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Published on: December 6, 2016
Volumetric brain magnetic resonance imaging analysis in children with obstructive sleep apnea
Mary Frances Musso1, Hannah M Lindsey2, Elisabeth A Wilde3
1Department of Otolaryngology and Head and Neck Surgery, Baylor College of Medicine, Houston, TX, USA; Department of Pediatric Otolaryngology and Head and Neck Surgery, Texas Children's Hospital, Houston, TX, USA.
Insights
Pediatric Obstructive Sleep Apnea (OSA) is linked to brain structure changes in children. MRI scans revealed reduced cortical thickness and gray and white matter volume in children with OSA, particularly in the left hemisphere.
Area of Science:
- Pediatric neurology
- Neuroimaging
- Sleep medicine
Background:
- Pediatric Obstructive Sleep Apnea (OSA) is associated with neurocognitive deficits.
- Cerebral structural alterations are documented in adult OSA, but pediatric data is limited.
- Key brain regions affected in adults include the frontal cortex, cerebellum, and hippocampus.
Purpose of the Study:
- To investigate differences in cortical thickness and volume using MRI in children with and without OSA.
- To compare cerebral structures between pediatric OSA patients and healthy controls.
- To identify specific brain regions affected by OSA in children.
Main Methods:
- Prospective, single institutional case-control study.
- Recruited 45 children (27 with OSA, 18 controls).
- Utilized high-resolution T1-weighted MRI to assess cortical thickness and gray/white matter volume.
Main Results:
- Children with OSA exhibited cortical thinning, predominantly in the left hemisphere.
- Reduced gray matter volume was observed in frontal regions of the left hemisphere in the OSA group.
- Reduced white matter volume was noted in frontal, parietal, and occipital lobes in both hemispheres of children with OSA.
Conclusions:
- Significant differences in cortical thickness and regional brain volumes were found in children with OSA.
- Findings align with other pediatric studies showing brain alterations in children with OSA.
- OSA severity did not correlate with the extent of observed MRI alterations.
Objectives:
Pediatric Obstructive Sleep Apnea (OSA) is associated with neurocognitive deficits. Cerebral structural alterations in the frontal cortex, cerebellum, and hippocampus have been reported in adult OSA patients. These brain areas are important for executive functioning, motor regulation of breathing, and memory function, respectively. Corresponding evidence comparing cerebral structures in pediatric OSA patients is limited. The objective of this study is to investigate MRI differences in cortical thickness and cortical volume in children with and without OSA.
Study Design:
Prospective, single institutional case-control study.
Methods:
Forty-five children were recruited at a pediatric tertiary care center (27 with OSA; mean age 9.9 ± 1.9 years, and 18 controls; mean age 10.5 ± 1.0 years). The OSA group underwent magnetic resonance imaging (MRI), polysomnography (PSG) and completed the Pediatric Daytime Sleepiness Scale (PDSS) and the Child's Sleep Habits Questionnaire (CSHQ). High-resolution T1-weighted MRI was utilized to examine cortical thickness and gray and white matter volume in children with OSA compared to a healthy group of demographically-comparable children without OSA selected from a pre-existing MRI dataset.
Results:
Children with OSA showed multiple regions of cortical thinning primarily in the left hemisphere. Reduced gray matter (GM) volume was noted in the OSA group in multiple frontal regions of the left hemisphere (superior frontal, rostral medial frontal, and caudal medial frontal regions). Reduced white matter (WM) volume in both the left and right hemisphere was observed in regions of the frontal, parietal, and occipital lobes in children with OSA.
Conclusion:
This study noted differences in cortical thickness and GM and WM regional brain volumes in children with OSA. These findings are consistent with other pediatric studies, which also report differences between healthy children and those with OSA. We found that the severity of OSA does not correlate with the extent of MRI alterations.
