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Tan B, Tamanyan K, Walter L, Nixon GM, Davey MJ, Ditchfield M, Horne RSC. Cortical grey matter changes, behavior and cognition in children with sleep disordered breathing. J Sleep Res 2024; 33:e14006. [PMID: 37475108 DOI: 10.1111/jsr.14006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2023] [Revised: 06/25/2023] [Accepted: 07/06/2023] [Indexed: 07/22/2023]
Abstract
This paper investigated cortical thickness and volumetric changes in children to better understand the impact of obstructive sleep disordered breathing (SDB) on the neurodevelopment of specific regions of the brain. We also aimed to investigate how these changes were related to the behavioral and cognitive deficits observed in the condition. Neuroimaging, behavioral, and sleep data were obtained from 30 children (15 non-snoring controls, 15 referred for assessment of SDB) aged 7 to 17 years. Gyral-based regions of interest were identified using the Desikan-Killiany atlas. Student's t-tests were used to compare regions of interest between the controls and SDB groups. We found that the cortical thickness was significantly greater in the right caudal anterior cingulate and right cuneus regions and there were volumetric increases in the left caudal middle frontal, bilateral rostral anterior cingulate, left, right, and bilateral caudate brain regions in children with SDB compared with controls. Neither cortical thickness nor volumetric changes were associated with behavioral or cognitive measures. The findings of this study indicate disruptions to neural developmental processes occurring in structural regions of the brain; however, these changes appear unrelated to behavioural or cognitive outcomes.
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Affiliation(s)
- Brendan Tan
- Department of Pediatrics, Monash University, Melbourne, Victoria, Australia
| | - Knarik Tamanyan
- Department of Pediatrics, Monash University, Melbourne, Victoria, Australia
| | - Lisa Walter
- Department of Pediatrics, Monash University, Melbourne, Victoria, Australia
| | - Gillian M Nixon
- Department of Pediatrics, Monash University, Melbourne, Victoria, Australia
- Melbourne Children's Sleep Centre, Monash Children's Hospital, Melbourne, Victoria, Australia
| | - Margot J Davey
- Department of Pediatrics, Monash University, Melbourne, Victoria, Australia
- Melbourne Children's Sleep Centre, Monash Children's Hospital, Melbourne, Victoria, Australia
| | - Michael Ditchfield
- Department of Pediatrics, Monash University, Melbourne, Victoria, Australia
- Department of Radiology, Monash Children's Hospital, Melbourne, Victoria, Australia
| | - Rosemary S C Horne
- Department of Pediatrics, Monash University, Melbourne, Victoria, Australia
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Selcuk OT, Aydenizoz D, Genc F, Ozkan MB, Turkoglu Selcuk N, Cekic B, Cetinkaya EA, Taga Senirli R, Eyigor H. Are there any differences at gray matter sites between severe obstructive sleep apnea patients and healthy controls? Sleep Med 2024; 116:27-31. [PMID: 38412571 DOI: 10.1016/j.sleep.2024.02.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/25/2023] [Revised: 02/05/2024] [Accepted: 02/11/2024] [Indexed: 02/29/2024]
Abstract
OBJECTIVES Obstructive sleep apnea (OSA) is a disease that may cause many medical conditions. Neurocognitive disorders may be triggered by OSA. In recent studies, selectively decreased gray matter tissue was observed in patients with OSA. We aimed to determine if there was a substantial difference in patients with extreme OSA by comparing the microstructural changes in different gray matter sub-areas with healthy controls using diffusion-weighted imaging methods. METHODS We studied 15 diagnosed severe OSA subjects before any treatment and 32 healthy control subjects. High resolution Magnetic Resonance Imaging (MRI) T1 and T2-weighted scans were visually examined to assess any major brain lesions. RESULTS There were no statistically significant differences of age and gender between the groups.The left and right globus pallidus, putamen and thalamus values did not differ significantly between OSA and control subjects. Right putamen values was negatively correlated with Apnea Hypopnea Index (AHI), supine AHI and non-REM AHI in OSA subjects, but no correlations appeared with left putamen values. The other gray matter parameters did not show any correlations with PSG parameters. AHI, Supine AHI, Non-Supine AHI, REM and NON-REM AHI values was not show any correlation with Right and Left Putamen volume sizes. CONCLUSIONS We made a morphological comparison of various gray matter areas of OSA patients and healthy volunteers in our study. We observed a significant decrease in right putamen gray matter volumes in patients with higher AHI values. Decreased cognitive functions are found in patients with OSA. In order to demonstrate this cognitive loss in patients with morphologically there is a need for further prospective studies with larger sample sizes.
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Affiliation(s)
- O T Selcuk
- University of Health Sciences, Antalya Training and Research Hospital, Otorhinolaryngology and Head and Neck Surgery Clinic, Turkey.
| | - D Aydenizoz
- University of Health Sciences, Antalya Training and Research Hospital, Otorhinolaryngology and Head and Neck Surgery Clinic, Turkey.
| | - F Genc
- University of Health Sciences, Antalya Training and Research Hospital, Neurology Clinic, Turkey.
| | - M B Ozkan
- University of Health Sciences, Antalya Training and Research Hospital, Radiology Clinic, Turkey.
| | - N Turkoglu Selcuk
- University of Health Sciences, Antalya Training and Research Hospital, Pulmonology Clinic, Turkey.
| | - B Cekic
- University of Health Sciences, Antalya Training and Research Hospital, Radiology Clinic, Turkey.
| | - E A Cetinkaya
- University of Health Sciences, Antalya Training and Research Hospital, Otorhinolaryngology and Head and Neck Surgery Clinic, Turkey.
| | - R Taga Senirli
- University of Health Sciences, Antalya Training and Research Hospital, Otorhinolaryngology and Head and Neck Surgery Clinic, Turkey.
| | - H Eyigor
- University of Health Sciences, Antalya Training and Research Hospital, Otorhinolaryngology and Head and Neck Surgery Clinic, Turkey.
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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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Torres-Lopez LV, Cadenas-Sanchez C, Migueles JH, Esteban-Cornejo I, Molina-Garcia P, H. Hillman C, Catena A, Ortega FB. Does sleep-disordered breathing add to impairments in academic performance and brain structure usually observed in children with overweight/obesity? Eur J Pediatr 2022; 181:2055-2065. [PMID: 35142932 PMCID: PMC9056447 DOI: 10.1007/s00431-022-04403-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/04/2021] [Revised: 01/26/2022] [Accepted: 01/29/2022] [Indexed: 12/01/2022]
Abstract
UNLABELLED Approximately 4-11% of children suffer from sleep-disordered breathing (SDB), and children with obesity are at increased risk. Both obesity and SDB have been separately associated with poorer brain health, yet whether SDB severity affects brain health in children with obesity remains unanswered. This study aimed to examine associations of SDB severity with academic performance and brain structure (i.e., total brain and gray and white matter volumes and gray matter volume in the hippocampus) in children with overweight/obesity. One hundred nine children aged 8-12 years with overweight/obesity were included. SDB severity and its subscales (i.e., snoring, daytime sleepiness, and inattention/hyperactivity) were evaluated via the Pediatric Sleep Questionnaire (PSQ), and academic performance was evaluated with the Woodcock-Muñoz standardized test and school grades. Brain structure was assessed by magnetic resonance imaging. SDB severity was not associated with academic performance measured by the standardized test (all |β|> 0.160, P > 0.076), yet it was associated with the school grade point average (β = -0.226, P = 0.007) and natural and social science grades (β = -0.269, P = 0.024). Intention/hyperactivity seemed to drive these associations. No associations were found between SDB severity and the remaining school grades (all β < -0.188, P > 0.065) or brain volumes (all P > 0.05). CONCLUSION Our study shows that SDB severity was associated with lower school grades, yet it was not associated with the standardized measurement of academic performance or with brain volumes in children with overweight/obesity. SDB severity may add to academic problems in children beyond the effects contributed by overweight/obesity status alone. WHAT IS KNOWN • Sleep-disordered breathing (SDB) may affect brain structure and academic performance in children. • Children with overweight/obesity are at higher risk for the development of SDB, yet the comorbid obesity-SDB relationship with brain health has not been investigated thus far. WHAT IS NEW • To our knowledge, this is the first study examining the associations of comorbid obesity-SDB severity with brain volumes and academic performance in children. • SDB symptoms may adversely affect academic performance at school in children with overweight/obesity, beyond the effects of weight status alone.
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Affiliation(s)
- Lucia V. Torres-Lopez
- PROFITH “PROmoting FITness and Health Through Physical Activity” Research Group, Department of Physical Education and Sports, Faculty of Sport Sciences, Sport and Health University Research Institute (iMUDS), University of Granada, Granada, 18011 Spain
| | - Cristina Cadenas-Sanchez
- PROFITH “PROmoting FITness and Health Through Physical Activity” Research Group, Department of Physical Education and Sports, Faculty of Sport Sciences, Sport and Health University Research Institute (iMUDS), University of Granada, Granada, 18011 Spain ,Institute for Innovation and Sustainable Development in the Food Chain (IS-FOOD), Public University of Navarra, Pamplona, Spain
| | - Jairo H. Migueles
- PROFITH “PROmoting FITness and Health Through Physical Activity” Research Group, Department of Physical Education and Sports, Faculty of Sport Sciences, Sport and Health University Research Institute (iMUDS), University of Granada, Granada, 18011 Spain ,Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden ,Department of Biosciences and Nutrition, Karolinska Institutet, Huddinge, 14183 Sweden
| | - Irene Esteban-Cornejo
- PROFITH “PROmoting FITness and Health Through Physical Activity” Research Group, Department of Physical Education and Sports, Faculty of Sport Sciences, Sport and Health University Research Institute (iMUDS), University of Granada, Granada, 18011 Spain
| | - Pablo Molina-Garcia
- PROFITH “PROmoting FITness and Health Through Physical Activity” Research Group, Department of Physical Education and Sports, Faculty of Sport Sciences, Sport and Health University Research Institute (iMUDS), University of Granada, Granada, 18011 Spain
| | - Charles H. Hillman
- Center for Cognitive and Brain Health, Department of Psychology, Department of Physical Therapy, Movement, and Rehabilitation Sciences, Northeastern University, Boston, MA USA
| | - Andres Catena
- School of Psychology, University of Granada, Granada, Spain
| | - Francisco B. Ortega
- PROFITH “PROmoting FITness and Health Through Physical Activity” Research Group, Department of Physical Education and Sports, Faculty of Sport Sciences, Sport and Health University Research Institute (iMUDS), University of Granada, Granada, 18011 Spain ,Department of Biosciences and Nutrition, Karolinska Institutet, Huddinge, 14183 Sweden ,Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
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Mei L, Li X, Zhou G, Ji T, Chen J, Xu Z, Peng Y, Liu Y, Li H, Zhang J, Wang S, Zhang Y, Ge W, Guo Y, Qiu Y, Jia X, Tian J, Zheng L, Liu J, Tai J, Ni X. Effects of obstructive sleep apnoea severity on neurocognitive and brain white matter alterations in children according to sex: a tract-based spatial statistics study. Sleep Med 2020; 82:134-143. [PMID: 33915429 DOI: 10.1016/j.sleep.2020.08.026] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/19/2020] [Revised: 08/22/2020] [Accepted: 08/25/2020] [Indexed: 10/23/2022]
Abstract
OBJECTIVES To investigate alterations in neurocognitive, attention, paediatric sleep questionnaire (PSQ) scores and whole brain white matter (WM) integrity between children with mild and severe obstructive sleep apnoea (OSA) according to sex and whether these changes are associated with OSA severity. METHODS Fifty-seven children (36 males and 21 females) diagnosed with OSA were recruited for this study. Children of both sexes were divided into mild (male-MG, female-MG) and severe (male-SG, female-SG) groups according to OSA severity. Polysomnography (PSG), neurocognitive, attention and PSQ tests were compared between groups by one-way samples analysis of variance (ANOVA) F test. Diffusion tensor imaging (DTI) was scanned using a 3T GE MRI scanner and analysed by Tract-based Spatial Statistics (TBSS). Spearman correlation was calculated between DTI Eigenvalues and clinical characteristics. RESULTS Compared to mild OSA patients, severe OSA patients presented greater severity of obstructive apnoea hypopnea index (OAHI), neurocognition, PSQ and attention tests in both male and female patients. Brain WM integrity in the male-SG, compared to the male-MG, demonstrated significantly reduced fractional anisotropy (FA) values in the right middle frontal gyrus and the right frontal sub-gyral regions and increased axial diffusivity (AD) values in the right inferior frontal gyrus, left parietal angular gyrus and sub-gyral regions, while no differences were found between the female-MG and female-SG. Alterations in male-SG brain regions were observably correlated with severity in male OSA patients. CONCLUSIONS The integrity of WM, which regulates autonomic, cognitive, and attention functions, is impaired in male, but not female, children with severe OSA.
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Affiliation(s)
- Lin Mei
- Department of Otolaryngology, Head and Surgery, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, 100045, China
| | - Xiaodan Li
- Department of Otolaryngology, Head and Surgery, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, 100045, China
| | - Guifei Zhou
- School of Computer and Information Technology, Beijing Jiaotong University, Beijing, China
| | - Tingting Ji
- Department of Otolaryngology, Head and Surgery, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, 100045, China
| | - Jun Chen
- Big Data and Engineering Research Center, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, 100045, China
| | - Zhifei Xu
- Department of Respiration, Beijing Children's Hospital, Capital Medical University,National Center for Children's Health, Beijing, 100045, China
| | - Yun Peng
- Department of Radiology, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, 100045, China
| | - Yue Liu
- Department of Radiology, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, 100045, China
| | - Hongbin Li
- Department of Otolaryngology, Head and Surgery, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, 100045, China
| | - Jie Zhang
- Department of Otolaryngology, Head and Surgery, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, 100045, China
| | - Shengcai Wang
- Department of Otolaryngology, Head and Surgery, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, 100045, China
| | - Yamei Zhang
- Department of Otolaryngology, Head and Surgery, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, 100045, China
| | - Wentong Ge
- Department of Otolaryngology, Head and Surgery, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, 100045, China
| | - Yongli Guo
- Beijing Key Laboratory for Pediatric Diseases of Otolaryngology, Head and Neck Surgery, Beijing Paediatric Research Institute, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health (NCCH), Beijing, 100045, China
| | - Yue Qiu
- Department of Otolaryngology, Head and Surgery, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, 100045, China
| | - Xinbei Jia
- Department of Otolaryngology, Head and Surgery, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, 100045, China
| | - Jinghong Tian
- Department of Neurorehabilitation, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, 100045, China
| | - Li Zheng
- Department of Respiration, Beijing Children's Hospital, Capital Medical University,National Center for Children's Health, Beijing, 100045, China
| | - Jiangang Liu
- School of Computer and Information Technology, Beijing Jiaotong University, Beijing, China; Beijing Advanced Innovation Center for Big Data-Based Precision Medicine, School of Medicine and Engineering, Beihang University, Beijing, 100191, China
| | - Jun Tai
- Department of Otolaryngology, Head and Surgery, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, 100045, China; Department of Otorhinolaryngology, Children's Hospital, Capital Institute of Paediatrics, Beijing, 100020, China.
| | - Xin Ni
- Department of Otolaryngology, Head and Surgery, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, 100045, China.
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Merlo S, Briley PM. Sleep problems in children who stutter: Evidence from population data. JOURNAL OF COMMUNICATION DISORDERS 2019; 82:105935. [PMID: 31522013 DOI: 10.1016/j.jcomdis.2019.105935] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/06/2019] [Revised: 07/29/2019] [Accepted: 09/01/2019] [Indexed: 06/10/2023]
Abstract
Purpose Previous research has identified seizures, intellectual disability, learning disability, pervasive developmental disorder, and attention deficit hyperactivity disorder as coexisting disabilities frequently seen in children who stutter (CWS). The observation that those conditions are affected by sleep has incited the present study, which aimed to explore if sleep problems are also more frequent in CWS. Method Data was obtained from the 2012 National Health Interview Survey. Children included in the analysis were those whose caregivers answered definitively whether or not the sample child stuttered in the last 12 months and whose caregivers definitively answered questions regarding insomnia or trouble sleeping, sleepiness during the day, and fatigue during the day in the last 12 months. This sample included 203 CWS and 10,005 children who do not stutter (CWNS). Results CWS were at greater odds of presenting insomnia or trouble sleeping (OR = 3.72, p < .001), sleepiness during the day (OR = 2.20, p < .001), and fatigue during the day (OR = 2.87, p < .001) when compared to CWNS. Moreover, CWS with coexisting disabilities were at greater odds of presenting with sleep problems when compared to CWS without coexisting disabilities. Finally, CWS without coexisting disabilities were at greater odds of presenting insomnia when compared to CWNS without coexisting disabilities. Conclusion CWS are at risk for presenting with sleep problems. Additionally, sleep problems persist from early childhood to adolescence. The implications of these findings are unclear, though future studies should look to explore the impact of sleep problems on stuttering.
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Affiliation(s)
- Sandra Merlo
- Brazilian Fluency Institute, Av. Brg. Faria Lima, 1811, conj 822, Sao Paulo, SP, 01452-001, Brazil.
| | - Patrick M Briley
- Department of Communication Sciences and Disorders, East Carolina University, 3310AC Health Sciences Building, MS 668, Greenville, NC, 27834, United States.
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Macey PM, Kheirandish-Gozal L, Prasad JP, Ma RA, Kumar R, Philby MF, Gozal D. Altered Regional Brain Cortical Thickness in Pediatric Obstructive Sleep Apnea. Front Neurol 2018; 9:4. [PMID: 29403430 PMCID: PMC5786747 DOI: 10.3389/fneur.2018.00004] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2017] [Accepted: 01/03/2018] [Indexed: 01/27/2023] Open
Abstract
Rationale Obstructive sleep apnea (OSA) affects 2–5% of all children and is associated with cognitive and behavioral deficits, resulting in poor school performance. These psychological deficits may arise from brain injury, as seen in preliminary findings of lower gray matter volume among pediatric OSA patients. However, the psychological deficits in OSA are closely related to functions in the cortex, and such brain areas have not been specifically assessed. The objective was to determine whether cortical thickness, a marker of possible brain injury, is altered in children with OSA. Methods We examined regional brain cortical thicknesses using high-resolution T1-weighted magnetic resonance images in 16 pediatric OSA patients (8 males; mean age ± SD = 8.4 ± 1.2 years; mean apnea/hypopnea index ± SD = 11 ± 6 events/h) and 138 controls (8.3 ± 1.1 years; 62 male; 138 subjects from the NIH Pediatric MRI database) to identify cortical thickness differences in pediatric OSA subjects. Results Cortical thinning occurred in multiple regions including the superior frontal, ventral medial prefrontal, and superior parietal cortices. The left side showed greater thinning in the superior frontal cortex. Cortical thickening was observed in bilateral precentral gyrus, mid-to-posterior insular cortices, and left central gyrus, as well as right anterior insula cortex. Conclusion Changes in cortical thickness are present in children with OSA and likely indicate disruption to neural developmental processes, including maturational patterns of cortical volume increases and synaptic pruning. Regions with thicker cortices may reflect inflammation or astrocyte activation. Both the thinning and thickening associated with OSA in children may contribute to the cognitive and behavioral dysfunction frequently found in the condition.
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Affiliation(s)
- Paul M Macey
- School of Nursing, University of California, Los Angeles, CA, United States.,Brain Research Institute, University of California, Los Angeles, CA, United States
| | - Leila Kheirandish-Gozal
- Department of Pediatrics, Section of Pediatric Sleep Medicine, Pritzker School of Medicine, Biological Sciences Division, The University of Chicago, Chicago, IL, United States
| | - Janani P Prasad
- School of Nursing, University of California, Los Angeles, CA, United States
| | - Richard A Ma
- School of Nursing, University of California, Los Angeles, CA, United States
| | - Rajesh Kumar
- Brain Research Institute, University of California, Los Angeles, CA, United States.,Department of Anesthesiology, University of California, Los Angeles, CA, United States.,Department of Radiological Sciences, David Geffen School of Medicine at UCLA, University of California, Los Angeles, CA, United States
| | - Mona F Philby
- Department of Pediatrics, Section of Pediatric Sleep Medicine, Pritzker School of Medicine, Biological Sciences Division, The University of Chicago, Chicago, IL, United States
| | - David Gozal
- Department of Pediatrics, Section of Pediatric Sleep Medicine, Pritzker School of Medicine, Biological Sciences Division, The University of Chicago, Chicago, IL, United States
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