculus), and other regions. In addition, the improvements in WM fibers in one part of the brain significantly were correlated with the Hamilton Anxiety Scale and Hamilton Depression Scale scores. Discussion Our results suggest that reversible recovery of reduced brain WM integrity due to OSA may require longer CPAP treatment. Moreover, changes in the integrity of the commissural fibers were associated with emotion regulation. These restored WM areas may explain the cognitive and mood improvements observed after OSA treatment.
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Affiliation(s)
- Xiang Liu
- Department of Radiology, the First Affiliated Hospital, Jiangxi Medical College, Nanchang University, Jiangxi, People’s Republic of China
| | - Zhipeng Wei
- Department of Radiology, the Second Affiliated Hospital, Jiangxi Medical College, Nanchang University, Jiangxi, People’s Republic of China
| | - Long Ting
- Department of Radiology, the First Affiliated Hospital, Jiangxi Medical College, Nanchang University, Jiangxi, People’s Republic of China
| | - Xuming Liu
- Department of Radiology, Wenzhou People’s Hospital, Wenzhou, Zhejiang, 325000, People’s Republic of China
| | - Yongqiang Shu
- Department of Radiology, the First Affiliated Hospital, Jiangxi Medical College, Nanchang University, Jiangxi, People’s Republic of China
| | - Huang Ling
- Department of Radiology, the First Affiliated Hospital, Jiangxi Medical College, Nanchang University, Jiangxi, People’s Republic of China
| | - Lifeng Li
- Department of Radiology, the First Affiliated Hospital, Jiangxi Medical College, Nanchang University, Jiangxi, People’s Republic of China
| | - Yumeng Liu
- Department of Radiology, the First Affiliated Hospital, Jiangxi Medical College, Nanchang University, Jiangxi, People’s Republic of China
| | - Guojin Xia
- Department of Radiology, the First Affiliated Hospital, Jiangxi Medical College, Nanchang University, Jiangxi, People’s Republic of China
| | - Dechang Peng
- Department of Radiology, the First Affiliated Hospital, Jiangxi Medical College, Nanchang University, Jiangxi, People’s Republic of China
| | - Haijun Li
- Department of Radiology, the First Affiliated Hospital, Jiangxi Medical College, Nanchang University, Jiangxi, People’s Republic of China
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Xiao F, Liu M, Wang Y, Zhou L, Luo J, Chen C, Chen W. Altered Functional Connectivity of Temporoparietal Lobe in Obstructive Sleep Apnea: A Resting-State fNIRS Study. Bioengineering (Basel) 2024; 11:389. [PMID: 38671810 PMCID: PMC11048547 DOI: 10.3390/bioengineering11040389] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2024] [Revised: 04/10/2024] [Accepted: 04/15/2024] [Indexed: 04/28/2024] Open
Abstract
Obstructive Sleep Apnea (OSA), a sleep disorder with high prevalence, is normally accompanied by affective, autonomic, and cognitive abnormalities, and is deemed to be linked to functional brain alterations. To investigate alterations in brain functional connectivity properties in patients with OSA, a comparative analysis of global and local topological properties of brain networks was conducted between patients with OSA and healthy controls (HCs), utilizing functional near-infrared spectroscopy (fNIRS) imaging. A total of 148 patients with OSA and 150 healthy individuals were involved. Firstly, quantitative alterations in blood oxygen concentration, changes in functional connectivity, and variations in graph theory-based network topological characteristics were assessed. Then, with Mann-Whitney statistics, this study compared whether there are significant differences in the above characteristics between patients with OSA and HCs. Lastly, the study further examined the correlation between the altered characteristics and the apnea hypopnea index (AHI) using linear regression. Results revealed a higher mean and standard deviation of hemoglobin concentration in the superior temporal gyrus among patients with OSA compared to HCs. Resting-state functional connectivity (RSFC) exhibited a slight increase between the superior temporal gyrus and other specific areas in patients with OSA. Notably, neither patients with OSA nor HCs demonstrated significant small-world network properties. Patients with OSA displayed an elevated clustering coefficient (p < 0.05) and local efficiency (p < 0.05). Additionally, patients with OSA exhibited a tendency towards increased nodal betweenness centrality (p < 0.05) and degree centrality (p < 0.05) in the right supramarginal gyrus, as well as a trend towards higher betweenness centrality (p < 0.05) in the right precentral gyrus. The results of multiple linear regressions indicate that the influence of the AHI on RSFC between the right precentral gyrus and right superior temporal gyrus (p < 0.05), as well as between the right precentral gyrus and right supramarginal gyrus (p < 0.05), are statistically significant. These findings suggest that OSA may compromise functional brain connectivity and network topological properties in affected individuals, serving as a potential neurological mechanism underlying the observed abnormalities in brain function associated with OSA.
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Affiliation(s)
- Fang Xiao
- School of Information Science and Technology, Fudan University, Shanghai 200437, China; (F.X.); (M.L.); (L.Z.)
| | - Minghui Liu
- School of Information Science and Technology, Fudan University, Shanghai 200437, China; (F.X.); (M.L.); (L.Z.)
| | - Yalin Wang
- School of Information Science and Engineering, Lanzhou University, Lanzhou 730000, China
| | - Ligang Zhou
- School of Information Science and Technology, Fudan University, Shanghai 200437, China; (F.X.); (M.L.); (L.Z.)
| | - Jingchun Luo
- Human Phenome Institute, Fudan University, Shanghai 200437, China;
| | - Chen Chen
- Human Phenome Institute, Fudan University, Shanghai 200437, China;
| | - Wei Chen
- School of Information Science and Technology, Fudan University, Shanghai 200437, China; (F.X.); (M.L.); (L.Z.)
- Human Phenome Institute, Fudan University, Shanghai 200437, China;
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3
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Klonteig S, Scarth M, Bjørnebekk A. Sleep pathology and use of anabolic androgen steroids among male weightlifters in Norway. BMC Psychiatry 2024; 24:62. [PMID: 38254047 PMCID: PMC10804719 DOI: 10.1186/s12888-024-05516-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/14/2023] [Accepted: 01/10/2024] [Indexed: 01/24/2024] Open
Abstract
Use of anabolic androgenic steroids (AAS) causes drastic changes in hormonal milieu and is associated with a range of medical and psychological consequences. Sleep pathology is a common side-effect of AAS use but few have studied these relations. This study examined the relationship between AAS use, psychological distress and sleep quality, and how phases of heavy use and abstinence influence sleep. The Pittsburgh-Sleep-Quality-Index (PSQI) and Jenkins Sleep Scale (JSS) were used to assess sleep quality, and psychological distress was measured with the Hopkins Symptoms Checklist (HSCL). Participants comprised men who have previous or current long-term use of AAS (n = 68) and non-using weightlifting controls (WLC) (n = 58), where a subgroup of participants (n = 22) was monitored over ~ 6 months during phases of AAS use and withdrawal. Group differences on PSQI and JSS were evaluated with Kruskal-Wallis H tests, and the mediating role of psychological distress was evaluated using structural equation modeling. Linear mixed models were used to assess the role of AAS use and withdrawal on sleep quality. Among the AAS group, 66% reported sleep problems as a side effect, and 38% had used sleep medication. PSQI scores showed significantly lower sleep quality in the AAS group compared to WLC (p < 0.001) on all subscales except "sleep latency". Furthermore, sleep quality was significantly poorer during withdrawal-phases than periods with AAS use (p < .001). Our findings provide key insight into sleep disturbances among men who use AAS, suggesting a link between sleep disturbances and hormone levels that deviate from physiologically normal levels in both directions.
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Affiliation(s)
- Sandra Klonteig
- SINTEF Digital, Box 124 Blindern, N-0314, Oslo, Norway.
- Anabolic Androgenic Steroid Research Group, Section for Clinical Addiction Research, Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway.
| | - Morgan Scarth
- Anabolic Androgenic Steroid Research Group, Section for Clinical Addiction Research, Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
- Department of Psychology, University of Oslo, Oslo, Norway
| | - Astrid Bjørnebekk
- Anabolic Androgenic Steroid Research Group, Section for Clinical Addiction Research, Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
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Li C, Shi S. Gut microbiota and metabolic profiles in chronic intermittent hypoxia-induced rats: disease-associated dysbiosis and metabolic disturbances. Front Endocrinol (Lausanne) 2024; 14:1224396. [PMID: 38283743 PMCID: PMC10811599 DOI: 10.3389/fendo.2023.1224396] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2023] [Accepted: 12/27/2023] [Indexed: 01/30/2024] Open
Abstract
Aim Chronic intermittent hypoxia (CIH) is a key characteristic of obstructive sleep apnea (OSA) syndrome, a chronic respiratory disorder. The mechanisms of CIH-induced metabolic disturbance and histopathological damage remain unclear. Methods CIH-induced rats underwent daily 8-h CIH, characterized by oxygen levels decreasing from 21% to 8.5% over 4 min, remaining for 2 min, and quickly returning to 21% for 1 min. The control rats received a continuous 21% oxygen supply. The levels of hypersensitive C reactive protein (h-CRP), tumor necrosis factor-α (TNF-α), interleukin 6 (IL-6), interleukin 8 (IL-8), and nuclear factor kappa-B (NF-κB) were measured by ELISA. Histological analysis of the soft palates was conducted using HE staining. The microbial profiling of fecal samples was carried out by Accu16STM assay. Untargeted metabolomics of serum and soft palate tissue samples were analyzed by UPLC-MS. The protein expression of cAMP-related pathways in the soft palate was determined by Western blot. Results After 28 h of CIH induction, a significant increase in pro-inflammatory cytokines was observed in the serum, along with mucosal layer thickening and soft palate tissue hypertrophy. CIH induction altered the diversity and composition of fecal microbiota, specifically reducing beneficial bacteria while increasing harmful bacteria/opportunistic pathogens. Notably, CIH induction led to a significant enrichment of genera such as Dorea, Oscillibacter, Enteractinococcus, Paenibacillus, Globicatella, and Flaviflexus genera. Meanwhile, Additionally, CIH induction had a notable impact on 108 serum marker metabolites. These marker metabolites, primarily involving amino acids, organic acids, and a limited number of flavonoids or sterols, were associated with protein transport, digestion and absorption, amino acid synthesis and metabolism, as well as cancer development. Furthermore, these differential serum metabolites significantly affected 175 differential metabolites in soft palate tissue, mainly related to cancer development, signaling pathways, amino acid metabolism, nucleotide precursor or intermediate metabolism, respiratory processes, and disease. Importantly, CIH induction could significantly affect the expression of the cAMP pathway in soft palate tissue. Conclusions Our findings suggest that targeting differential metabolites in serum and soft palate tissue may represent a new approach to clinical intervention and treatment of OSA simulated by the CIH.
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Affiliation(s)
| | - Song Shi
- Department of Otorhinolaryngology, Tongren Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
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Leconte CE, Ng JW, Manzardo AM, Douglass MM. A Pediatric Patient with Severe Obstructive Sleep Apnea and Comorbid Depression and Substance Abuse. Case Rep Psychiatry 2023; 2023:9985503. [PMID: 38028754 PMCID: PMC10656197 DOI: 10.1155/2023/9985503] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2023] [Revised: 10/16/2023] [Accepted: 10/18/2023] [Indexed: 12/01/2023] Open
Abstract
Obstructive sleep apnea (OSA), depression, and substance abuse problems share similar symptomatology and have significant interplay. An underlying diagnosis of OSA can often be overlooked in patients with significant psychiatric illness and polysubstance use. Pediatric OSA is often associated with adenotonsillar hypertrophy and frequently requires surgical intervention for resolution of symptoms. Untreated OSA can worsen mental status and encourage polysubstance abuse as a form of self-medication. Proper identification and management of OSA plays an important role in treating psychiatric conditions. We report a 16-year-old with major depressive disorder (MDD), suicide attempts, polysubstance use disorder, and severe OSA admitted to an inpatient psychiatric facility. History included sleep and mood disturbances started at age 12. Patient presented with apnea-hypopnea index greater than 50 and started on bilevel-positive airway pressure (BiPAP) prior to admission. Management of OSA led to significant improvement of MDD, insomnia, and polysubstance abuse. OSA can often be overlooked in patients with MDD or substance abuse. Among adolescent patients with poorly managed psychiatric conditions, significant sleep disturbances, and polysubstance abuse, providers should maintain a high degree of suspicion for OSA, as its proper management will aid in the management of the other conditions.
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Affiliation(s)
- Caitlin E. Leconte
- University of Kansas School of Medicine, 2060 W 39th Avenue, Kansas City, KS 66103, USA
| | - Joshua W. Ng
- University of Kansas School of Medicine-Wichita, 1010 N Kansas Street, Wichita, KS 67214, USA
| | - Ann M. Manzardo
- Department of Psychiatry and Behavioral Sciences, University of Kansas Medical Center, 3901 Rainbow Boulevard, Kansas City, KS 66103, USA
| | - Mitchell M. Douglass
- Department of Psychiatry and Behavioral Sciences, University of Kansas Medical Center, 3901 Rainbow Boulevard, Kansas City, KS 66103, USA
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Chai Y, Park HR, Jo H, Seo MY, Kim HY, Joo EY, Kim H. White matter microstructure and connectivity changes after surgery in male adults with obstructive sleep apnea: recovery or reorganization? Front Neurosci 2023; 17:1221290. [PMID: 37841681 PMCID: PMC10568132 DOI: 10.3389/fnins.2023.1221290] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2023] [Accepted: 09/06/2023] [Indexed: 10/17/2023] Open
Abstract
Study objectives Obstructive sleep apnea (OSA) is a prevalent clinical problem significantly affecting cognitive functions. Surgical treatment is recommended for those unable to use continuous positive airway pressure. We aimed to investigate the therapeutic effect of upper airway surgery on the white matter (WM) microstructure and brain connectivity in patients with OSA. Methods Twenty-one male patients with moderate-to-severe OSA were recruited for multi-level upper airway surgery. Overnight polysomnography (PSG), neuropsychiatric tests, and brain MRI scans were acquired before and 6.1 ± 0.8 months after surgery. Nineteen male patients with untreated OSA were also included as a reference group. We calculated the longitudinal changes of diffusion tensor imaging (DTI) parameters, including fractional anisotropy (ΔFA) and mean/axial/radial diffusivity (ΔMD/AD/RD). We also assessed changes in network properties based on graph theory. Results Surgically treated patients showed improvement in PSG parameters and verbal memory after surgery. Globally, ΔFA was significantly higher and ΔRD was lower in the surgery group than in the untreated group. Especially ΔFA of the tracts involved in the limbic system was higher after surgery. In network analysis, higher Δbetweenness and lower Δclustering coefficients were observed in the surgical group than in the untreated group. Finally, the improvement of verbal memory after surgery positively correlated with ΔFA in superior thalamic radiation (p = 0.021), fronto aslant tracts (p = 0.027), and forceps minor tracts (p = 0.032). Conclusion Surgical treatment of OSA can alleviate alterations in WM integrity and disruptions in local networks, particularly for the tracts involved in the limbic system. These findings may further explain the cognitive improvement observed after the treatment of OSA.
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Affiliation(s)
- Yaqiong Chai
- USC Stevens Neuroimaging and Informatics Institute, Keck School of Medicine of USC, University of Southern California, Los Angeles, CA, United States
| | - Hea Ree Park
- Department of Neurology, Inje University College of Medicine, Ilsan Paik Hospital, Goyang, Republic of Korea
| | - Hyunjin Jo
- USC Stevens Neuroimaging and Informatics Institute, Keck School of Medicine of USC, University of Southern California, Los Angeles, CA, United States
| | - Min Young Seo
- Department of Otorhinolaryngology—Head and Neck Surgery, Korea University College of Medicine, Korea University Ansan Hospital, Ansan, Republic of Korea
| | - Hyo Yeol Kim
- Department of Otorhinolaryngology—Head and Neck Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Eun Yeon Joo
- Department of Neurology, Neuroscience Center, Samsung Medical Center, Samsung Biomedical Research Institute, School of Medicine, Sungkyunkwan University, Seoul, Republic of Korea
| | - Hosung Kim
- USC Stevens Neuroimaging and Informatics Institute, Keck School of Medicine of USC, University of Southern California, Los Angeles, CA, United States
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7
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Zheng JH, Ma JJ, Sun WH, Wang ZD, Chang QQ, Dong LR, Shi XX, Li MJ. Excessive Daytime Sleepiness in Parkinson's Disease is Related to Functional Abnormalities in the Left Angular Gyrus. Clin Neuroradiol 2023; 33:121-127. [PMID: 35768695 DOI: 10.1007/s00062-022-01190-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2022] [Accepted: 06/14/2022] [Indexed: 11/24/2022]
Abstract
PURPOSE Excessive daytime sleepiness (EDS) is a common non-motor symptom in Parkinson's disease (PD), but its neuropathology remains elusive. Our goal is to explore the potential neural substrates of EDS in a large sample of individuals with PD. METHODS We recruited 48 PD patients with and 87 PD patients without EDS. We used resting-state functional magnetic resonance imaging to compare amplitudes of low-frequency fluctuations (ALFF) between the two groups. We also explored functional connectivity (FC) between the entire brain and regions where ALFF differed between the two groups as well as FC between selected regions of interest. Age, Part III of the Movement Disorder Society Unified Parkinson's Disease Rating Scale (MDS-UPDRS-III) score and use of dopamine receptor agonists were treated as covariates in the comparisons. RESULTS EDS was associated with significantly lower ALFF in the left angular gyrus, and ALFF in this region correlated negatively with score on the Epworth Sleepiness Scale in patients with PD. EDS was also associated with significantly lower FC between the left angular gyrus and right cerebellum, based on seed-to-voxel and inter-ROI analyses. CONCLUSION Our results suggest that EDS in PD patients is associated with reduced spontaneous neural activity in the left angular gyrus and with reduced FC between the left angular gyrus and cerebellum. These findings may help understand and treat EDS in PD.
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Affiliation(s)
- Jin Hua Zheng
- Department of Neurology, Henan Provincial People's Hospital, 450003, Zhengzhou, Henan Province, China.,Department of Neurology, People's Hospital of Zhengzhou University, Zhengzhou, Henan Province, China.,Department of Neurology, People's Hospital of Henan University, Henan Province, Zhengzhou, China
| | - Jian Jun Ma
- Department of Neurology, Henan Provincial People's Hospital, 450003, Zhengzhou, Henan Province, China. .,Department of Neurology, People's Hospital of Zhengzhou University, Zhengzhou, Henan Province, China. .,Department of Neurology, People's Hospital of Henan University, Henan Province, Zhengzhou, China.
| | - Wen Hua Sun
- Department of Neurology, Henan Provincial People's Hospital, 450003, Zhengzhou, Henan Province, China.,Department of Neurology, People's Hospital of Zhengzhou University, Zhengzhou, Henan Province, China
| | - Zhi Dong Wang
- Department of Neurology, Henan Provincial People's Hospital, 450003, Zhengzhou, Henan Province, China.,Department of Neurology, People's Hospital of Zhengzhou University, Zhengzhou, Henan Province, China
| | - Qing Qing Chang
- Department of Neurology, Henan Provincial People's Hospital, 450003, Zhengzhou, Henan Province, China.,Department of Neurology, People's Hospital of Zhengzhou University, Zhengzhou, Henan Province, China
| | - Lin Rui Dong
- Department of Neurology, Henan Provincial People's Hospital, 450003, Zhengzhou, Henan Province, China.,Department of Neurology, People's Hospital of Zhengzhou University, Zhengzhou, Henan Province, China
| | - Xiao Xue Shi
- Department of Neurology, Henan Provincial People's Hospital, 450003, Zhengzhou, Henan Province, China.,Department of Neurology, People's Hospital of Zhengzhou University, Zhengzhou, Henan Province, China
| | - Ming Jian Li
- Department of Neurology, Henan Provincial People's Hospital, 450003, Zhengzhou, Henan Province, China.,Department of Neurology, People's Hospital of Henan University, Henan Province, Zhengzhou, China
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Long T, Li H, Shu Y, Li K, Xie W, Zeng Y, Huang L, Zeng L, Liu X, Peng D. Functional Connectivity Changes in the Insular Subregions of Patients with Obstructive Sleep Apnea after 6 Months of Continuous Positive Airway Pressure Treatment. Neural Plast 2023; 2023:5598047. [PMID: 36865671 PMCID: PMC9974286 DOI: 10.1155/2023/5598047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2022] [Revised: 01/21/2023] [Accepted: 01/31/2023] [Indexed: 02/25/2023] Open
Abstract
This study was aimed at investigating the functional connectivity (FC) changes between the insular subregions and whole brain in patients with obstructive sleep apnea (OSA) after 6 months of continuous positive airway pressure (CPAP) treatment and at exploring the relationship between resting-state FC changes and cognitive impairment in OSA patients. Data from 15 patients with OSA before and after 6 months of CPAP treatment were included in this study. The FC between the insular subregions and whole brain was compared between baseline and after 6 months of CPAP treatment in OSA. After 6 months of treatment, OSA patients had increased FC from the right ventral anterior insula to the bilateral superior frontal gyrus and bilateral middle frontal gyrus and increased FC from the left posterior insula to the left middle temporal gyrus and left inferior temporal gyrus. Hyperconnectivity was found from the right posterior insula to the right middle temporal gyrus, bilateral precuneus, and bilateral posterior cingulate cortex, which mainly involved the default mode network. There are changes in functional connectivity patterns between the insular subregions and whole brain in OSA patients after 6 months of CPAP treatment. These changes provide a better understanding of the neuroimaging mechanisms underlying the improvement in cognitive function and emotional impairment in OSA patients and can be used as potential biomarkers for clinical CPAP treatment.
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Affiliation(s)
- Ting Long
- 1Medical Imaging Center, The First Affiliated Hospital of Nanchang University, Jiangxi Province, China
| | - Haijun Li
- 1Medical Imaging Center, The First Affiliated Hospital of Nanchang University, Jiangxi Province, China
- 2PET Center, The First Affiliated Hospital of Nanchang University, Jiangxi Province, China
| | - Yongqiang Shu
- 1Medical Imaging Center, The First Affiliated Hospital of Nanchang University, Jiangxi Province, China
| | - Kunyao Li
- 1Medical Imaging Center, The First Affiliated Hospital of Nanchang University, Jiangxi Province, China
| | - Wei Xie
- 1Medical Imaging Center, The First Affiliated Hospital of Nanchang University, Jiangxi Province, China
| | - Yaping Zeng
- 1Medical Imaging Center, The First Affiliated Hospital of Nanchang University, Jiangxi Province, China
| | - Ling Huang
- 1Medical Imaging Center, The First Affiliated Hospital of Nanchang University, Jiangxi Province, China
| | - Li Zeng
- 1Medical Imaging Center, The First Affiliated Hospital of Nanchang University, Jiangxi Province, China
| | - Xiang Liu
- 1Medical Imaging Center, The First Affiliated Hospital of Nanchang University, Jiangxi Province, China
| | - Dechang Peng
- 1Medical Imaging Center, The First Affiliated Hospital of Nanchang University, Jiangxi Province, China
- 2PET Center, The First Affiliated Hospital of Nanchang University, Jiangxi Province, China
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9
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Shu Y, Chen L, Li K, Li H, Kong L, Liu X, Li P, Xie W, Zeng Y, Peng D. Abnormal cerebellar-prefrontal cortical pathways in obstructive sleep apnea with/without mild cognitive impairment. Front Neurosci 2022; 16:1002184. [PMID: 36340771 PMCID: PMC9630600 DOI: 10.3389/fnins.2022.1002184] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2022] [Accepted: 09/26/2022] [Indexed: 12/04/2022] Open
Abstract
Obstructive sleep apnea (OSA), a common respiratory sleep disorder, is often associated with mild cognitive impairment (MCI), which is a precursor stage to Alzheimer’s disease (AD). However, the neuroimaging changes in patients with OSA with/without MCI are still under discussion. This study aimed to investigate the temporal variability of spontaneous brain activity in OSA. Fifty-two OSA patients (26 with OSA with MCI (OSA-MCI), 26 OSA without MCI (OSA-nMCI), and 26 healthy controls (HCs) underwent MRI scans and scale questionnaires. A dynamic amplitude of low-frequency fluctuation (dALFF) evaluation was performed to examine the time-varying nature of OSA-MCI and OSA-nMCI. Compared with OSA-MCI, OSA-nMCI had increased dALFF in the posterior cerebellar and right superior frontal gyrus; compared with HCs, OSA-nMCI patients showed increased dALFF in the right posterior cerebellum. A positive correlation between the bilateral posterior cerebellar lobes and right superior frontal gyrus was observed in OSA-MCI patients; however, in OSA-nMCI patients, a positive correlation was observed only between the bilateral posterior cerebellar lobes. The dALFF value of the left posterior cerebellar lobe was positively correlated with the apnea-hypopnea index (AHI), epworth sleepiness scale (ESS) score, and arousal index in OSA-nMCIs, while the dALFF value of the right posterior cerebellum was positively correlated with the AHI and negatively correlated with the lowest oxygen saturation (SaO2). This study argues that OSA-nMCIs and OSA-MCIs exhibit different temporal variabilities in dynamic brain functions, OSA-nMCIs may have variable intermediate states. We concluded that the functional abnormalities of the cerebellar-prefrontal cortex pathway in OSA-MCIs may cause cognitive impairment with OSA.
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Affiliation(s)
- Yongqiang Shu
- Department of Radiology, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China
| | - Liting Chen
- Medical Imaging Center, First Affiliated Hospital of Jinan University, Guangzhou, China
| | - Kunyao Li
- Department of Radiology, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China
| | - Haijun Li
- Department of Radiology, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China
| | - Linghong Kong
- Department of Radiology, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China
| | - Xiang Liu
- Department of Radiology, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China
| | - Panmei Li
- Department of Radiology, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China
| | - Wei Xie
- Department of Radiology, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China
| | - Yaping Zeng
- Department of Radiology, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China
| | - Dechang Peng
- Department of Radiology, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China
- *Correspondence: Dechang Peng,
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10
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Zeng Y, Shu Y, Liu X, Li P, Kong L, Li K, Xie W, Zeng L, Long T, Huang L, Li H, Peng D. Frequency-specific alterations in intrinsic low-frequency oscillations in newly diagnosed male patients with obstructive sleep apnea. Front Neurosci 2022; 16:987015. [PMID: 36248662 PMCID: PMC9561418 DOI: 10.3389/fnins.2022.987015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2022] [Accepted: 09/13/2022] [Indexed: 11/13/2022] Open
Abstract
Purpose Previous studies found abnormal low-frequency spontaneous brain activity related to cognitive impairment in patients with obstructive sleep apnea (OSA). However, it is unclear if low-frequency spontaneous brain activity is related to specific frequency bands in OSA patients. In this study, we used the amplitude of low-frequency fluctuation (ALFF) method in patients with OSA to explore characteristics of spontaneous brain activity in the classical (0.01–0.1 Hz) and five sub-frequency bands (slow-2 to slow-6) and analyzed the relationship between spontaneous brain activity and clinical evaluation was analyzed. Patients and methods Resting-state magnetic resonance imaging data and clinical assessments were collected from 52 newly-diagnosed OSA patients and 62 healthy controls (HCs). We calculated the individual group ALFF values in the classical and five different sub-frequency bands. A two-sample t-test compared ALFF differences, and one-way analysis of variance explored interactions in frequency bands between the two groups. Results ALFF values in the OSA group were lower than those in the HC group in the bilateral precuneus/posterior cingulate cortex, bilateral angular gyrus, left inferior parietal lobule, brainstem, and right fusiform gyrus. In contrast, ALFF values in the OSA group were higher than those in the HC group in the bilateral cerebellum posterior lobe, bilateral superior frontal gyrus, bilateral middle frontal gyrus, left inferior frontal gyrus, left inferior temporal gyrus, and left fusiform gyrus. Some ALFF values in altered brain regions were associated with body mass index, apnea-hypopnea index, neck circumference, snoring history, minimum SaO2, average SaO2, arousal index, oxygen reduction index, deep sleep period naming, abstraction, and delayed recall in specific frequency bands. Conclusion Our results indicated the existence of frequency-specific differences in spontaneous brain activity in OSA patients, which were related to cognitive and other clinical symptoms. This study identified frequency-band characteristics related to brain damage, expanded the cognitive neuroimaging mechanism, and provided additional OSA neuroimaging markers.
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Affiliation(s)
- Yaping Zeng
- Medical Imaging Center, The First Affiliated Hospital of Nanchang University, Nanchang, China
| | - Yongqiang Shu
- Medical Imaging Center, The First Affiliated Hospital of Nanchang University, Nanchang, China
| | - Xiang Liu
- Medical Imaging Center, The First Affiliated Hospital of Nanchang University, Nanchang, China
| | - Panmei Li
- Medical Imaging Center, The First Affiliated Hospital of Nanchang University, Nanchang, China
| | - Linghong Kong
- Medical Imaging Center, The First Affiliated Hospital of Nanchang University, Nanchang, China
| | - Kunyao Li
- Medical Imaging Center, The First Affiliated Hospital of Nanchang University, Nanchang, China
| | - Wei Xie
- Medical Imaging Center, The First Affiliated Hospital of Nanchang University, Nanchang, China
| | - Li Zeng
- Medical Imaging Center, The First Affiliated Hospital of Nanchang University, Nanchang, China
| | - Ting Long
- Medical Imaging Center, The First Affiliated Hospital of Nanchang University, Nanchang, China
| | - Ling Huang
- Medical Imaging Center, The First Affiliated Hospital of Nanchang University, Nanchang, China
| | - Haijun Li
- Medical Imaging Center, The First Affiliated Hospital of Nanchang University, Nanchang, China
- PET Center, The First Affiliated Hospital of Nanchang University, Nanchang, China
- *Correspondence: Haijun Li,
| | - Dechang Peng
- Medical Imaging Center, The First Affiliated Hospital of Nanchang University, Nanchang, China
- PET Center, The First Affiliated Hospital of Nanchang University, Nanchang, China
- Dechang Peng,
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11
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Distinct functional brain abnormalities in insomnia disorder and obstructive sleep apnea. Eur Arch Psychiatry Clin Neurosci 2022; 273:493-509. [PMID: 36094570 DOI: 10.1007/s00406-022-01485-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/24/2022] [Accepted: 08/29/2022] [Indexed: 11/03/2022]
Abstract
Insomnia disorder (ID) and obstructive sleep apnea (OSA) are the two most prevalent sleep disorders worldwide, but the pathological mechanism has not been fully understood. Functional neuroimaging findings indicated regional abnormal neural activities existed in both diseases, but the results were inconsistent. This meta-analysis aimed to explore concordant regional functional brain changes in ID and OSA, respectively. We conducted a coordinate-based meta-analysis (CBMA) of resting-state functional magnetic resonance imaging (rs-fMRI) studies using the anisotropic effect-size seed-based d mapping (AES-SDM) approach. Studies that applied regional homogeneity (ReHo), amplitude of low-frequency fluctuations (ALFF) or fractional ALFF (fALFF) to analyze regional spontaneous brain activities in ID or OSA were included. Meta-regressions were then applied to investigate potential associations between demographic variables and regional neural activity alterations. Significantly increased brain activities in the left superior temporal gyrus (STG.L) and right superior longitudinal fasciculus (SLF.R), as well as decreased brain activities in several right cerebral hemisphere areas were identified in ID patients. As for OSA patients, more distinct and complicated functional activation alterations were identified. Several neuroimaging alterations were functionally correlated with mean age, duration or illness severity in two patients groups revealed by meta-regressions. These functionally altered areas could be served as potential targets for non-invasive brain stimulation methods. This present meta-analysis distinguished distinct brain function changes in ID and OSA, improving our knowledge of the neuropathological mechanism of these two most common sleep disturbances, and also provided potential orientations for future clinical applications.Registration number: CRD42022301938.
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Li K, Shu Y, Liu X, Xie W, Li P, Kong L, Yu P, Zeng Y, Huang L, Long T, Zeng L, Li H, Peng D. Dynamic regional homogeneity alterations and cognitive impairment in patients with moderate and severe obstructive sleep apnea. Front Neurosci 2022; 16:940721. [PMID: 36090274 PMCID: PMC9459312 DOI: 10.3389/fnins.2022.940721] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2022] [Accepted: 08/03/2022] [Indexed: 11/13/2022] Open
Abstract
Background and purposePrevious studies have found that abnormal local spontaneous brain activity in patients with obstructive sleep apnea (OSA) was associated with cognitive impairment, and dynamic functional connections can capture the time changes of functional connections during magnetic resonance imaging acquisition. The purpose of this study was to investigate the dynamic characteristics of regional brain connectivity and its relationship with cognitive function in patients with OSA and to explore whether the dynamic changes can be used to distinguish them from healthy controls (HCs).MethodsSeventy-nine moderate and severe male OSA patients without any treatment and 84 HCs with similar age and education were recruited, and clinical data and resting functional magnetic resonance imaging data were collected. The dynamic regional homogeneity (dReHo) was calculated using a sliding window technique, and a double-sample t-test was used to test the difference in the dReHo map between OSA patients and HCs. We explored the relationship between dReHo and clinical and cognitive function in OSA patients using Pearson correlation analysis. A support vector machine was used to classify the OSA patients and HCs based on abnormal dReHo.ResultCompared with HCs, OSA patients exhibited higher dReHo values in the right medial frontal gyrus and significantly lower dReHo values in the right putamen, right superior temporal gyrus, right cingulate gyrus, left insula and left precuneus. The correlation analysis showed that the abnormal dReHo values in multiple brain regions in patients with OSA were significantly correlated with nadir oxygen saturation, the oxygen depletion index, sleep period time, and Montreal cognitive assessment score. The support vector machine classification accuracy based on the dReHo difference in brain regions was 81.60%, precision was 81.01%, sensitivity was 81.01%, specificity was 82.14%, and area under the curve was 0.89.ConclusionThe results of this study suggested that there was abnormal dynamic regional spontaneous brain activity in patients with OSA, which was related to clinical and cognitive evaluation and can be used to distinguish OSA patients from HCs. The dReHo is a potential objective neuroimaging marker for patients with OSA that can further the understanding of the neuropathological mechanism of patients with OSA.
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Affiliation(s)
- Kunyao Li
- Medical Imaging Center, The First Affiliated Hospital of Nanchang University, Nanchang, China
| | - Yongqiang Shu
- Medical Imaging Center, The First Affiliated Hospital of Nanchang University, Nanchang, China
| | - Xiang Liu
- Medical Imaging Center, The First Affiliated Hospital of Nanchang University, Nanchang, China
| | - Wei Xie
- Medical Imaging Center, The First Affiliated Hospital of Nanchang University, Nanchang, China
| | - Panmei Li
- Medical Imaging Center, The First Affiliated Hospital of Nanchang University, Nanchang, China
| | - Linghong Kong
- Medical Imaging Center, The First Affiliated Hospital of Nanchang University, Nanchang, China
| | - Pengfei Yu
- Science and Technology Division, Big Data Research Center, The Second Affiliated Hospital of Nanchang University, Nanchang, China
| | - Yaping Zeng
- Medical Imaging Center, The First Affiliated Hospital of Nanchang University, Nanchang, China
| | - Ling Huang
- Medical Imaging Center, The First Affiliated Hospital of Nanchang University, Nanchang, China
| | - Ting Long
- Medical Imaging Center, The First Affiliated Hospital of Nanchang University, Nanchang, China
| | - Li Zeng
- Medical Imaging Center, The First Affiliated Hospital of Nanchang University, Nanchang, China
| | - Haijun Li
- Medical Imaging Center, The First Affiliated Hospital of Nanchang University, Nanchang, China
- PET Center, The First Affiliated Hospital of Nanchang University, Nanchang, China
- Haijun Li,
| | - Dechang Peng
- Medical Imaging Center, The First Affiliated Hospital of Nanchang University, Nanchang, China
- PET Center, The First Affiliated Hospital of Nanchang University, Nanchang, China
- *Correspondence: Dechang Peng,
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Liu X, Shu Y, Yu P, Li H, Duan W, Wei Z, Li K, Xie W, Zeng Y, Peng D. Classification of severe obstructive sleep apnea with cognitive impairment using degree centrality: A machine learning analysis. Front Neurol 2022; 13:1005650. [PMID: 36090863 PMCID: PMC9453022 DOI: 10.3389/fneur.2022.1005650] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Accepted: 08/11/2022] [Indexed: 11/24/2022] Open
Abstract
In this study, we aimed to use voxel-level degree centrality (DC) features in combination with machine learning methods to distinguish obstructive sleep apnea (OSA) patients with and without mild cognitive impairment (MCI). Ninety-nine OSA patients were recruited for rs-MRI scanning, including 51 MCI patients and 48 participants with no mild cognitive impairment. Based on the Automated Anatomical Labeling (AAL) brain atlas, the DC features of all participants were calculated and extracted. Ten DC features were screened out by deleting variables with high pin-correlation and minimum absolute contraction and performing selective operator lasso regression. Finally, three machine learning methods were used to establish classification models. The support vector machine method had the best classification efficiency (AUC = 0.78), followed by random forest (AUC = 0.71) and logistic regression (AUC = 0.77). These findings demonstrate an effective machine learning approach for differentiating OSA patients with and without MCI and provide potential neuroimaging evidence for cognitive impairment caused by OSA.
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Affiliation(s)
- Xiang Liu
- Department of Radiology, the First Affiliated Hospital of Nanchang University, Jiangxi, China
| | - Yongqiang Shu
- Department of Radiology, the First Affiliated Hospital of Nanchang University, Jiangxi, China
| | - Pengfei Yu
- Big Data Center, the Second Affiliated Hospital of Nanchang University, Jiangxi, China
| | - Haijun Li
- Department of PET Center, the First Affiliated Hospital of Nanchang University, Jiangxi, China
| | - Wenfeng Duan
- Department of Radiology, the First Affiliated Hospital of Nanchang University, Jiangxi, China
| | - Zhipeng Wei
- Department of Radiology, the First Affiliated Hospital of Nanchang University, Jiangxi, China
| | - Kunyao Li
- Department of Radiology, the First Affiliated Hospital of Nanchang University, Jiangxi, China
| | - Wei Xie
- Department of Radiology, the First Affiliated Hospital of Nanchang University, Jiangxi, China
| | - Yaping Zeng
- Department of Radiology, the First Affiliated Hospital of Nanchang University, Jiangxi, China
| | - Dechang Peng
- Department of Radiology, the First Affiliated Hospital of Nanchang University, Jiangxi, China
- *Correspondence: Dechang Peng
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Sun Y, Yang SX, Xie M, Zou K, Tang X. Aberrant amplitude of low-frequency fluctuations in different frequency bands and changes after one-night positive airway pressure treatment in severe obstructive sleep apnea. Front Neurol 2022; 13:985321. [PMID: 36071907 PMCID: PMC9441702 DOI: 10.3389/fneur.2022.985321] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2022] [Accepted: 08/05/2022] [Indexed: 11/13/2022] Open
Abstract
ObjectiveThis study was aimed to investigate the characteristics of the amplitude of low-frequency fluctuation (ALFF) at specific frequencies in severe obstructive sleep apnea (OSA) patients. A comparison was made between pre-CPAP treatment and one night after continuous positive airway pressure (CPAP) treatment.Methods30 severe OSA patients and 19 healthy controls (HC) were recruited. The ALFF method was used to assess the local features of spontaneous brain activity and calculated at different bands (slow-5 and slow-4). A correlation analysis was performed to evaluate the relationship between the changes of the ALFF and polysomnography data.ResultsCompared with HC, in slow-5 frequency band, OSA patients showed significantly decreased ALFF in the left inferior temporal gyrus, and significantly increased ALFF in the left middle frontal gyrus, left inferior frontal gyrus, triangular part, right superior frontal gyrus, dorsolateral and right middle temporal gyrus. In slow-4 frequency, there was significantly decreased ALFF in the right inferior temporal gyrus, and significantly increased ALFF in the left precuneus, right posterior cingulate gyrus and right median cingulate besides the slow-5 difference band showed. Compared with pre-CPAP, we found that after CPAP treatment, ALFF signals in the left insula in slow-5 and left caudate in slow-4 increased, but the calcarine in slow-4 significantly reduced. Correlation analysis showed that the left angular slow-4 band change was positively correlated with the slow wave sleep change (r = 0.4933, p = 0.0056). The left cerebellum 6 slow-5 band change was positively correlated with the duration of the REM sleep change (r = 0.4563, p = 0.0113), and the left cerebellum 6 slow-4 band change was also positively correlated with the mean blood oxygen change in the REM (r = 0.4591, p = 0.0107) and NREM sleep (r = 0.4492, p = 0.0128).ConclusionWe found that the use of slow-4 was more specific in OSA studies. These results suggested that the severe OSA patients have frequency-related abnormal spontaneous neural activity, which may contribute to a better understanding of the pathological basis of OSA-related diseases and provide a potential therapeutic target for OSA patients.
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Affiliation(s)
- Yuanfeng Sun
- Sleep Medicine Center, West China Hospital, Sichuan University, Chengdu, China
| | - Sophine Xin Yang
- Business Administration of Business School, Sichuan University, Chengdu, China
| | - Min Xie
- Mental Health Center, West China Hospital, Sichuan University, Chengdu, China
| | - Ke Zou
- Sleep Medicine Center, West China Hospital, Sichuan University, Chengdu, China
- *Correspondence: Ke Zou
| | - Xiangdong Tang
- Sleep Medicine Center, West China Hospital, Sichuan University, Chengdu, China
- Xiangdong Tang
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15
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Hou A, Pang X, Zhang X, Peng Y, Li D, Wang H, Zhang Q, Liang M, Gao F. Widespread aberrant functional connectivity throughout the whole brain in obstructive sleep apnea. Front Neurosci 2022; 16:920765. [PMID: 35979339 PMCID: PMC9377518 DOI: 10.3389/fnins.2022.920765] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2022] [Accepted: 07/01/2022] [Indexed: 11/13/2022] Open
Abstract
Objective Obstructive sleep apnea (OSA) is a sleep-related breathing disorder with high prevalence and is associated with cognitive impairment. Previous neuroimaging studies have reported abnormal brain functional connectivity (FC) in patients with OSA that might contribute to their neurocognitive impairments. However, it is unclear whether patients with OSA have a characteristic pattern of FC changes that can serve as a neuroimaging biomarker for identifying OSA. Methods A total of 21 patients with OSA and 21 healthy controls (HCs) were included in this study and scanned using resting-state functional magnetic resonance imaging (fMRI). The automated anatomical labeling (AAL) atlas was used to divide the cerebrum into 90 regions, and FC between each pair of regions was calculated. Univariate analyses were then performed to detect abnormal FCs in patients with OSA compared with controls, and multivariate pattern analyses (MVPAs) were applied to classify between patients with OSA and controls. Results The univariate comparisons did not detect any significantly altered FC. However, the MVPA showed a successful classification between patients with OSA and controls with an accuracy of 83.33% (p = 0.0001). Furthermore, the selected FCs were associated with nearly all brain regions and widely distributed in the whole brain, both within and between, many resting-state functional networks. Among these selected FCs, 3 were significantly correlated with the apnea-hypopnea index (AHI) and 2 were significantly correlated with the percentage of time with the saturation of oxygen (SaO2) below 90% of the total sleep time (%TST < 90%). Conclusion There existed widespread abnormal FCs in the whole brain in patients with OSA. This aberrant FC pattern has the potential to serve as a neurological biomarker of OSA, highlighting its importance for understanding the complex neural mechanism underlying OSA and its cognitive impairment.
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Affiliation(s)
- Ailin Hou
- College of Precision Instrument and Optoelectronics Engineering, Tianjin University, Tianjin, China
- School of Medical Imaging and Tianjin Key Laboratory of Functional Imaging, Tianjin Medical University, Tianjin, China
| | - Xueming Pang
- School of Medical Imaging and Tianjin Key Laboratory of Functional Imaging, Tianjin Medical University, Tianjin, China
| | - Xi Zhang
- School of Medical Imaging and Tianjin Key Laboratory of Functional Imaging, Tianjin Medical University, Tianjin, China
| | - Yanmin Peng
- School of Medical Imaging and Tianjin Key Laboratory of Functional Imaging, Tianjin Medical University, Tianjin, China
| | - Dongyue Li
- School of Medical Imaging and Tianjin Key Laboratory of Functional Imaging, Tianjin Medical University, Tianjin, China
| | - He Wang
- School of Medical Imaging and Tianjin Key Laboratory of Functional Imaging, Tianjin Medical University, Tianjin, China
| | - Quan Zhang
- Department of Radiology, Characteristic Medical Center of Chinese People’s Armed Police Force, Tianjin, China
- *Correspondence: Quan Zhang,
| | - Meng Liang
- School of Medical Imaging and Tianjin Key Laboratory of Functional Imaging, Tianjin Medical University, Tianjin, China
- Meng Liang,
| | - Feng Gao
- College of Precision Instrument and Optoelectronics Engineering, Tianjin University, Tianjin, China
- Tianjin Key Laboratory of Biomedical Detecting Techniques and Instruments, Tianjin University, Tianjin, China
- Feng Gao,
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16
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Liu X, Chen L, Duan W, Li H, Kong L, Shu Y, Li P, Li K, Xie W, Zeng Y, Peng D. Abnormal Functional Connectivity of Hippocampal Subdivisions in Obstructive Sleep Apnea: A Resting-State Functional Magnetic Resonance Imaging Study. Front Neurosci 2022; 16:850940. [PMID: 35546892 PMCID: PMC9082679 DOI: 10.3389/fnins.2022.850940] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2022] [Accepted: 03/14/2022] [Indexed: 01/16/2023] Open
Abstract
The hippocampus is involved in various cognitive function, including memory. Hippocampal structural and functional abnormalities have been observed in patients with obstructive sleep apnoea (OSA), but the functional connectivity (FC) patterns among hippocampal subdivisions in OSA patients remain unclear. The purpose of this study was to investigate the changes in FC between hippocampal subdivisions and their relationship with neurocognitive function in male patients with OSA. Resting-state fMRI were obtained from 46 male patients with untreated severe OSA and 46 male good sleepers. The hippocampus was divided into anterior, middle, and posterior parts, and the differences in FC between hippocampal subdivisions and other brain regions were determined. Correlation analysis was used to explore the relationships between abnormal FC of hippocampal subdivisions and clinical characteristics in patients with OSA. Our results revealed increased FC in the OSA group between the left anterior hippocampus and left middle temporal gyrus; between the left middle hippocampus and the left inferior frontal gyrus, right anterior central gyrus, and left anterior central gyrus; between the left posterior hippocampus and right middle frontal gyrus; between the right middle hippocampus and left inferior frontal gyrus; and between the right posterior hippocampus and left middle frontal gyrus. These FC abnormalities predominantly manifested in the sensorimotor network, fronto-parietal network, and semantic/default mode network, which are closely related to the neurocognitive impairment observed in OSA patients. This study advances our understanding of the potential pathophysiological mechanism of neurocognitive dysfunction in OSA.
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Affiliation(s)
- Xiang Liu
- Department of Radiology, The First Affiliated Hospital of Nanchang University, Nanchang, China
| | - Liting Chen
- Medical Imaging Center, First Affiliated Hospital of Jinan University, Guangzhou, China
| | - Wenfeng Duan
- Department of Radiology, The First Affiliated Hospital of Nanchang University, Nanchang, China
| | - Haijun Li
- Department of Radiology, The First Affiliated Hospital of Nanchang University, Nanchang, China
| | - Linghong Kong
- Department of Radiology, The First Affiliated Hospital of Nanchang University, Nanchang, China
| | - Yongqiang Shu
- Department of Radiology, The First Affiliated Hospital of Nanchang University, Nanchang, China
| | - Panmei Li
- Department of Radiology, The First Affiliated Hospital of Nanchang University, Nanchang, China
| | - Kunyao Li
- Department of Radiology, The First Affiliated Hospital of Nanchang University, Nanchang, China
| | - Wei Xie
- Department of Radiology, The First Affiliated Hospital of Nanchang University, Nanchang, China
| | - Yaping Zeng
- Department of Radiology, The First Affiliated Hospital of Nanchang University, Nanchang, China
| | - Dechang Peng
- Department of Radiology, The First Affiliated Hospital of Nanchang University, Nanchang, China
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17
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Wang X, Bai Z, He Y, Wu Q. Relationship between blood amyloid A and resting magnetic resonance functional brain connections in patients with obstructive sleep apnea-hypopnea syndrome. Sleep Breath 2022; 27:477-485. [PMID: 35503197 DOI: 10.1007/s11325-022-02613-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2021] [Revised: 03/25/2022] [Accepted: 04/06/2022] [Indexed: 11/30/2022]
Abstract
OBJECTIVE The aim of this study was to analyze the relationship between serum amyloid A (SAA) concentrations in patients with obstructive sleep apnea-hypopnea syndrome (OSAHS) and their magnetic resonance imaging (MRI) of resting brain function. METHODS Male patients with OSAHS were enrolled from January to June 2019 in Suzhou Ninth People's Hospital Affiliated to Soochow University, and nineteen healthy male volunteers were selected as the normal control group. The patients with OSAHS were divided into mild, moderate, and severe groups according to their apnea-hypopnea index (AHI). Early in the morning after the polysomnography (PSG), blood samples were collected and serum levels of serum amyloid A (SAA) were measured by enzyme-linked immunosorbent assay. All subjects were scored by the Auditory Verbal Learning Test (AVLT) scale. Resting brain function images of healthy male volunteers and patients in the severe group were collected by 3.0 T magnetic resonance scanner. SPSS25.0 software was used for statistical analysis. RESULTS The SAA of the OSAHS group (n = 43) were higher than those of control group (n = 19). The scores of AVLT-immediate and AVLT-delay in the severe OSAHS group were lower than those in the control group (P < 0.05), and it was negatively correlated with SAA. In the severe OSAHS group, the rest state Function Connection (rsFC) in temporal lobe, marginal lobe, and frontal lobe was lower than that in the control group (P < 0.05) and was significantly negatively correlated with SAA. The rsFC in bilateral parietal lobes was higher than that in the control group (P < 0.05), was significantly positively correlated with SAA, and was negatively correlated with AVLT-delay. CONCLUSIONS The significant increase in SAA concentration in patients with OSAHS correlated with brain rsFC intensity, providing a reference role for the diagnosis, treatment, and prognosis of cognitive dysfunction in patients with OSAHS.
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Affiliation(s)
- Xiang Wang
- Department of Respiratory, Suzhou Ninth Hospital Affiliated to Soochow University, Suzhou Ninth People's Hospital, Suzhou, 215200, China
| | - Zhiyu Bai
- Department of Respiratory, Suzhou Ninth Hospital Affiliated to Soochow University, Suzhou Ninth People's Hospital, Suzhou, 215200, China
| | - Yaqing He
- Department of Respiratory, Suzhou Ninth Hospital Affiliated to Soochow University, Suzhou Ninth People's Hospital, Suzhou, 215200, China
| | - Qiaozhen Wu
- Department of Respiratory, Suzhou Ninth Hospital Affiliated to Soochow University, Suzhou Ninth People's Hospital, Suzhou, 215200, China.
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Li P, Shu Y, Liu X, Kong L, Li K, Xie W, Zeng Y, Li H, Peng D. The Effects of CPAP Treatment on Resting-State Network Centrality in Obstructive Sleep Apnea Patients. Front Neurol 2022; 13:801121. [PMID: 35418931 PMCID: PMC8995649 DOI: 10.3389/fneur.2022.801121] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2021] [Accepted: 03/07/2022] [Indexed: 12/26/2022] Open
Abstract
Background and Objectives Obstructive sleep apnea (OSA) is the most common sleep disorder and previous studies have shown that OSA patients suffer from brain network impairments associated with cognitive deficits, and continuous positive airway pressure (CPAP) treatment can improve clinical symptoms. However, the relationship between CPAP treatment and brain network changes remains unclear. This study explored the characteristics of brain network changes in OSA patients before (pre-CPAP) and after one month of CPAP treatment (post-CPAP). Methods We collected data, including sleep monitoring, clinical assessment, and magnetic resonance imaging scans, from 21 OSA patients and 21 age-matched healthy controls (HCs). Voxel-level degree centrality (DC) was used to assess whole-brain network connectivity characteristics, a two-sample t-test was used to compare network differences between pre-CPAP OSA patients and HCs, and a paired sample t-test was used to compare the characteristics of brain network changes in OSA patients before and after treatment. The correlations between the DC value and each of the clinical variables were analyzed in the OSA patients. Results Compared with HCs, pre-CPAP OSA patients showed increased DC values in the bilateral cerebellar posterior lobes (CPLs) and decreased DC values in the right superior temporal gyrus, left superior frontal gyrus and right middle frontal gyrus. Compared with pre-CPAP OSA patients, post-CPAP OSA patients showed reduced DC values in the bilateral CPL and increased DC values in several brain regions in the frontal, temporal, and insular lobes after CPAP treatment. The Montreal Cognitive Assessment MoCA (MoCA) scores were positively correlated with the DC value of the bilateral cerebellum posterior lobe, right middle temporal gyrus, left superior temporal gyrus, left paracentral lobule and left paracentral lobule. Also, Pittsburgh Sleep Quality Index (PSQI) scores were negatively correlated with the DC value of the right middle temporal gyrus in post-CPAP OSA patients. Conclusion CPAP treatment can effectively reverse the compensatory response of the bilateral CPL and functional network damage brought about by OSA, which may provide potential neuroimaging biomarkers for CPAP treatment evaluation.
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Affiliation(s)
- Panmei Li
- Medical Imaging Center, The First Affiliated Hospital of Nanchang University, Nanchang, China
| | - Yongqiang Shu
- Medical Imaging Center, The First Affiliated Hospital of Nanchang University, Nanchang, China
| | - Xiang Liu
- Medical Imaging Center, The First Affiliated Hospital of Nanchang University, Nanchang, China
| | - Linghong Kong
- Medical Imaging Center, The First Affiliated Hospital of Nanchang University, Nanchang, China
| | - Kunyao Li
- Medical Imaging Center, The First Affiliated Hospital of Nanchang University, Nanchang, China
| | - Wei Xie
- Medical Imaging Center, The First Affiliated Hospital of Nanchang University, Nanchang, China
| | - Yaping Zeng
- Medical Imaging Center, The First Affiliated Hospital of Nanchang University, Nanchang, China
| | - Haijun Li
- Medical Imaging Center, The First Affiliated Hospital of Nanchang University, Nanchang, China.,Positron Emission Tomography (PET) Center, The First Affiliated Hospital of Nanchang University, Nanchang, China
| | - Dechang Peng
- Medical Imaging Center, The First Affiliated Hospital of Nanchang University, Nanchang, China.,Positron Emission Tomography (PET) Center, The First Affiliated Hospital of Nanchang University, Nanchang, China
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Kong L, Li H, Shu Y, Liu X, Li P, Li K, Xie W, Zeng Y, Peng D. Aberrant Resting-State Functional Brain Connectivity of Insular Subregions in Obstructive Sleep Apnea. Front Neurosci 2022; 15:765775. [PMID: 35126035 PMCID: PMC8813041 DOI: 10.3389/fnins.2021.765775] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2021] [Accepted: 12/13/2021] [Indexed: 12/14/2022] Open
Abstract
The insular cortex is a cortical regulatory area involved in dyspnea, cognition, emotion, and sensorimotor function. Previous studies reported that obstructive sleep apnea (OSA) shows insular tissue damage and abnormal functional connections for the whole insula. The insula can be divided into different subregions with distinct functional profiles, including the ventral anterior insula (vAI) participating in affective processing, dorsal anterior insula (dAI) involved in cognitive processing, and posterior insula (PI) involved in the processing of sensorimotor information. However, the functional connectivity (FC) of these insular subregions in OSA has yet to be established. Hence, the purpose of this study was to explore the resting-state FC of the insular subregions with other brain areas and its relationship with clinical symptoms of OSA. Resting-state functional magnetic resonance imaging data from 83 male OSA patients and 84 healthy controls were analyzed by whole-brain voxel-based FC using spherical seeds from six insular subregions, namely, the bilateral vAI, dAI, and PI, to identify abnormalities in the insular subregions network and related brain regions. Ultimately, the Pearson correlation analysis was carried out between the dysfunction results and the neuropsychological tests. Compared with the healthy control group, the OSA patients exhibited disturbed FC from the dAI to areas relevant to cognition, such as the bilateral cerebellum posterior lobe, superior frontal gyrus, right middle frontal gyrus and middle temporal gyrus; decreased FC from the vAI to areas linked with emotion, such as the bilateral fusiform gyrus, superior parietal lobule, precuneus and cerebellum posterior lobe; and abnormal FC from the PI to the brain regions involved in sensorimotor such as the bilateral precentral gyrus, right superior/middle temporal gyrus and left superior frontal gyrus. The linear regression result showed that the apnea-hypopnea index was positively correlated with the increased FC between the right PI and the right precuneus (after Bonferroni correlation, P < 0.001) In conclusion, the abnormal FC between insular subregions and other brain regions were related to cognitive, emotional and sensorimotor networks in OSA patients. These results may provide a new imaging perspective for further understanding of OSA-related cognitive and affective disorders.
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Feng M, Wen H, Xin H, Zhang N, Liang C, Guo L. Altered Spontaneous Brain Activity Related to Neurologic Dysfunction in Patients With Cerebral Small Vessel Disease. Front Aging Neurosci 2022; 13:731585. [PMID: 34975450 PMCID: PMC8718906 DOI: 10.3389/fnagi.2021.731585] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2021] [Accepted: 11/30/2021] [Indexed: 12/04/2022] Open
Abstract
Cerebral small vessel disease (CSVD) encompasses several diseases affecting the small arteries, arterioles, venules, and capillaries of the brain and refers to several pathological processes and etiologies. Neuroimaging is considered the gold standard for detecting CSVD, which can present diverse features on MRI. Cerebral microbleeds (CMBs) in CSVD have been demonstrated to play a synergistic role in both cerebrovascular and neurodegenerative pathology. Considering previous studies on brain structural abnormalities in CSVD, in the present study, we aimed to explore altered spontaneous brain activity among CSVD patients using amplitude of low-frequency fluctuation (ALFF), fractional ALFF (fALFF) and regional homogeneity (ReHo) methods based on resting-state functional MRI. In this study, we recruited 24 CSVD patients with CMBs (CSVD-c), 42 CSVD patients without CMBs (CSVD-n) and 36 healthy controls from outpatient clinics in Shandong Provincial Hospital affiliated to Shandong First Medical University between September 2018 and June 2019. All subjects underwent 3-T MRI, including blood oxygen level-dependent (BOLD) and susceptibility-weighted imaging (SWI). Anatomic structures were segmented, ALFF/fALFF values were calculated, and ReHo maps were generated. Further statistical analysis was applied to study the difference in ALFF/fALFF/ReHo among the three groups and the association between ALFF/fALFF/ReHo changes in different brain regions and clinical characteristics. Twenty-four CSVD-c patients (age: 67.54 ± 6.00 years, 10 females), 42 CSVD-n patients (age: 66.33 ± 5.25 years, 22 females) and 36 healthy subjects (age: 64.14 ± 8.57 years, 19 females) were evaluated. Compared with controls, the CSVD-c group showed significantly increased ALFF values in the right insula, putamen and left precuneus; decreased fALFF values in the right precentral gyrus and postcentral gyrus; and increased ReHo values in the left precuneus, fusiform gyrus, right supplementary motor area (SMA), and superior frontal gyrus. Notably, the mean ALFF values of the right insula and putamen were not only significantly related to all clinical parameters but also demonstrated the best performance in Receiver Operating Characteristic (ROC) curve analysis. These findings reveal CSVD-c patients have dysfunctions in the default mode network, sensorimotor network and frontoparietal network, which may implicate the underlying neurophysiological mechanisms of intrinsic brain activity. The correlation between altered spontaneous neuronal activity and clinical parameters provides early useful diagnostic biomarkers for CSVD.
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Affiliation(s)
- Mengmeng Feng
- Department of Radiology, Cheeloo College of Medicine, Shandong Provincial Hospital, Shandong University, Jinan, China
| | - Hongwei Wen
- Key Laboratory of Cognition and Personality, Ministry of Education, Chongqing, China.,School of Psychology, Southwest University, Chongqing, China
| | - Haotian Xin
- Department of Radiology, Cheeloo College of Medicine, Shandong Provincial Hospital, Shandong University, Jinan, China
| | - Nan Zhang
- Department of Radiology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, China
| | - Changhu Liang
- Department of Radiology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, China
| | - Lingfei Guo
- Department of Radiology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, China
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21
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Xie W, Shu Y, Liu X, Li K, Li P, Kong L, Yu P, Huang L, Long T, Zeng L, Li H, Peng D. Abnormal Spontaneous Brain Activity and Cognitive Impairment in Obstructive Sleep Apnea. Nat Sci Sleep 2022; 14:1575-1587. [PMID: 36090000 PMCID: PMC9462436 DOI: 10.2147/nss.s376638] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/29/2022] [Accepted: 08/28/2022] [Indexed: 11/23/2022] Open
Abstract
PURPOSE This study aimed to explore the alterations in spontaneous brain activity in obstructive sleep apnea (OSA) using percent amplitude of fluctuation (PerAF) and investigate the relationship between abnormal spontaneous brain activity and cognitive impairment in OSA. PATIENTS AND METHODS Overall, 52 patients with moderate to severe OSA and 61 healthy controls (HCs) were eventually enrolled in this study. All participants underwent resting-state functional magnetic resonance (rs-fMRI) and T1-weighted imaging. The PerAF was calculated and compared between patients with OSA and HCs, with voxel level P < 0.001 and cluster level P < 0.05 corrected with Gaussian Random Field was be considered statistically different. A partial correlation analysis was used to assess the relationship between altered PerAF and clinical assessments in patients with OSA. RESULTS Compared to HCs, patients with OSA had significantly lower PerAF values in the right rectal gyrus and left superior frontal gyrus, but higher PerAF values in the right cerebellum posterior lobe and left middle frontal gyrus. The PerAF values of some specific regions in patients with OSA correlated with sleep efficiency and Montreal Cognitive Assessment scores. Additionally, support vector machine analysis showed that PerAF values in all differential brain regions could differentiate patients with OSA from HCs with good accuracy. CONCLUSION Specific brain areas in OSA patients may exhibit aberrant neuronal activity, and these anomalies may be linked to decreased cognitive performance. This discovery offers fresh perspectives on these patients' neurocognition.
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Affiliation(s)
- Wei Xie
- Medical Imaging Center, The First Affiliated Hospital of Nanchang University, Nanchang, People's Republic of China
| | - Yongqiang Shu
- Medical Imaging Center, The First Affiliated Hospital of Nanchang University, Nanchang, People's Republic of China
| | - Xiang Liu
- Medical Imaging Center, The First Affiliated Hospital of Nanchang University, Nanchang, People's Republic of China
| | - Kunyao Li
- Medical Imaging Center, The First Affiliated Hospital of Nanchang University, Nanchang, People's Republic of China
| | - Panmei Li
- Medical Imaging Center, The First Affiliated Hospital of Nanchang University, Nanchang, People's Republic of China
| | - Linghong Kong
- Medical Imaging Center, The First Affiliated Hospital of Nanchang University, Nanchang, People's Republic of China
| | - Pengfei Yu
- Big Data Research Center, The Second Affiliated Hospital of Nanchang University, Nanchang, People's Republic of China
| | - Ling Huang
- Medical Imaging Center, The First Affiliated Hospital of Nanchang University, Nanchang, People's Republic of China
| | - Ting Long
- Medical Imaging Center, The First Affiliated Hospital of Nanchang University, Nanchang, People's Republic of China
| | - Li Zeng
- Medical Imaging Center, The First Affiliated Hospital of Nanchang University, Nanchang, People's Republic of China
| | - Haijun Li
- Medical Imaging Center, The First Affiliated Hospital of Nanchang University, Nanchang, People's Republic of China.,PET Center, The First Affiliated Hospital of Nanchang University, Nanchang, People's Republic of China
| | - Dechang Peng
- Medical Imaging Center, The First Affiliated Hospital of Nanchang University, Nanchang, People's Republic of China.,PET Center, The First Affiliated Hospital of Nanchang University, Nanchang, People's Republic of China
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22
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Bai J, Wen H, Tai J, Peng Y, Li H, Mei L, Ji T, Li X, Li Y, Ni X, Liu Y. Altered Spontaneous Brain Activity Related to Neurologic and Sleep Dysfunction in Children With Obstructive Sleep Apnea Syndrome. Front Neurosci 2021; 15:595412. [PMID: 34867137 PMCID: PMC8634797 DOI: 10.3389/fnins.2021.595412] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2020] [Accepted: 09/27/2021] [Indexed: 11/13/2022] Open
Abstract
Childhood obstructive sleep apnea (OSA) is a common chronic sleep-related breathing disorder in children, which leads to growth retardation, neurocognitive impairments, and serious complications. Considering the previous studies about brain structural abnormalities in OSA, in the present study, we aimed to explore the altered spontaneous brain activity among OSA patients, using amplitude of low-frequency fluctuation (ALFF), fractional ALFF (fALFF), and regional homogeneity (ReHo) methods based on resting-state functional magnetic resonance imaging (MRI). Thirty-one untreated OSA children and 33 age-and gender-matched healthy children (HC) were included in this study. Compared with controls, the OSA group showed significant lower ALFF in the right lingual gyrus, decreased fALFF in the left middle frontal gyrus (MFG), but increased fALFF in the left precuneus. Decreased ReHo was found in the left inferior frontal gyrus (orbital part) and left middle frontal gyrus. Notably, the mean fALFF value of left MFG was not only significantly related to multiple sleep parameters but also demonstrated the best performance in ROC curve analysis. These findings revealed OSA children were associated with dysfunctions in the default mode network, the frontal lobe, and the lingual gyrus, which may implicate the underlying neurophysiological mechanisms of intrinsic brain activity. The correlation between the altered spontaneous neuronal activity and the clinical index provides early useful diagnostic biomarkers for OSA children as well.
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Affiliation(s)
- Jie Bai
- Department of Radiology, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China
| | - Hongwei Wen
- Key Laboratory of Cognition and Personality, Ministry of Education, Chongqing, China.,School of Psychology, Southwest University, Chongqing, China
| | - Jun Tai
- Department of Otolaryngology, Head and Neck Surgery, Children's Hospital Capital Institute of Pediatrics, Beijing, China
| | - Yun Peng
- Department of Radiology, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China
| | - Hongbin Li
- Department of Otolaryngology, Head and Neck Surgery, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China
| | - Lin Mei
- Department of Otolaryngology, Head and Neck Surgery, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China
| | - Tingting Ji
- Department of Otolaryngology, Head and Neck Surgery, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China
| | - Xiaodan Li
- Department of Otolaryngology, Head and Neck Surgery, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China
| | - Yanhua Li
- Department of Radiology, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China
| | - Xin Ni
- Department of Otolaryngology, Head and Neck Surgery, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China
| | - Yue Liu
- Department of Radiology, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China
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23
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Yu K, Guo Y, Ge QM, Su T, Shi WQ, Zhang LJ, Shu HY, Pan YC, Liang RB, Li QY, Shao Y. Altered spontaneous activity in the frontal gyrus in dry eye: a resting-state functional MRI study. Sci Rep 2021; 11:12943. [PMID: 34155240 PMCID: PMC8217547 DOI: 10.1038/s41598-021-92199-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2021] [Accepted: 05/28/2021] [Indexed: 02/05/2023] Open
Abstract
This study investigated neurologic changes in patients with dry eye (DE) by functional magnetic resonance imaging (fMRI) and to used regional homogeneity (ReHo) analysis to clarify the relationship between these changes and clinical features of DE. A total of 28 patients with DE and 28 matched healthy control (HC) subjects (10 males and 18 females in each group) were enrolled. fMRI scans were performed in both groups. We carried out ReHo analysis to assess differences in neural activity between the 2 groups, and receiver operating characteristic curve (ROC) analysis was performed to evaluate the performance of ReHo values of specific brain areas in distinguishing DE patients from HCs. The relationship between average ReHo values and clinical characteristics was assessed by correlation analysis. ReHo values of the middle frontal gyrus, inferior frontal gyrus, and superior frontal gyrus were significantly lower in DE patients compared to HCs. The ROC analysis showed that ReHo value had high accuracy in distinguishing between DE patients and HCs (P < 0.0001). The ReHo values of the middle frontal gyrus and dorsolateral superior frontal gyrus were correlated to disease duration (P < 0.05). Symptoms of ocular surface injury in DE patients are associated with dysfunction in specific brain regions, which may underlie the cognitive impairment, psychiatric symptoms, and depressive mood observed in DE patients. The decreased ReHo values of some brain gyri in this study may provide a reference for clinical diagnosis and determination of treatment efficacy.
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Affiliation(s)
- Kang Yu
- grid.412604.50000 0004 1758 4073Department of Ophthalmology and Radiology, Jiangxi Center of Natural Ocular Disease Clinical Research Center, The First Affiliated Hospital of Nanchang University, No 17, YongWaiZheng Street, DongHu District, Nanchang, 330006 Jiangxi People’s Republic of China
| | - Yu Guo
- grid.412604.50000 0004 1758 4073Department of Ophthalmology and Radiology, Jiangxi Center of Natural Ocular Disease Clinical Research Center, The First Affiliated Hospital of Nanchang University, No 17, YongWaiZheng Street, DongHu District, Nanchang, 330006 Jiangxi People’s Republic of China
| | - Qian-Min Ge
- grid.412604.50000 0004 1758 4073Department of Ophthalmology and Radiology, Jiangxi Center of Natural Ocular Disease Clinical Research Center, The First Affiliated Hospital of Nanchang University, No 17, YongWaiZheng Street, DongHu District, Nanchang, 330006 Jiangxi People’s Republic of China
| | - Ting Su
- grid.12955.3a0000 0001 2264 7233Fujian Provincial Key Laboratory of Ophthalmology and Visual Science, Medical College of Xiamen University, Eye Institute of Xiamen University, Xiamen, 361102 Fujian Province China ,grid.38142.3c000000041936754XDepartment of Ophthalmology, Massachusetts Eye and Ear, Harvard Medical School, Boston, MA 02114 USA
| | - Wen-Qing Shi
- grid.412604.50000 0004 1758 4073Department of Ophthalmology and Radiology, Jiangxi Center of Natural Ocular Disease Clinical Research Center, The First Affiliated Hospital of Nanchang University, No 17, YongWaiZheng Street, DongHu District, Nanchang, 330006 Jiangxi People’s Republic of China
| | - Li-Juan Zhang
- grid.412604.50000 0004 1758 4073Department of Ophthalmology and Radiology, Jiangxi Center of Natural Ocular Disease Clinical Research Center, The First Affiliated Hospital of Nanchang University, No 17, YongWaiZheng Street, DongHu District, Nanchang, 330006 Jiangxi People’s Republic of China
| | - Hui-Ye Shu
- grid.412604.50000 0004 1758 4073Department of Ophthalmology and Radiology, Jiangxi Center of Natural Ocular Disease Clinical Research Center, The First Affiliated Hospital of Nanchang University, No 17, YongWaiZheng Street, DongHu District, Nanchang, 330006 Jiangxi People’s Republic of China
| | - Yi-Cong Pan
- grid.412604.50000 0004 1758 4073Department of Ophthalmology and Radiology, Jiangxi Center of Natural Ocular Disease Clinical Research Center, The First Affiliated Hospital of Nanchang University, No 17, YongWaiZheng Street, DongHu District, Nanchang, 330006 Jiangxi People’s Republic of China
| | - Rong-Bin Liang
- grid.412604.50000 0004 1758 4073Department of Ophthalmology and Radiology, Jiangxi Center of Natural Ocular Disease Clinical Research Center, The First Affiliated Hospital of Nanchang University, No 17, YongWaiZheng Street, DongHu District, Nanchang, 330006 Jiangxi People’s Republic of China
| | - Qiu-Yu Li
- grid.412604.50000 0004 1758 4073Department of Ophthalmology and Radiology, Jiangxi Center of Natural Ocular Disease Clinical Research Center, The First Affiliated Hospital of Nanchang University, No 17, YongWaiZheng Street, DongHu District, Nanchang, 330006 Jiangxi People’s Republic of China
| | - Yi Shao
- grid.412604.50000 0004 1758 4073Department of Ophthalmology and Radiology, Jiangxi Center of Natural Ocular Disease Clinical Research Center, The First Affiliated Hospital of Nanchang University, No 17, YongWaiZheng Street, DongHu District, Nanchang, 330006 Jiangxi People’s Republic of China
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24
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Gong L, Yu S, Xu R, Liu D, Dai X, Wang Z, Hu Y, Yan B, Kui Y, Zhang B, Feng F. The abnormal reward network associated with insomnia severity and depression in chronic insomnia disorder. Brain Imaging Behav 2021; 15:1033-1042. [PMID: 32710331 DOI: 10.1007/s11682-020-00310-w] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Previous research has shown that acute sleep deprivation can influence the reward networks. However, it is unclear whether and how the intrinsic reward network is altered in chronic insomnia disorder (CID). In the present study, we aimed to investigate whether the reward network is altered in patients with CID using resting-state functional magnetic resonance imaging (fMRI) data. Forty-two patients with CID and 33 healthy controls (HCs) were enrolled and underwent resting-state fMRI. Nucleus accumbens (NAc) - based functional connectivity (NAFC) was evaluated to explore the differences in the reward network between the CID and HC groups. Pearson correlation analysis was used to evaluate the clinical significance of altered NAFC networks. Compared to those in the HC group, increased NAFC was found in the salience and limbic networks, while decreased NAFC was found in the default mode network (DMN) and within the reward circuit in patients with CID. In addition, decreased FC between the NAc and DMN was associated with insomnia severity, while NAFC within the reward network was associated with depression symptoms in patients with CID. These findings showed that the reward network is dysfunctional and associated with depression symptom in patients with CID. Future studies of CID should consider both insomnia and depression symptoms to disentangle the role of insomnia and depression in the relationship under study.
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Affiliation(s)
- Liang Gong
- Department of Neurology, Chengdu Second People's Hospital, Chengdu, 610017, Sichuan, China
| | - Siyi Yu
- Department of Acupuncture & Tuina, Chengdu University of Traditional Chinese Medicine, Chengdu, 610075, Sichuan, China
| | - Ronghua Xu
- Department of Neurology, Chengdu Second People's Hospital, Chengdu, 610017, Sichuan, China
| | - Duan Liu
- Department of Neurology, Chengdu Second People's Hospital, Chengdu, 610017, Sichuan, China
| | - Xijian Dai
- Department of Medical Imaging, Jinling Hospital, Medical School of Nanjing University, Nanjing, 210002, Jiangsu, China
| | - Zhengyan Wang
- Department of Pain Management, Sichuan Integrative Medicine, Sichuan, 610041, Chengdu, China
| | - Youping Hu
- Department of Acupuncture & Tuina, Chengdu University of Traditional Chinese Medicine, Chengdu, 610075, Sichuan, China
| | - Bohua Yan
- Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, 610072, Sichuan, China
| | - Yu Kui
- The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, 510120, Guangdong, China
| | - Bei Zhang
- Department of Neurology, Chengdu Second People's Hospital, Chengdu, 610017, Sichuan, China
| | - Fen Feng
- Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, 610072, Sichuan, China.
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25
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Ji T, Li X, Qiu Y, Mei L, Jia X, Tai J, Guo Y, Zhang J, Wang S, Ni X. Disease characteristics and neuropathological changes associated with cognitive dysfunction in obstructive sleep apnea. Pediatr Investig 2021; 5:52-57. [PMID: 33778428 PMCID: PMC7984002 DOI: 10.1002/ped4.12247] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2020] [Accepted: 10/13/2020] [Indexed: 12/11/2022] Open
Abstract
Obstructive sleep apnea (OSA) is a common sleep-disordered breathing disease that often leads to many comorbidities (e.g., cognitive dysfunction), which adversely affect the quality of life for patients with OSA. Thus far, the underlying mechanisms of this dysfunction remain unclear. Many studies have focused on OSA-related characteristics, including intermittent hypoxemia and sleep fragmentation. There is increasing emphasis on neuroimaging studies to explore underlying relationships between neuropathological changes and cognitive dysfunction. This article reviews recent research progress concerning cognitive dysfunction associated with OSA to reveal potential mechanisms that contribute to this dysfunction.
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Affiliation(s)
- Tingting Ji
- Department of Otolaryngology, Head and Neck SurgeryBeijing Children’s HospitalCapital Medical UniversityNational Center for Children’s HealthBeijingChina
| | - Xiaodan Li
- Department of Otolaryngology, Head and Neck SurgeryBeijing Children’s HospitalCapital Medical UniversityNational Center for Children’s HealthBeijingChina
| | - Yue Qiu
- Department of Otolaryngology, Head and Neck SurgeryBeijing Children’s HospitalCapital Medical UniversityNational Center for Children’s HealthBeijingChina
| | - Lin Mei
- Department of Otolaryngology, Head and Neck SurgeryBeijing Children’s HospitalCapital Medical UniversityNational Center for Children’s HealthBeijingChina
| | - Xinbei Jia
- Department of Otolaryngology, Head and Neck SurgeryBeijing Children’s HospitalCapital Medical UniversityNational Center for Children’s HealthBeijingChina
| | - Jun Tai
- Department of OtorhinolaryngologyBeijing Children’s HospitalCapital Institute of PediatricsBeijingChina
| | - Yongli Guo
- Beijing Key Laboratory for Pediatric Diseases of OtolaryngologyHead and Neck SurgeryBeijing Pediatric Research InstituteBeijing Children’s HospitalCapital Medical UniversityNational Center for Children’s HealthBeijingChina
| | - Jie Zhang
- Department of Otolaryngology, Head and Neck SurgeryBeijing Children’s HospitalCapital Medical UniversityNational Center for Children’s HealthBeijingChina
| | - Shengcai Wang
- Department of Otolaryngology, Head and Neck SurgeryBeijing Children’s HospitalCapital Medical UniversityNational Center for Children’s HealthBeijingChina
| | - Xin Ni
- Department of Otolaryngology, Head and Neck SurgeryBeijing Children’s HospitalCapital Medical UniversityNational Center for Children’s HealthBeijingChina
- Beijing Key Laboratory for Pediatric Diseases of OtolaryngologyHead and Neck SurgeryBeijing Pediatric Research InstituteBeijing Children’s HospitalCapital Medical UniversityNational Center for Children’s HealthBeijingChina
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26
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Pal A, Ogren JA, Aysola RS, Kumar R, Henderson LA, Harper RM, Macey PM. Insular functional organization during handgrip in females and males with obstructive sleep apnea. PLoS One 2021; 16:e0246368. [PMID: 33600443 PMCID: PMC7891756 DOI: 10.1371/journal.pone.0246368] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2020] [Accepted: 01/18/2021] [Indexed: 11/18/2022] Open
Abstract
STUDY OBJECTIVES Brain regulation of autonomic function in obstructive sleep apnea (OSA) is disrupted in a sex-specific manner, including in the insula, which may contribute to several comorbidities. The insular gyri have anatomically distinct functions with respect to autonomic nervous system regulation; yet, OSA exerts little effect on the organization of insular gyral responses to sympathetic components of an autonomic challenge, the Valsalva. We further assessed neural responses of insular gyri in people with OSA to a static handgrip task, which principally involves parasympathetic withdrawal. METHODS We measured insular function with blood oxygen level dependent functional MRI. We studied 48 newly-diagnosed OSA (age mean±std:46.5±9 years; AHI±std:32.6±21.1 events/hour; 36 male) and 63 healthy (47.2±8.8 years;40 male) participants. Subjects performed four 16s handgrips (1 min intervals, 80% subjective maximum strength) during scanning. fMRI time trends from five insular gyri-anterior short (ASG); mid short (MSG); posterior short (PSG); anterior long (ALG); and posterior long (PLG)-were assessed for within-group responses and between-group differences with repeated measures ANOVA (p<0.05) in combined and separate female-male models; age and resting heart-rate (HR) influences were also assessed. RESULTS Females showed greater right anterior dominance at the ASG, but no differences emerged between OSA and controls in relation to functional organization of the insula in response to handgrip. Males showed greater left anterior dominance at the ASG, but there were also no differences between OSA and controls. The males showed a group difference between OSA and controls only in the ALG. OSA males had lower left activation at the ALG compared to control males. Responses were mostly influenced by HR and age; however, age did not impact the response for right anterior dominance in females. CONCLUSIONS Insular gyri functional responses to handgrip differ in OSA vs controls in a sex-based manner, but only in laterality of one gyrus, suggesting anterior and right-side insular dominance during sympathetic activation but parasympathetic withdrawal is largely intact, despite morphologic injury to the overall structure.
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Affiliation(s)
- Amrita Pal
- UCLA School of Nursing, University of California, Los Angeles, California, United States of America
| | - Jennifer A. Ogren
- Department of Neurobiology, University of California, Los Angeles, California, United States of America
| | - Ravi S. Aysola
- Division of Pulmonary and Critical Care, David Geffen School of Medicine at UCLA, University of California, Los Angeles, California, United States of America
| | - Rajesh Kumar
- Department of Anesthesiology, University of California, Los Angeles, California, United States of America
- Department of Radiological Sciences, University of California, Los Angeles, California, United States of America
| | - Luke A. Henderson
- Department of Anatomy and Histology, Sydney Medical School, University of Sydney, Sydney, Australia
| | - Ronald M. Harper
- Department of Neurobiology, University of California, Los Angeles, California, United States of America
| | - Paul M. Macey
- UCLA School of Nursing, University of California, Los Angeles, California, United States of America
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27
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Zeng B, Zhou J, Li Z, Zhang H, Li Z, Yu P. Altered Percent Amplitude of Fluctuation in Healthy Subjects After 36 h Sleep Deprivation. Front Neurol 2021; 11:565025. [PMID: 33519662 PMCID: PMC7843545 DOI: 10.3389/fneur.2020.565025] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2020] [Accepted: 08/26/2020] [Indexed: 12/16/2022] Open
Abstract
Objective: To investigate regional brain activity alteration in healthy subjects in a sleep deprivation (SD) status relative to a rested wakefulness status using a percent amplitude of fluctuation (PerAF) method. Methods: A total of 20 healthy participants (12 males, 8 females; age, 22.25 ± 1.12 years) were recruited. All participants underwent attention tests and resting-state functional MRI scans during rested wakefulness before SD and after 36 h SD, respectively. The PerAF method was applied to identify SD-related regional brain activity alteration. A ROC curve was conducted to evaluate the ability of the PerAF method in distinguishing different sleep statuses. The relationships between SD-induced brain alterations and attention deficits were determined by Pearson correlation analysis. Results: SD resulted in a 2.23% decrease in accuracy rate and an 8.82% increase in reaction time. SD was associated with increased PerAF differences in the bilateral visual cortex and bilateral sensorimotor cortex, and was associated with decreased PerAF differences in bilateral dorsolateral prefrontal cortex and bilateral cerebellum posterior lobe. These SD-induced brain alterations exhibited a high discriminatory power of extremely high AUC values (0.993-1) in distinguishing the two statuses. The accuracy rate positively correlated with the bilateral cerebellum posterior lobe, and bilateral dorsolateral prefrontal cortex, and negatively correlated with the bilateral sensorimotor cortex. Conclusions: Acute SD could lead to an ~8% attention deficit, which was associated with regional brain activity deficits. The PerAF method might work as a potential sensitivity biomarker for identifying different sleep statuses.
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Affiliation(s)
- Bingliang Zeng
- Department of Radiology, Jiangxi Provincial People's Hospital Affiliated to Nanchang University, Nanchang, China
| | - Jian Zhou
- Department of Radiology, Jiangxi Provincial People's Hospital Affiliated to Nanchang University, Nanchang, China
| | - Zicong Li
- Department of Radiology, Jiangxi Provincial People's Hospital Affiliated to Nanchang University, Nanchang, China
| | - Hua Zhang
- Department of Imaging, The Third Affiliated Hospital of Nanchang University, Nanchang, China
- Department of Imaging, The First Hospital of Nanchang, Nanchang, China
| | - Zongliang Li
- Department of Radiology, Nanfeng County People's Hospital, Fuzhou, China
| | - Peng Yu
- Radiology Department, Jinxian County People's Hospital, Nanchang, China
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Li H, Li L, Kong L, Li P, Zeng Y, Li K, Xie W, Shu Y, Liu X, Peng D. Frequency‑Specific Regional Homogeneity Alterations and Cognitive Function in Obstructive Sleep Apnea Before and After Short-Term Continuous Positive Airway Pressure Treatment. Nat Sci Sleep 2021; 13:2221-2238. [PMID: 34992481 PMCID: PMC8714019 DOI: 10.2147/nss.s344842] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/22/2021] [Accepted: 12/14/2021] [Indexed: 12/11/2022] Open
Abstract
PURPOSE Previous studies have demonstrated abnormal local spontaneous brain activity in the conventional frequency bands (0.01-0.08 Hz) in obstructive sleep apnea (OSA). However, it is not clear whether these abnormalities are associated with the specific frequency band of low-frequency oscillations or whether it can be improved with a continuous positive airway pressure (CPAP) treatment. This study aimed to investigate the regional homogeneity (ReHo) in specific frequency at baseline (pre-CPAP) and after one month of CPAP adherence treatment (post-CPAP) in OSA patients. METHODS Twenty-one patients with moderate-to-severe OSA and 21 age- and sex-matched healthy controls (HCs) were included in the final analysis. ReHo was calculated in three different frequency bands (typical frequency band: 0.01-0.1 Hz; slow-5 band: 0.01-0.027 Hz; slow-4 band: 0.027-0.073 Hz), respectively. A partial correlational analysis was performed to assess the relationship between altered ReHo and clinical evaluation. RESULTS OSA patients revealed increased ReHo in the brainstem, bilateral inferior temporal gyrus (ITG)/fusiform, and right-cerebellum posterior lobe (CPL), and decreased ReHo in the bilateral inferior parietal lobule (IPL), right superior temporal gyrus (STG), and left precentral gyrus (PG) compared to HC groups in different frequency bands. Significantly changed ReHo in the bilateral middle temporal gyrus (MTG), PG, medial frontal gyrus (MFG), supplementary motor area (SMA), CPL, IPL, left superior frontal gyrus (SFG), ITG, MTG, and right STG were observed between post-CPAP and pre-CPAP OSA patients, which was associated with specific frequency bands. The altered ReHo in specific frequency bands was correlated with Montreal cognitive assessment score, Epworth sleepiness scale, and apnea hypopnea index in pre-CPAP OSA patients. CONCLUSION These findings indicate that OSA has frequency-related abnormalities of spontaneous neural activity before and after short-term CPAP treatment, which might contribute to a better understanding of local neural psychopathology and may serve as potential biomarkers for clinical CPAP treatment.
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Affiliation(s)
- Haijun Li
- Medical Imaging Center, The First Affiliated Hospital of Nanchang University, Nanchang City, Jiangxi Province, People's Republic of China.,PET Center, The First Affiliated Hospital of Nanchang University, Nanchang City, Jiangxi Province, People's Republic of China
| | - Lan Li
- Jiangxi Provincial Institute of Parasitic Diseases Control, Nanchang City, Jiangxi Province, People's Republic of China
| | - Linghong Kong
- Medical Imaging Center, The First Affiliated Hospital of Nanchang University, Nanchang City, Jiangxi Province, People's Republic of China
| | - Panmei Li
- Medical Imaging Center, The First Affiliated Hospital of Nanchang University, Nanchang City, Jiangxi Province, People's Republic of China
| | - Yaping Zeng
- Medical Imaging Center, The First Affiliated Hospital of Nanchang University, Nanchang City, Jiangxi Province, People's Republic of China
| | - Kunyao Li
- Medical Imaging Center, The First Affiliated Hospital of Nanchang University, Nanchang City, Jiangxi Province, People's Republic of China
| | - Wei Xie
- Medical Imaging Center, The First Affiliated Hospital of Nanchang University, Nanchang City, Jiangxi Province, People's Republic of China
| | - Yongqiang Shu
- Medical Imaging Center, The First Affiliated Hospital of Nanchang University, Nanchang City, Jiangxi Province, People's Republic of China
| | - Xiang Liu
- Medical Imaging Center, The First Affiliated Hospital of Nanchang University, Nanchang City, Jiangxi Province, People's Republic of China
| | - Dechang Peng
- Medical Imaging Center, The First Affiliated Hospital of Nanchang University, Nanchang City, Jiangxi Province, People's Republic of China.,PET Center, The First Affiliated Hospital of Nanchang University, Nanchang City, Jiangxi Province, People's Republic of China
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Resting-state functional magnetic resonance imaging of high altitude patients with obstructive sleep apnoea hypopnoea syndrome. Sci Rep 2020; 10:15546. [PMID: 32968086 PMCID: PMC7511410 DOI: 10.1038/s41598-020-72339-2] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2019] [Accepted: 08/19/2020] [Indexed: 12/19/2022] Open
Abstract
The objective of the study was to observe brain function changes in Obstructive Sleep Apnoea Hypopnoea Syndrome (OSAHS) patients at high altitude. Resting-state functional magnetic resonance imaging (rs-fMRI) in patients with OSAHS was assessed using regional homogeneity (ReHo), amplitude of low frequency fluctuation (ALFF) and functional connectivity (FC). In this study, 36 male patients with OSAHS and 38 healthy male subjects were recruited from high-altitude areas, specifically, altitudes of 2,000–3,000 m. OSAHS was diagnosed by polysomnography (PSG). The blood oxygen level-dependent (BOLD) signals of OSAHS patients and healthy controls in the resting state were obtained and compared using ReHo, ALFF and FC methods. The posterior cingulate cortex (PCC) was selected as the seed region in the comparison of FC between the two groups. Compared with the healthy control group, multiple brain functions in the OSAHS patient group were different. There were correlations between the brain function values of some brain regions and demographic data. We also found that in contrast to earlier findings with individuals in plains areas, the brain function at the frontal lobe and the precuneus were higher in OSAHS patients, and the PCC showed higher FC with the left caudate, which may be due to the high-altitude hypoxic environment.
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30
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Wu Y, Zhao W, Chen X, Wan X, Lei X. Aberrant Awake Spontaneous Brain Activity in Obstructive Sleep Apnea: A Review Focused on Resting-State EEG and Resting-State fMRI. Front Neurol 2020; 11:768. [PMID: 32849223 PMCID: PMC7431882 DOI: 10.3389/fneur.2020.00768] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2020] [Accepted: 06/22/2020] [Indexed: 12/27/2022] Open
Abstract
As one of the most common sleep-related respiratory disorders, obstructive sleep apnea (OSA) is characterized by excessive snoring, repetitive apnea, arousal, sleep fragmentation, and intermittent nocturnal hypoxemia. Focused on the resting-state brain imaging techniques, we reviewed the OSA-related resting-state electroencephalogram and resting-state functional magnetic resonance imaging (rsfMRI) studies. Compared with the healthy control group, patients with OSA presented increased frontal and central δ/θ powers during resting-state wakefulness, and their slow-wave activity showed a positive correlation with apnea–hypopnea index. For rsfMRI, the prefrontal cortex and insula may be the vital regions for OSA and are strongly related to the severity of the disease. Meanwhile, some large-scale brain networks, such as the default-mode network, salience network, and central executive network, play pivotal roles in the pathology of OSA. We then discussed the contribution of resting-state brain imaging as an evaluation approach for disease interventions. Finally, we briefly introduced the effects of OSA-related physiological and mental diseases and discussed some future research directions from the perspective of resting-state brain imaging.
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Affiliation(s)
- Yue Wu
- Sleep and NeuroImaging Center, Faculty of Psychology, Southwest University, Chongqing, China.,Key Laboratory of Cognition and Personality of Ministry of Education, Chongqing, China
| | - Wenrui Zhao
- Sleep and NeuroImaging Center, Faculty of Psychology, Southwest University, Chongqing, China.,Key Laboratory of Cognition and Personality of Ministry of Education, Chongqing, China
| | - Xinyuan Chen
- Sleep and NeuroImaging Center, Faculty of Psychology, Southwest University, Chongqing, China.,Key Laboratory of Cognition and Personality of Ministry of Education, Chongqing, China
| | - Xiaoyong Wan
- Sleep and NeuroImaging Center, Faculty of Psychology, Southwest University, Chongqing, China.,Key Laboratory of Cognition and Personality of Ministry of Education, Chongqing, China
| | - Xu Lei
- Sleep and NeuroImaging Center, Faculty of Psychology, Southwest University, Chongqing, China.,Key Laboratory of Cognition and Personality of Ministry of Education, Chongqing, China.,Key Laboratory for NeuroInformation of Ministry of Education, Center for Information in Medicine, University of Electronic Science and Technology of China, Chengdu, China
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31
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Caporale M, Palmeri R, Corallo F, Muscarà N, Romeo L, Bramanti A, Marino S, Lo Buono V. Cognitive impairment in obstructive sleep apnea syndrome: a descriptive review. Sleep Breath 2020; 25:29-40. [PMID: 32447633 DOI: 10.1007/s11325-020-02084-3] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2020] [Revised: 03/27/2020] [Accepted: 04/08/2020] [Indexed: 12/31/2022]
Abstract
PURPOSE Obstructive sleep apnea syndrome is a clinical sleep disorder defined by total or partial airflow restraint during sleep that results in fragmented sleep and hypoxemia, impacting negatively with cognitive functioning. This review was conducted on studies investigating structural brain alteration and cognitive impairment in obstructive sleep apnea syndrome. METHOD We searched on PubMed databases and screening references of included studies and review articles for additional citations. From initial 190 publications, only 17 met search criteria and described the cognitive impairment in obstructive sleep apnea syndrome. RESULTS Findings showed that patients with this syndrome had worse performance than healthy controls in attention, memory, and executive functions, showing specific neuroanathomical features. Cognitive impairment is also related to the severity of pathology. Treatment could improve certain cognitive aspects. CONCLUSIONS Cognitive deficits seem to be mainly attributable to decreased daytime vigilance and nocturnal hypoxemia.
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Affiliation(s)
- Mina Caporale
- IRCCS Centro Neurolesi "Bonino-Pulejo", S.S. 113 Via Palermo, C.da Casazza, 98124, Messina, Italy
| | - Rosanna Palmeri
- IRCCS Centro Neurolesi "Bonino-Pulejo", S.S. 113 Via Palermo, C.da Casazza, 98124, Messina, Italy.
| | - Francesco Corallo
- IRCCS Centro Neurolesi "Bonino-Pulejo", S.S. 113 Via Palermo, C.da Casazza, 98124, Messina, Italy
| | - Nunzio Muscarà
- IRCCS Centro Neurolesi "Bonino-Pulejo", S.S. 113 Via Palermo, C.da Casazza, 98124, Messina, Italy
| | - Laura Romeo
- IRCCS Centro Neurolesi "Bonino-Pulejo", S.S. 113 Via Palermo, C.da Casazza, 98124, Messina, Italy
| | - Alessia Bramanti
- IRCCS Centro Neurolesi "Bonino-Pulejo", S.S. 113 Via Palermo, C.da Casazza, 98124, Messina, Italy
| | - Silvia Marino
- IRCCS Centro Neurolesi "Bonino-Pulejo", S.S. 113 Via Palermo, C.da Casazza, 98124, Messina, Italy
| | - Viviana Lo Buono
- IRCCS Centro Neurolesi "Bonino-Pulejo", S.S. 113 Via Palermo, C.da Casazza, 98124, Messina, Italy
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Lunsford-Avery JR, Damme KSF, Engelhard MM, Kollins SH, Mittal VA. Sleep/Wake Regularity Associated with Default Mode Network Structure among Healthy Adolescents and Young Adults. Sci Rep 2020; 10:509. [PMID: 31949189 PMCID: PMC6965093 DOI: 10.1038/s41598-019-57024-3] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2019] [Accepted: 12/20/2019] [Indexed: 12/31/2022] Open
Abstract
Sleep deprivation and disorders are linked to reduced DMN connectivity. Less is known about how naturalistic sleep patterns - specifically sleep irregularity - relate to the DMN, particularly among adolescents and young adults. Additionally, no studies have utilized graph theory analysis to clarify whether sleep-related decreases in connectivity reflect global or local DMN changes. Twenty-five healthy adolescents and young adults (age range = 12-22; mean = 18.08; SD = 2.64, 56% female) completed 7 days of actigraphy and resting-state fMRI. Sleep regularity was captured by the Sleep Regularity Index (SRI) and the relationship between the SRI and DMN was examined using graph theory analysis. Analogous analyses explored relationships between the SRI and additional resting-state networks. Greater sleep regularity related to decreased path length (increased network connectivity) in DMN regions, particularly the right and left lateral parietal lobule, and the Language Network, including the left inferior frontal gyrus and the left posterior superior frontal gyrus. Findings were robust to covariates including sex and age. Sleep and DMN function may be tightly linked during adolescence and young adulthood, and reduced DMN connectivity may reflect local changes within the network. Future studies should assess how this relationship impacts cognitive development and neuropsychiatric outcomes in this age group.
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Affiliation(s)
- Jessica R Lunsford-Avery
- Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, North Carolina, USA.
| | | | - Matthew M Engelhard
- Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, North Carolina, USA
| | - Scott H Kollins
- Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, North Carolina, USA
| | - Vijay A Mittal
- Department of Psychology, Northwestern University, Evanston, IL, USA
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Liu W, Cao C, Hu B, Li D, Sun Y, Wu J, Zhang Q. Topological Regularization of Networks in Adult Patients with Moderate-to-Severe Obstructive Sleep Apnea-Hypopnea Syndrome: A Structural MRI Study. Nat Sci Sleep 2020; 12:333-345. [PMID: 32607033 PMCID: PMC7293417 DOI: 10.2147/nss.s248643] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/06/2020] [Accepted: 05/11/2020] [Indexed: 12/16/2022] Open
Abstract
OBJECTIVE Patients with obstructive sleep apnea-hypopnea syndrome (OSAHS) exhibit neurocognitive impairments; however, the neuroimaging mechanism of neurocognitive impairments remains unclear. The aim of this study was to understand the neuroimaging mechanism in adult patients with moderate-to-severe OSAHS, from the perspective of the connectome. PATIENTS AND METHODS Thirty-one untreated patients with moderate-to-severe OSAHS (mean age: 41.23±8.22) were compared with 26 good sleepers (GS) (mean age: 39.50±7.92) matched according to age, gender, handedness, and education level. All subjects underwent thin-slice T1WI scanning of the skull using a 3.0T MRI. Then, a large-scale structural covariance network was constructed based on the gray matter volume extracted from the structural MRI. Graph theory was then used to determine the topological changes in the structural covariance network of OSAHS patients. RESULTS Although small-world networks were retained,the structural covariance network exhibited topological irregularities in regular architecture as evidenced by an increase in the clustering coefficient (p=0.009), transfer coefficient (p=0.029) and local efficiency (p=0.031), and a local increase in the shortest path length (p<0.05) compared with the GS group. Locally, OSAHS patients showed a decrease in nodal betweenness and degree in the left inferior parietal gyrus, left angular gyrus and right anterior cingulate cortex compared with the GS group (p<0.05, uncorrected). In addition, the resistance of structural covariance networks in OSAHS patients to random fault is significantly lower than that of the GS group (p=0.044). CONCLUSION Structural covariance networks are abnormal in terms of multiple network parameters, which provide network-level insight into the neuroimaging mechanism of cognitive impairments in adult OSAHS patients.
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Affiliation(s)
- Wanqing Liu
- Department of Radiology, Affiliated Zhongshan Hospital of Dalian University, Dalian 116001, People's Republic of China
| | - Chuanlong Cao
- Department of Radiology, Affiliated Xinhua Hospital of Dalian University, Dalian 116001, People's Republic of China
| | - Bing Hu
- Department of Radiology, Affiliated Zhongshan Hospital of Dalian University, Dalian 116001, People's Republic of China
| | - Danyang Li
- Department of Radiology, Affiliated Zhongshan Hospital of Dalian University, Dalian 116001, People's Republic of China
| | - Yumei Sun
- Department of Radiology, Affiliated Zhongshan Hospital of Dalian University, Dalian 116001, People's Republic of China
| | - Jianlin Wu
- Department of Radiology, Affiliated Zhongshan Hospital of Dalian University, Dalian 116001, People's Republic of China
| | - Qing Zhang
- Department of Radiology, Affiliated Zhongshan Hospital of Dalian University, Dalian 116001, People's Republic of China
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Mehta TR, Gurung P, Nene Y, Fayyaz M, Bollu PC. Sleep and ADHD: A review article. CURRENT DEVELOPMENTAL DISORDERS REPORTS 2019. [DOI: 10.1007/s40474-019-00178-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
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Fan Z, Chen X, Qi ZX, Li L, Lu B, Jiang CL, Zhu RQ, Yan CG, Chen L. Physiological significance of R-fMRI indices: Can functional metrics differentiate structural lesions (brain tumors)? NEUROIMAGE-CLINICAL 2019; 22:101741. [PMID: 30878611 PMCID: PMC6423471 DOI: 10.1016/j.nicl.2019.101741] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/02/2018] [Revised: 02/16/2019] [Accepted: 02/28/2019] [Indexed: 12/04/2022]
Abstract
Resting-state functional MRI (R-fMRI) research has recently entered the era of “big data”, however, few studies have provided a rigorous validation of the physiological underpinnings of R-fMRI indices. Although studies have reported that various neuropsychiatric disorders exhibit abnormalities in R-fMRI measures, these “biomarkers” have not been validated in differentiating structural lesions (brain tumors) as a concept proof. We enrolled 60 patients with intracranial tumors located in the unilateral cranialcavity and 60 matched normal controls to test whether R-fMRI indices can differentiate tumors, which represents a prerequisite for adapting such indices as biomarkers for neuropsychiatric disorders. Common R-fMRI indices of tumors and their counterpart control regions, which were defined as the contralateral normal areas (for amplitude of low frequency fluctuations (ALFF), fractional ALFF (fALFF), regional homogeneity (ReHo) and degree centrality (DC)) and ipsilateral regions surrounding the tumors (for voxel-mirrored homotopic connectivity (VMHC)), were comprehensively assessed. According to robust paired t-tests with a Bonferroni correction, only VMHC (Fisher's r-to-z transformed) could successfully differentiate substantial tumors from their counterpart normal regions in patients. Furthermore, ALFF and DC were not able to differentiate tumor from normal unless Z-standardization was employed. To validate the lower power of the between-subject design compared to the within-subject design, each metric was calculated in a matched control group, and robust two-sample t-tests were used to compare the patient tumors and the normal controls at the same place. Similarly, only VMHC succeeded in differentiating significant differences between tumors and the sham tumor areas of normal controls. This study tested the premise of R-fMRI biomarkers for differentiating lesions, and brings a new understanding to physical significance of the Z-standardization. R-fMRI indices could differentiate tumors, validating their physical availability. ALFF and DC could not differentiate tumors unless Z-standardization was employed. Within-subject design is more powerful for R-fMRI indices in differentiating tumors.
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Affiliation(s)
- Zhen Fan
- Department of Neurosurgery, Huashan Hospital, Fudan University, Shanghai Neurosurgical Clinical Center, Shanghai, China
| | - Xiao Chen
- CAS Key Laboratory of Behavioral Science, Institute of Psychology, Beijing, China; Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
| | - Zeng-Xin Qi
- Department of Neurosurgery, Huashan Hospital, Fudan University, Shanghai Neurosurgical Clinical Center, Shanghai, China
| | - Le Li
- CAS Key Laboratory of Behavioral Science, Institute of Psychology, Beijing, China; Magnetic Resonance Imaging Research Center, Institute of Psychology, Chinese Academy of Sciences, Beijing, China
| | - Bin Lu
- CAS Key Laboratory of Behavioral Science, Institute of Psychology, Beijing, China; Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
| | - Cong-Lin Jiang
- Department of Neurosurgery, Huashan Hospital, Fudan University, Shanghai Neurosurgical Clinical Center, Shanghai, China
| | - Ren-Qing Zhu
- Department of Neurosurgery, Huashan Hospital, Fudan University, Shanghai Neurosurgical Clinical Center, Shanghai, China
| | - Chao-Gan Yan
- CAS Key Laboratory of Behavioral Science, Institute of Psychology, Beijing, China; Department of Psychology, University of Chinese Academy of Sciences, Beijing, China; Magnetic Resonance Imaging Research Center, Institute of Psychology, Chinese Academy of Sciences, Beijing, China; Department of Child and Adolescent Psychiatry, NYU Langone Medical Center School of Medicine, New York, NY, USA.
| | - Liang Chen
- Department of Neurosurgery, Huashan Hospital, Fudan University, Shanghai Neurosurgical Clinical Center, Shanghai, China.
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Xin H, Li H, Yu H, Yu J, Zhang J, Wang W, Peng D. Disrupted resting-state spontaneous neural activity in stable COPD. Int J Chron Obstruct Pulmon Dis 2019; 14:499-508. [PMID: 30880940 PMCID: PMC6398400 DOI: 10.2147/copd.s190671] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023] Open
Abstract
Introduction and aim Abnormal brain structure and function in COPD has been reported on MRI. However, the deficit in local synchronization of spontaneous activity in patients with stable COPD remains unknown. The main aim of the present study was to explore spontaneous brain activity in patients with COPD compared with normal controls using the regional homogeneity (ReHo) method based on resting-state functional MRI. Methods Nineteen patients with stable COPD and 20 well-matched (including age, sex, and number of years of education) normal controls who were recruited for the present study underwent resting-state functional MRI examinations and a series of neuropsychological and clinical assessments. The ReHo method was used to assess the strength of local brain signal synchrony. The mean ReHo values in brain areas with abnormal ReHo were evaluated with a receiver operating characteristic curve. The relationships between the brain regions with altered ReHo values and the clinical and neuropsychological parameters in COPD patients were assessed using Pearson’s correlation. Results Patients with COPD showed significantly lower ReHo values in the left occipital lobe and the right lingual, bilateral precuneus, and right precentral gyrus. The result of receiver operating characteristic curve analysis showed that the altered average ReHo values have high efficacy for distinguishing function. The mean lower ReHo values in the precuneus gyrus showed a significant positive correlation with FEV1%, FEV1/FVC, and orientation function but a significant negative correlation with arterial partial pressure of carbon dioxide. Conclusion The COPD patients demonstrated abnormal synchrony of regional spontaneous activity, and the regions with abnormal activity were all correlated with visual processing pathways, which might provide us with a new perspective to further understand the underlying pathophysiology of cognitive impairment in patients with COPD.
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Affiliation(s)
- Huizhen Xin
- Department of Radiology, The First Affiliated Hospital, Nanchang University, Nanchang, People's Republic of China,
| | - Haijun Li
- Department of Radiology, The First Affiliated Hospital, Nanchang University, Nanchang, People's Republic of China,
| | - Honghui Yu
- Department of Radiology, The First Affiliated Hospital, Nanchang University, Nanchang, People's Republic of China,
| | - Jingjing Yu
- Department of Respiratory, The First Affiliated Hospital, Nanchang University, Nanchang, People's Republic of China
| | - Juan Zhang
- Department of Radiology, The First Affiliated Hospital, Nanchang University, Nanchang, People's Republic of China,
| | - Wenjing Wang
- Department of Respiratory, The First Affiliated Hospital, Nanchang University, Nanchang, People's Republic of China
| | - Dechang Peng
- Department of Radiology, The First Affiliated Hospital, Nanchang University, Nanchang, People's Republic of China,
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Yu H, Chen L, Li H, Xin H, Zhang J, Wei Z, Peng D. Abnormal resting-state functional connectivity of amygdala subregions in patients with obstructive sleep apnea. Neuropsychiatr Dis Treat 2019; 15:977-987. [PMID: 31114206 PMCID: PMC6489564 DOI: 10.2147/ndt.s191441] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2018] [Accepted: 03/01/2019] [Indexed: 12/03/2022] Open
Abstract
Background: The amygdala is one of the core areas of the emotional circuits. Previous neuroimaging studies have revealed that patients with obstructive sleep apnea (OSA) have aberrant structure and function in several brain areas (including the amygdala). However, the resting-state functional connectivity (rs-FC) of amgydala subregions remains uncertain. Objective: To determine whether aberrant rs-FC exists between the amygdala subregions and other brain areas and whether such abnormalities are related to emotional disorders and cognitive impairment in OSA. Methods: The resting-state functional magnetic resonance imaging (rs-fMRI) data of 40 male severe OSA patients and 40 matched healthy controls (HCs) were collected. The rs-FC between the amygdala subregions and other brain areas was compared between the two groups. The correlations between aberrant rs-FC and clinical variables and neuropsychological assessments were evaluated. Results: Compared with the HCs, the OSA patients showed significantly increased rs-FC between the left dorsal amygdala (DA) and the anterior lobe of the cerebellum, among the left ventrolateral amygdala (VA), the left inferior frontal gyrus (IFG) and the left superior temporal gyrus (STG), and between the right VA and the left IFG. However, significantly decreased rs-FC was observed between the right DA and the right prefrontal cortex (PFC) in OSA patients. No regional differences in rs-FC were found between the OSA patients and HCs in the bilateral medial amygdala (MA). Conclusion: In this study, male severe OSA patients showed complex rs-FC patterns in the amygdala subregions, which may be the result of OSA-related selective damage to the amygdala, and abnormal rs-FC between the amygdala subregions and brain regions associated with emotional, cognitive and executive functions may partly explain the affective deficits and cognitive impairment observed in male severe OSA patients.
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Affiliation(s)
- Honghui Yu
- Department of Radiology, the First Affiliated Hospital, Nanchang University, Nanchang, Jiangxi, People's Republic of China
| | - Liting Chen
- Department of Radiology, the First Affiliated Hospital, Jinan University, Guangzhou, Guangdong, People's Republic of China
| | - Haijun Li
- Department of Radiology, the First Affiliated Hospital, Nanchang University, Nanchang, Jiangxi, People's Republic of China
| | - Huizhen Xin
- Department of Radiology, the First Affiliated Hospital, Nanchang University, Nanchang, Jiangxi, People's Republic of China
| | - Juan Zhang
- Department of Radiology, the First Affiliated Hospital, Nanchang University, Nanchang, Jiangxi, People's Republic of China
| | - Zhipeng Wei
- Department of Radiology, the First Affiliated Hospital, Nanchang University, Nanchang, Jiangxi, People's Republic of China
| | - Dechang Peng
- Department of Radiology, the First Affiliated Hospital, Nanchang University, Nanchang, Jiangxi, People's Republic of China
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Chen L, Qi X, Zheng J. Altered Regional Cortical Brain Activity in Healthy Subjects After Sleep Deprivation: A Functional Magnetic Resonance Imaging Study. Front Neurol 2018; 9:588. [PMID: 30116216 PMCID: PMC6082940 DOI: 10.3389/fneur.2018.00588] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2018] [Accepted: 06/29/2018] [Indexed: 12/18/2022] Open
Abstract
Objective: To investigate acute sleep deprivation (SD)-related regional brain activity changes and their relationships with behavioral performances. Methods: Twenty-two female subjects underwent an MRI scan and an attention network test at rested wakefulness (RW) status and after 24 h SD. The amplitude of low-frequency fluctuations (ALFF) was used to investigate SD-related regional brain activity changes. We used the receiver operating characteristic (ROC) curve to evaluate the ability of the ALFF differences in regional brain areas to distinguish the SD status from the RW status. We used Pearson correlations to evaluate the relationships between the ALFF differences in brain areas and the behavioral performances during the SD status. Results: Subjects at the SD status exhibited a lower accuracy rate and a longer reaction time relative to the RW status. Compared with RW, SD showed significant lower ALFF values in the right cerebellum anterior lobe, and higher ALFF areas in the bilateral inferior occipital gyrus, left thalamus, left insula, and bilateral postcentral gyrus. The area under the curve values of the specific ALFF differences in brain areas were (mean ± std, 0.851 ± 0.045; 0.805–0.93). Further, the ROC curve analysis demonstrated that the ALFF differences in those regional brain areas alone discriminated the SD status from the RW status with high degrees of sensitivities (82.16 ± 7.61%; 75–93.8%) and specificities (81.23 ± 11.39%; 62.5–93.7%). The accuracy rate showed negative correlations with the left inferior occipital gyrus, left thalamus, and left postcentral gyrus, and showed a positive correlation with the right cerebellum. Conclusions: The ALFF analysis is a potential indicator for detecting the excitation–inhibition imbalance of regional cortical activations disturbed by acute SD with high performances.
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Affiliation(s)
- Lingling Chen
- Department of Pediatric Internal Medicine, Linyi Central Hospital, Yishui, China
| | - Xueliang Qi
- Department of Pediatric Internal Medicine, Linyi Central Hospital, Yishui, China
| | - Jiyong Zheng
- Department of Medical Imaging, The Affiliated Huaian No. 1 People's Hospital of Nanjing Medical University, Huaian, China
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Kong D, Liu R, Song L, Zheng J, Zhang J, Chen W. Altered Long- and Short-Range Functional Connectivity Density in Healthy Subjects After Sleep Deprivations. Front Neurol 2018; 9:546. [PMID: 30061857 PMCID: PMC6054999 DOI: 10.3389/fneur.2018.00546] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2018] [Accepted: 06/19/2018] [Indexed: 12/14/2022] Open
Abstract
Objective: To investigate the brain functional organization induced by sleep deprivation (SD) using functional connectivity density (FCD) analysis. Methods: Twenty healthy subjects (12 female, 8 male; mean age, 20.6 ± 1.9 years) participated a 24 h sleep deprivation (SD) design. All subjects underwent the MRI scan and attention network test twice, once during rested wakefulness (RW) status, and the other was after 24 h acute SD. FCD was divided into the shortFCD and longFCD. Receiver operating characteristic (ROC) curve was used to evaluate the discriminating ability of those FCD differences in brain areas during the SD status from the RW status, while Pearson correlations was used to evaluate the relationships between those differences and behavioral performances. Results: Subjects at SD status exhibited lower accuracy rate and longer reaction time relative to RW status. Compared with RW, SD had a significant decreased shortFCD in the left cerebellum posterior lobe, right cerebellum anterior lobe, and right orbitofrontal cortex, and increased shortFCD in the left occipital gyrus, bilateral thalamus, right paracentral lobule, bilateral precentral gyrus, and bilateral postcentral gyrus. Compared with RW, SD had a significant increased longFCD in the right precentral gyrus, bilateral postcentral gyrus, and right visuospatial network, and decreased longFCD in the default mode network. The area under the curve values of those specific FCD differences in brain areas were (mean ± std, 0.933 ± 0.035; 0.863~0.977). Further ROC curve analysis demonstrated that the FCD differences in those brain areas alone discriminated the SD status from the RW status with high degree of sensitivities (89.19 ± 6%; 81.3~100%) and specificities (89.15 ± 6.87%; 75~100%). Reaction time showed a negative correlation with the right orbitofrontal cortex (r = −0.48, p = 0.032), and accuracy rate demonstrated a positive correlation with the right default mode network (r = 0.573, p = 0.008). Conclusions: The longFCD and shortFCD analysis might be potential indicator biomarkers to locate the underlying altered intrinsic brain functional organization disturbed by SD. SD sustains the cognitive performance by the decreased high-order cognition related areas and the arousal and sensorimotor related areas.
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Affiliation(s)
- Dan Kong
- Department of Medical Imaging, The Affiliated Huai'an No. 1 People's Hospital of Nanjing Medical University, Huai'an, China
| | - Run Liu
- Department of Radiology, The Affiliated Xi'an Central Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Lixiao Song
- Department of Hematology, The Affiliated Huai'an No. 1 People's Hospital of Nanjing Medical University, Huai'an, China
| | - Jiyong Zheng
- Department of Medical Imaging, The Affiliated Huai'an No. 1 People's Hospital of Nanjing Medical University, Huai'an, China
| | - Jiandong Zhang
- Department of Medical Imaging, The Affiliated Huai'an No. 1 People's Hospital of Nanjing Medical University, Huai'an, China
| | - Wei Chen
- Department of Interventional Radiology, The Affiliated Huai'an No. 1 People's Hospital of Nanjing Medical University, Huai'an, China
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Chen L, Fan X, Li H, Ye C, Yu H, Gong H, Zeng X, Peng D, Yan L. Topological Reorganization of the Default Mode Network in Severe Male Obstructive Sleep Apnea. Front Neurol 2018; 9:363. [PMID: 29951028 PMCID: PMC6008385 DOI: 10.3389/fneur.2018.00363] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2017] [Accepted: 05/04/2018] [Indexed: 11/13/2022] Open
Abstract
Impaired spontaneous regional activity and altered topology of the brain network have been observed in obstructive sleep apnea (OSA). However, the mechanisms of disrupted functional connectivity (FC) and topological reorganization of the default mode network (DMN) in patients with OSA remain largely unknown. We explored whether the FC is altered within the DMN and examined topological changes occur in the DMN in patients with OSA using a graph theory analysis of resting-state functional magnetic resonance imaging data and evaluated the relationship between neuroimaging measures and clinical variables. Resting-state data were obtained from 46 male patients with untreated severe OSA and 46 male good sleepers (GSs). We specifically selected 20 DMN subregions to construct the DMN architecture. The disrupted FC and topological properties of the DMN in patients with OSA were characterized using graph theory. The OSA group showed significantly decreased FC of the anterior-posterior DMN and within the posterior DMN, and also showed increased FC within the DMN. The DMN exhibited small-world topology in both OSA and GS groups. Compared to GSs, patients with OSA showed a decreased clustering coefficient (Cp) and local efficiency, and decreased nodal centralities in the left posterior cingulate cortex and dorsal medial prefrontal cortex, and increased nodal centralities in the ventral medial prefrontal cortex and the right parahippocampal cortex. Finally, the abnormal DMN FC was significantly related to Cp, path length, global efficiency, and Montreal cognitive assessment score. OSA showed disrupted FC within the DMN, which may have contributed to the observed topological reorganization. These findings may provide further evidence of cognitive deficits in patients with OSA.
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Affiliation(s)
- Liting Chen
- Department of Radiology, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China
| | - Xiaole Fan
- Department of General Surgery, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China
| | - Haijun Li
- Department of Radiology, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China
| | - Chenglong Ye
- Department of Radiology, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China
| | - Honghui Yu
- Department of Radiology, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China
| | - Honghan Gong
- Department of Radiology, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China
| | - Xianjun Zeng
- Department of Radiology, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China
| | - Dechang Peng
- Department of Radiology, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China
| | - Liping Yan
- Department of Cardiology, People's Hospital of Jiangxi Province, Nanchang, Jiangxi, China
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Liu YT, Zhang HX, Li HJ, Chen T, Huang YQ, Zhang L, Huang ZC, Liu B, Yang M. Aberrant Interhemispheric Connectivity in Obstructive Sleep Apnea-Hypopnea Syndrome. Front Neurol 2018; 9:314. [PMID: 29867724 PMCID: PMC5951937 DOI: 10.3389/fneur.2018.00314] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2018] [Accepted: 04/20/2018] [Indexed: 01/06/2023] Open
Abstract
Objective To determine the changes in interhemispheric functional coordination in patients with obstructive sleep apnea–hypopnea syndrome (OSAHS) relative to controls, using a recently introduced method of analysis: voxel-mirrored homotopic connectivity (VMHC). Methods Twenty-nine patients with OSAHS and twenty-six normal sex-, age-, and education-matched controls were recruited and resting-state functional magnetic resonance imaging data were obtained. We employed VMHC to analyze the interhemispheric functional connectivity differences between groups. The z-values of alterations in VMHC in brain region were correlated with clinical characteristics. Results Compared with controls, patients with OSAHS had significantly higher scores for body mass index (t = 5.749, P < 0.001), apnea–hypopnea index (AHI; t = 7.706, P < 0.001), oxygen desaturation index (t = 6.041, P < 0.001), and Epworth sleepiness scale (t = 3.711, P < 0.001), but significantly lower scores on the Rey–Osterrieth complex figure test-immediate recall (t = −3.727, P < 0.05). On the same basis, the VMHC showed significant increases in bilateral calcarine cortex and precuneus. Moreover, significant, positive correlations were found in only these areas between the AHI and the VMHC change coefficients (r = 0.399, P = 0.032; r = 0.378, P = 0.043). Conclusion We found a memory defect in patients with OSAHS. The correlation between the abnormal VMHC and the AHI in patients with OSAHS suggested that AHI might be a key factor in cognitive dysfunction, which might offer new insights into the neural pathophysiology underlying OSAHS-related cognitive deficits.
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Affiliation(s)
- Yu-Ting Liu
- Department of Radiology, Children's Hospital of Nanjing Medical University, Nanjing, China
| | - Hui-Xin Zhang
- School of Medicine, Southeast University, Nanjing, China
| | - Hui-Jun Li
- Department of Radiology, Children's Hospital of Nanjing Medical University, Nanjing, China
| | - Ting Chen
- School of Medicine, Southeast University, Nanjing, China
| | - Ya-Qing Huang
- Department of Radiology, Children's Hospital of Nanjing Medical University, Nanjing, China
| | - Lian Zhang
- Department of Otolaryngology-Head and Neck Surgery, Zhongda Hospital, Southeast University, Nanjing, China
| | - Zhi-Chun Huang
- Department of Otolaryngology-Head and Neck Surgery, Zhongda Hospital, Southeast University, Nanjing, China
| | - Bin Liu
- Department of Radiology, Zhongda Hospital, Southeast University, Nanjing, China
| | - Ming Yang
- Department of Radiology, Children's Hospital of Nanjing Medical University, Nanjing, China
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Snyder B, Cunningham RL. Sex differences in sleep apnea and comorbid neurodegenerative diseases. Steroids 2018; 133:28-33. [PMID: 29258810 PMCID: PMC5864541 DOI: 10.1016/j.steroids.2017.12.006] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2017] [Revised: 12/05/2017] [Accepted: 12/10/2017] [Indexed: 12/13/2022]
Abstract
Sleep apnea is a disorder, which increasingly affects people worldwide. Whether the associated hypoxic events during sleep are central or obstructive in origin, the end result is excessive daytime sleepiness and an increased risk for several comorbidities, such as cardiovascular and neurodegenerative disorders. Sleep apnea is diagnosed more frequently in men than women, suggesting a role of sex hormones in the pathology of the disease. Furthermore, there are sex differences in the development and progression of comorbid diseases associated with sleep apnea. Therefore, treatment of sleep apnea may be clinically relevant for prevention of subsequent sex-specific comorbid disorders. While the impact sleep apnea has on cardiovascular events has been the subject of many research studies, the role of sleep apnea in neurodegeneration is less established. Here we review known risk factors for sleep apnea and the implications of the observed sex differences in this disease. We also summarize the evidence and mechanisms for how sleep apnea may contribute to the onset of neurodegenerative disorders, such as Alzheimer's disease and Parkinson's disease.
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Affiliation(s)
- Brina Snyder
- Department of Physiology and Anatomy, University of North Texas Health Science Center, Fort Worth, TX, United States
| | - Rebecca L Cunningham
- Department of Physiology and Anatomy, University of North Texas Health Science Center, Fort Worth, TX, United States.
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Chen LT, Fan XL, Li HJ, Ye CL, Yu HH, Xin HZ, Gong HH, Peng DC, Yan LP. Aberrant brain functional connectome in patients with obstructive sleep apnea. Neuropsychiatr Dis Treat 2018; 14:1059-1070. [PMID: 29713176 PMCID: PMC5912371 DOI: 10.2147/ndt.s161085] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVE Obstructive sleep apnea (OSA) is accompanied by widespread abnormal spontaneous regional activity related to cognitive deficits. However, little is known about the topological properties of the functional brain connectome of patients with OSA. This study aimed to use the graph theory approaches to investigate the topological properties and functional connectivity (FC) of the functional connectome in patients with OSA, based on resting-state functional magnetic resonance imaging (rs-fMRI). METHODS Forty-five male patients with newly diagnosed untreated severe OSA and 45 male good sleepers (GSs) underwent a polysomnography (PSG), clinical evaluations, and rs-fMRI scans. The automated anatomical labeling (AAL) atlas was used to construct the functional brain connectome. The topological organization and FC of brain functional networks in patients with OSA were characterized using graph theory methods and investigated the relationship between functional network topology and clinical variables. RESULTS Both the patients with OSA and the GSs exhibited high-efficiency "small-world" network attributes. However, the patients with OSA exhibited decreased σ, γ, Eglob; increased Lp, λ; and abnormal nodal centralities in several default-mode network (DMN), salience network (SN), and central executive network (CEN) regions. However, the patients with OSA exhibited abnormal functional connections between the DMN, SN, and CEN. The disrupted FC was significantly positive correlations with the global network metrics γ and σ. The global network metrics were significantly correlated with the Epworth Sleepiness Scale (ESS) score, Montreal Cognitive Assessment (MoCA) score, and oxygen desaturation index. CONCLUSION The findings suggest that the functional connectome of patients with OSA exhibited disrupted functional integration and segregation, and functional disconnections of the DMN, SN, and CEN. The aberrant topological attributes may be associated with disrupted FC and cognitive functions. These topological abnormalities and disconnections might be potential biomarkers of cognitive impairments in patients with OSA.
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Affiliation(s)
- Li-Ting Chen
- Department of Radiology, the First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi Province, China
| | - Xiao-Le Fan
- Department of General Surgery, the First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi Province, China
| | - Hai-Jun Li
- Department of Radiology, the First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi Province, China
| | - Cheng-Long Ye
- Department of Radiology, the First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi Province, China
| | - Hong-Hui Yu
- Department of Radiology, the First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi Province, China
| | - Hui-Zhen Xin
- Department of Radiology, the First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi Province, China
| | - Hong-Han Gong
- Department of Radiology, the First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi Province, China
| | - De-Chang Peng
- Department of Radiology, the First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi Province, China
| | - Li-Ping Yan
- Department of Cardiology, People’s Hospital of Jiangxi Province, Nanchang, Jiangxi Province, China
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Snyder B, Shell B, Cunningham JT, Cunningham RL. Chronic intermittent hypoxia induces oxidative stress and inflammation in brain regions associated with early-stage neurodegeneration. Physiol Rep 2018; 5:5/9/e13258. [PMID: 28473320 PMCID: PMC5430123 DOI: 10.14814/phy2.13258] [Citation(s) in RCA: 113] [Impact Index Per Article: 18.8] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2017] [Accepted: 03/23/2017] [Indexed: 01/18/2023] Open
Abstract
Sleep apnea is a common comorbidity of neurodegenerative diseases, such as Alzheimer's disease (AD) and Parkinson's disease (PD). Previous studies have shown an association between elevated oxidative stress and inflammation with severe sleep apnea. Elevated oxidative stress and inflammation are also hallmarks of neurodegenerative diseases. We show increased oxidative stress and inflammation in a manner consistent with early stages of neurodegenerative disease in an animal model of mild sleep apnea. Male rats were exposed to 7 days chronic intermittent hypoxia (CIH) for 8 h/day during the light period. Following CIH, plasma was collected and tested for circulating oxidative stress and inflammatory markers associated with proinflammatory M1 or anti-inflammatory M2 profiles. Tissue punches from brain regions associated with different stages of neurodegenerative diseases (early stage: substantia nigra and entorhinal cortex; intermediate: hippocampus; late stage: rostral ventrolateral medulla and solitary tract nucleus) were also assayed for inflammatory markers. A subset of the samples was examined for 8-hydroxydeoxyguanosine (8-OHdG) expression, a marker of oxidative stress-induced DNA damage. Our results showed increased circulating oxidative stress and inflammation. Furthermore, brain regions associated with early-stage (but not late-stage) AD and PD expressed oxidative stress and inflammatory profiles consistent with reported observations in preclinical neurodegenerative disease populations. These results suggest mild CIH induces key features that are characteristic of early-stage neurodegenerative diseases and may be an effective model to investigate mechanisms contributing to oxidative stress and inflammation in those brain regions.
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Affiliation(s)
- Brina Snyder
- Institute for Health Aging, University of North Texas Health Science Center, Fort Worth, Texas
| | - Brent Shell
- Institute for Cardiovascular and Metabolic Disease, University of North Texas Health Science Center, Fort Worth, Texas
| | - J Thomas Cunningham
- Institute for Cardiovascular and Metabolic Disease, University of North Texas Health Science Center, Fort Worth, Texas
| | - Rebecca L Cunningham
- Institute for Health Aging, University of North Texas Health Science Center, Fort Worth, Texas
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Dai XJ, Jiang J, Zhang Z, Nie X, Liu BX, Pei L, Gong H, Hu J, Lu G, Zhan Y. Plasticity and Susceptibility of Brain Morphometry Alterations to Insufficient Sleep. Front Psychiatry 2018; 9:266. [PMID: 29997530 PMCID: PMC6030367 DOI: 10.3389/fpsyt.2018.00266] [Citation(s) in RCA: 41] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2018] [Accepted: 05/31/2018] [Indexed: 12/20/2022] Open
Abstract
UNLABELLED Background: Insufficient sleep is common in daily life and can lead to cognitive impairment. Sleep disturbance also exists in neuropsychiatric diseases. However, whether and how acute and chronic sleep loss affect brain morphology remain largely unknown. Methods: We used voxel-based morphology method to study the brain structural changes during sleep deprivation (SD) at six time points of rested wakefulness, 20, 24, 32, 36 h SD, and after one night sleep in 22 healthy subjects, and in 39 patients with chronic primary insomnia relative to 39 status-matched good sleepers. Attention network and spatial memory tests were performed at each SD time point in the SD Procedure. The longitudinal data were analyzed using one-way repeated measures ANOVA, and post-hoc analysis was used to determine the between-group differences. Results: Acute SD is associated with widespread gray matter volume (GMV) changes in the thalamus, cerebellum, insula and parietal cortex. Insomnia is associated with increased GMV in temporal cortex, insula and cerebellum. Acute SD is associated with brain atrophy and as SD hours prolong more areas show reduced GMV, and after one night sleep the brain atrophy is restored and replaced by increased GMV in brain areas. SD has accumulative negative effects on attention and working memory. Conclusions: Acute SD and insomnia exhibit distinct morphological changes of GMV. SD has accumulative negative effects on brain morphology and advanced cognitive function. The altered GMV may provide neurobiological basis for attention and memory impairments following sleep loss. STATEMENT OF SIGNIFICANCE Sleep is less frequently studied using imaging techniques than neurological and psychiatric disorders. Whether and how acute and chronic sleep loss affect brain morphology remain largely unknown. We used voxel-based morphology method to study brain structural changes in healthy subjects over multiple time points during sleep deprivation (SD) status and in patients with chronic insomnia. We found that prolonged acute SD together with one night sleep recovery exhibits accumulative atrophic effect and recovering plasticity on brain morphology, in line with behavioral changes on attentional tasks. Furthermore, acute SD and chronic insomnia exhibit distinct morphological changes of gray matter volume (GMV) but they also share overlapping GMV changes. The altered GMV may provide structural basis for attention and memory impairments following sleep loss.
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Affiliation(s)
- Xi-Jian Dai
- Department of Medical Imaging, Medical School of Nanjing University, Jinling Hospital, Nanjing, China.,Department of Radiology, The First Affiliated Hospital of Nanchang University, Nangchang, China
| | - Jian Jiang
- Department of Radiology, The First Affiliated Hospital of Nanchang University, Nangchang, China
| | - Zhiqiang Zhang
- Department of Medical Imaging, Medical School of Nanjing University, Jinling Hospital, Nanjing, China
| | - Xiao Nie
- Department of Radiology, The First Affiliated Hospital of Nanchang University, Nangchang, China.,Department of Radiology, Yiyang Central Hospital, Yiyang, China
| | - Bi-Xia Liu
- Department of ICU, Jiangxi Cancer Hospital, Nanchang, China
| | - Li Pei
- Department of Radiology, The First Affiliated Hospital of Nanchang University, Nangchang, China
| | - Honghan Gong
- Department of Radiology, The First Affiliated Hospital of Nanchang University, Nangchang, China
| | - Jianping Hu
- Department of Medical Imaging, Medical School of Nanjing University, Jinling Hospital, Nanjing, China
| | - Guangming Lu
- Department of Medical Imaging, Medical School of Nanjing University, Jinling Hospital, Nanjing, China
| | - Yang Zhan
- Brain Cognition and Brain Disease Institute, Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen, China
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Tu X, Wang J, Liu X, Zheng J. Aberrant regional brain activities in alcohol dependence: a functional magnetic resonance imaging study. Neuropsychiatr Dis Treat 2018; 14:847-853. [PMID: 29606878 PMCID: PMC5868577 DOI: 10.2147/ndt.s158221] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
OBJECTIVE Whether moderate alcohol consumption has health benefits remains controversial, but the harmful effects of excessive alcohol consumption on behavior and brain function are well recognized. The aim of this study was to investigate alcohol-induced regional brain activities and their relationships with behavioral factors. SUBJECTS AND METHODS A total of 29 alcohol-dependent subjects (9 females and 20 males) and 29 status-matched healthy controls (11 females and 18 males) were recruited. Severity of alcohol dependence questionnaire (SADQ) and alcohol use disorders identification test (AUDIT) were used to evaluate the severity of alcohol craving. Regional homogeneity (ReHo) analysis was used to explore the alcohol-induced regional brain changes. Receiver operating characteristic (ROC) curve was used to investigate the ability of regional brain activities to distinguish alcohol-dependent subjects from healthy controls. Pearson correlations were used to investigate the relationships between alcohol-induced ReHo differences and behavioral factors. RESULTS Alcohol-dependent subjects related to healthy controls showed higher ReHo areas in the right superior frontal gyrus (SFG), bilateral medial frontal gyrus (MFG), left precentral gyrus (PG), bilateral middle temporal gyrus (MTG), and right inferior temporal gyrus (ITG) and lower ReHo areas in the right cerebellum posterior lobe (CPL), left rectal gyrus (RG), and right cluster of pons and cerebellum anterior lobe (CAL). ROC curve revealed high area under the curve (AUC) values (mean ± SD: 0.864 ± 0.028; range: 0.828-0.911) of ReHo differences. Diagnostic analysis showed that these areas alone discriminated alcohol-dependent subjects from healthy controls with high degree of sensitivities (mean ± SD: 81.25% ± 11.49%; range: 62.5%-100%) and specificities (mean ± SD: 81.75% ± 12.36%; range: 67.5%-100%). Years of drink showed negative correlation with left RG (r = -0.493, p = 0.007), the same finding was shown between AUDIT and right CPL (r = -0.52, p = 0.004). CONCLUSION Alcohol dependence is associated with aberrant regional activities in multiple brain areas. ReHo analysis may be a useful biological indicator for the detection of regional brain activities in individuals with alcohol dependence.
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Affiliation(s)
- Xianzhu Tu
- Department of Psychiatry, Seventh People's Hospital of Wenzhou City, Wenzhou, Zhejiang, People's Republic of China
| | - Juanjuan Wang
- Department of Neurology, The Second Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, People's Republic of China
| | - Xuming Liu
- Department of Radiology, The Third Clinical Institute Affiliated to Wenzhou Medical University, Wenzhou, Zhejiang, People's Republic of China
| | - Jiyong Zheng
- Department of Medical Imaging, The Affiliated Huai'an No 1 People's Hospital of Nanjing Medical University, Huai'an, Jiangsu, People's Republic of China
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A Meta-analysis of Voxel-based Brain Morphometry Studies in Obstructive Sleep Apnea. Sci Rep 2017; 7:10095. [PMID: 28855654 PMCID: PMC5577238 DOI: 10.1038/s41598-017-09319-6] [Citation(s) in RCA: 43] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2017] [Accepted: 07/18/2017] [Indexed: 02/05/2023] Open
Abstract
Gray matter (GM) anomalies may represent a critical pathology underlying obstructive sleep apnea (OSA). However, the evidence regarding their clinical relevance is inconsistent. We conducted a meta-analysis of voxel-based morphometry (VBM) studies of patients with OSA to identify their brain abnormalities. A systematic search was conducted based on PRISMA guidelines, and a meta-analysis was performed using the anisotropic effect-size-based algorithms (ASE-SDM) to quantitatively estimate regional GM changes in patients with OSA. Fifteen studies with 16 datasets comprising 353 untreated patients with OSA and 444 healthy controls were included. Our results revealed GM reductions in the bilateral anterior cingulate/paracingulate gyri (ACG/ApCG), left cerebellum (lobules IV/V and VIII), bilateral superior frontal gyrus (SFG, medial rostral part), right middle temporal gyrus (MTG), and right premotor cortex. Moreover, GM reductions in the bilateral ACG/ApCG were positively associated with body mass index (BMI) and age among patients with OSA, and GM reductions in the SFG (medial rostral part) were negatively associated with Epworth sleepiness scale (ESS) scores and sex (male). These abnormalities may represent structural brain underpinnings of neurocognitive abnormalities and respiratory-related abnormalities in OSA. In particular, this study adds to Psychoradiology, which is a promising subspecialty of clinical radiology mainly for psychiatric disorders.
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Dai XJ. Brain response to sleep-related attentional bias in patients with chronic insomnia. J Thorac Dis 2017; 9:1466-1468. [PMID: 28740660 DOI: 10.21037/jtd.2017.05.23] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- Xi-Jian Dai
- Department of Medical Imaging, Jinling Hospital, Medical School of Nanjing University, Nanjing 210002, China
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Santosa H, Aarabi A, Perlman SB, Huppert TJ. Characterization and correction of the false-discovery rates in resting state connectivity using functional near-infrared spectroscopy. JOURNAL OF BIOMEDICAL OPTICS 2017; 22:55002. [PMID: 28492852 PMCID: PMC5424771 DOI: 10.1117/1.jbo.22.5.055002] [Citation(s) in RCA: 54] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/21/2016] [Accepted: 04/11/2017] [Indexed: 05/18/2023]
Abstract
Functional near-infrared spectroscopy (fNIRS) is a noninvasive neuroimaging technique that uses low levels of red to near-infrared light to measure changes in cerebral blood oxygenation. Spontaneous (resting state) functional connectivity (sFC) has become a critical tool for cognitive neuroscience for understanding task-independent neural networks, revealing pertinent details differentiating healthy from disordered brain function, and discovering fluctuations in the synchronization of interacting individuals during hyperscanning paradigms. Two of the main challenges to sFC-NIRS analysis are (i) the slow temporal structure of both systemic physiology and the response of blood vessels, which introduces false spurious correlations, and (ii) motion-related artifacts that result from movement of the fNIRS sensors on the participants’ head and can introduce non-normal and heavy-tailed noise structures. In this work, we systematically examine the false-discovery rates of several time- and frequency-domain metrics of functional connectivity for characterizing sFC-NIRS. Specifically, we detail the modifications to the statistical models of these methods needed to avoid high levels of false-discovery related to these two sources of noise in fNIRS. We compare these analysis procedures using both simulated and experimental resting-state fNIRS data. Our proposed robust correlation method has better performance in terms of being more reliable to the noise outliers due to the motion artifacts.
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Affiliation(s)
- Hendrik Santosa
- University of Pittsburgh, Department of Radiology, Pittsburgh, Pennsylvania, United States
| | - Ardalan Aarabi
- Universite de Picardie Jules Verne, Department of Medicine, Amiens, France
| | - Susan B. Perlman
- University of Pittsburgh, Department of Psychiatry, Pittsburgh, Pennsylvania, United States
| | - Theodore J. Huppert
- University of Pittsburgh, Departments of Radiology and Bioengineering, Clinical Science Translational Institute, and Center for the Neural Basis of Cognition, Pittsburgh, Pennsylvania, United States
- Address all correspondence to: Theodore J. Huppert, E-mail:
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Khazaie H, Veronese M, Noori K, Emamian F, Zarei M, Ashkan K, Leschziner GD, Eickhoff CR, Eickhoff SB, Morrell MJ, Osorio RS, Spiegelhalder K, Tahmasian M, Rosenzweig I. Functional reorganization in obstructive sleep apnoea and insomnia: A systematic review of the resting-state fMRI. Neurosci Biobehav Rev 2017; 77:219-231. [PMID: 28344075 PMCID: PMC6167921 DOI: 10.1016/j.neubiorev.2017.03.013] [Citation(s) in RCA: 104] [Impact Index Per Article: 14.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2016] [Revised: 02/24/2017] [Accepted: 03/21/2017] [Indexed: 12/12/2022]
Abstract
Resting state functional MRI studies is a promising non-invasive tool for better understanding of the pathophysiology of sleep disorders. The salience network is involved in hyperarousal and affective symptoms in insomnia. The posterior default mode network appears to underlie cognitive and depressive symptoms of obstructive sleep apnoea. Disruption of intrinsic networks have been demonstrated in major depression, which is a common co-morbidity of sleep disorders.
Functional neuroimaging techniques have accelerated progress in the study of sleep disorders. Considering the striking prevalence of these disorders in the general population, however, as well as their strong bidirectional relationship with major neuropsychiatric disorders, including major depressive disorder, their numbers are still surprisingly low. This review examines the contribution of resting state functional MRI to current understanding of two major sleep disorders, insomnia disorder and obstructive sleep apnoea. An attempt is made to learn from parallels of previous resting state functional neuroimaging findings in major depressive disorder. Moreover, shared connectivity biomarkers are suggested for each of the sleep disorders. Taken together, despite some inconsistencies, the synthesis of findings to date highlights the importance of the salience network in hyperarousal and affective symptoms in insomnia. Conversely, dysfunctional connectivity of the posterior default mode network appears to underlie cognitive and depressive symptoms of obstructive sleep apnoea.
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Affiliation(s)
- Habibolah Khazaie
- Sleep Disorders Research Center, Kermanshah University of Medical Sciences (KUMS), Kermanshah, Iran
| | - Mattia Veronese
- Sleep and Brain Plasticity Centre, Department of Neuroimaging, IoPPN, King's College, London, UK
| | - Khadijeh Noori
- Sleep Disorders Research Center, Kermanshah University of Medical Sciences (KUMS), Kermanshah, Iran
| | - Farnoosh Emamian
- Sleep Disorders Research Center, Kermanshah University of Medical Sciences (KUMS), Kermanshah, Iran; Department of Psychiatry, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Mojtaba Zarei
- Institute of Medical Sciences and Technology, Shahid Beheshti University, Tehran, Iran; School of Cognitive Sciences, Institute for Research in Fundamental Sciences (IPM), Tehran, Iran
| | - Keyoumars Ashkan
- Sleep and Brain Plasticity Centre, Department of Neuroimaging, IoPPN, King's College, London, UK; Department of Neurosurgery, King's College Hospital, London, UK
| | - Guy D Leschziner
- Sleep and Brain Plasticity Centre, Department of Neuroimaging, IoPPN, King's College, London, UK; Sleep Disorders Centre, Guy's and St Thomas' Hospital, London, UK
| | - Claudia R Eickhoff
- Institute of Neuroscience and Medicine (INM-1), Research Center Jülich, Jülich, Germany; Department of Psychiatry, Psychotherapy, and Psychosomatics, RWTH Aachen University, Aachen, Germany
| | - Simon B Eickhoff
- Institute of Neuroscience and Medicine (INM-1), Research Center Jülich, Jülich, Germany; Institute of Clinical Neuroscience & Medical Psychology, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
| | - Mary J Morrell
- Academic Unit of Sleep and Breathing, National Heart and Lung Institute, Imperial College London, UK and NIHR Respiratory Disease Biomedical Research Unit at the Royal Brompton and Harefield NHS Foundation Trust,Sydney Street, London, SW3 6NP, UK
| | - Ricardo S Osorio
- Center for Brain Health, NYU School of Medicine, New York, NY, United States
| | - Kai Spiegelhalder
- Department of Clinical Psychology and Psychophysiology/Sleep Medicine, Center for Mental Disorders, University of Freiburg Medical Center, Freiburg, Germany
| | - Masoud Tahmasian
- Sleep Disorders Research Center, Kermanshah University of Medical Sciences (KUMS), Kermanshah, Iran; Institute of Medical Sciences and Technology, Shahid Beheshti University, Tehran, Iran; School of Cognitive Sciences, Institute for Research in Fundamental Sciences (IPM), Tehran, Iran.
| | - Ivana Rosenzweig
- Sleep and Brain Plasticity Centre, Department of Neuroimaging, IoPPN, King's College, London, UK; Sleep Disorders Centre, Guy's and St Thomas' Hospital, London, UK
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