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Sex-specific hippocampus volume changes in obstructive sleep apnea.

Paul M Macey1, Janani P Prasad2, Jennifer A Ogren3

  • 1UCLA School of Nursing, University of California at Los Angeles, Los Angeles, CA 90095, United States; Brain Research Institute, David Geffen School of Medicine at UCLA, University of California at Los Angeles, Los Angeles, CA 90095, United States.

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Summary

Obstructive sleep apnea (OSA) causes sex-specific changes in hippocampal volume. These differences in brain structure may explain varied symptoms like memory loss and depression in OSA patients.

Keywords:
AHI, apnea-hypopnea indexAutonomicCA, cornu ammonisInflammationIntermittent hypoxiaNeuroimagingOSA, obstructive sleep apneaOxidative stress

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Area of Science:

  • Neuroimaging
  • Sleep Medicine
  • Neurology

Background:

  • Obstructive sleep apnea (OSA) is linked to neurological and autonomic symptoms, including memory impairment and depression.
  • These symptoms exhibit sex-specific differences and are associated with distinct hippocampal subfields.
  • Understanding localized brain injury in OSA is crucial for linking structural damage to symptoms.

Purpose of the Study:

  • To determine the sites and extent of hippocampal sub-regional volume differences in patients with obstructive sleep apnea (OSA).
  • To investigate whether these structural changes are lateralized and sex-specific.
  • To correlate hippocampal structural damage with OSA-related symptoms.

Main Methods:

  • High-resolution T1-weighted MRI scans were acquired from newly-diagnosed, untreated OSA patients and age-matched controls.
  • Hippocampal segmentation and surface analysis were performed using FSL FIRST software.
  • Group differences in regional hippocampal volumes were evaluated using ANCOVA, controlling for total intracranial volume and sex.

Main Results:

  • Obstructive sleep apnea (OSA) patients showed bilateral hippocampal volume increases in CA1, subiculum, and uncus, and decreased volume in the right posterior CA3/dentate.
  • Males with OSA exhibited greater bilateral volume increases in CA1 and subiculum, and decreased volumes in posterior CA3/dentate compared to controls.
  • Females with OSA showed right-sided increases in CA1 and subiculum/uncus, and decreased posterior CA3/dentate volumes, with additional volume decreases in the hippocampus head and tail.

Conclusions:

  • The hippocampus displays lateralized and sex-specific regional volume alterations in obstructive sleep apnea (OSA).
  • Volume increases may indicate inflammation and glial activation, while decreases suggest neuronal injury.
  • These structural changes likely contribute to the sex-related manifestation of OSA symptoms.