Preliminary functional MRI neural correlates of executive functioning and empathy in children with obstructive sleep
Leila Kheirandish-Gozal1, Keith Yoder2, Richa Kulkarni1
1Department of Pediatrics, Pritzker School of Medicine, Biological Sciences Division, The University of Chicago, Chicago, IL.
Insights
Children with obstructive sleep apnea (OSA) exhibit altered brain activity during cognitive and emotional tasks. Increased neural recruitment in OSA patients suggests compensatory mechanisms, while severity correlates with reduced amygdala sensitivity to harm.
Area of Science:
- Neuroscience
- Pediatric Sleep Medicine
- Cognitive Psychology
Background:
- Pediatric obstructive sleep apnea (OSA) is linked to neurocognitive deficits.
- The specific neural mechanisms underlying these deficits are not well understood.
Purpose of the Study:
- To investigate executive control and emotional processing in children with OSA using functional MRI.
- To identify neural substrates associated with cognitive and empathy impairments in pediatric OSA.
Main Methods:
- 10 children with OSA and 7 controls (ages 7-11) performed a Stroop task and an empathy task during fMRI.
- Region of Interest (ROI) analyses were conducted on functional MRI data using SPM8.
Main Results:
- Children with OSA showed increased neural activity in cognitive control regions during the Stroop task compared to controls.
- A significant correlation was found between OSA severity (apnea-hypopnea index) and reduced left amygdala activity during empathy tasks.
- Anterior cingulate cortex activity differed significantly between groups.
Conclusions:
- This study provides the first fMRI evidence of altered cognitive and empathetic processing in pediatric OSA.
- Children with OSA demonstrate greater neural recruitment for cognitive tasks, indicating compensatory mechanisms.
- OSA severity is associated with diminished sensitivity to harm, as reflected by left amygdala function.
Background:
Pediatric obstructive sleep apnea (OSA) is associated with neurocognitive deficits. However, the neural substrates underlying such deficits remain unknown.
Methods:
To examine executive control and emotional processing in OSA, 10 children age 7 to 11 y with polysomnographically diagnosed OSA and 7 age- and sex-matched controls underwent a color-word Stroop task and an empathy task consisting of dynamic visual scenarios depicting interpersonal harm or neutral actions in a magnetic resonance imaging (MRI) scanner. Functional MRI data were processed using MATLAB 7.12 with SPM8 for region of interest (ROI) analyses, and a general linear model was used with regressors for each trial type in each task.
Results:
For the Stroop task, accuracy was similar in the two groups, with no differences in the effect of incongruency on success rates. OSA showed greater neural activity than controls in eight ROI clusters for incongruent versus congruent trials (P < 0.001). Within the a priori ROIs, the anterior cingulate cortex was significantly different between groups (P < 0.05). For perceiving harm versus neutral actions, ROI analysis revealed a significant correlation between apnea-hypopnea index and left amygdala activity in harm versus neutral actions (r = -0.71, P < 0.05).
Conclusions:
These results provide the first functional MRI evidence that cognitive and empathetic processing is influenced by obstructive sleep apnea (OSA) in children. Children with OSA show greater neural recruitment of regions implicated in cognitive control, conflict monitoring, and attentional allocation in order to perform at the same level as children without OSA. When viewing empathy-eliciting scenarios, the severity of OSA predicted less sensitivity to harm in the left amygdala.
