Corticoperipheral neuromuscular disconnection in obstructive sleep apnoea

Area of Science:

• Neuroscience
• Sleep Medicine
• Respiratory Physiology

Background:

• The precise role of central nervous system mechanisms and cortical output in obstructive sleep apnoea (OSA) is not fully understood.
• Investigating the corticomuscular coupling between cortical sensorimotor areas and lower facial motor units may elucidate mechanistic pathways and serve as a marker for corticoperipheral motor control in OSA.

Purpose of the Study:

• To explore the relationship between obstructive sleep apnoea severity and corticomuscular coupling.
• To determine if corticomuscular coupling is influenced by sleep stages, respiratory events, body mass index, or autonomic nervous system activation.

Main Methods:

• An exploratory, cross-sectional, retrospective study analyzed EEG and chin EMG data from polysomnography recordings of 86 participants.
• Participants included those with mild, moderate, and severe obstructive sleep apnoea, and a control group.
• Corticomuscular coupling was assessed by computing C3/C4-EEG-chin EMG coherence in time and frequency domains during sleep and respiratory events.

Main Results:

• Corticomuscular coupling significantly weakened with increasing obstructive sleep apnoea severity.
• Coupling was strongest during N3 sleep and weakest during N1, N2, and REM sleep stages.
• Coupling increased during obstructive respiratory events compared to periods before and after events, independent of BMI or autonomic activation.

Conclusions:

• Obstructive respiratory events in OSA are strongly associated with a disconnection in the cortical sensorimotor areas-lower facial motor units pathway.
• This coordinated activity pattern suggests a central pattern generator driven by cortical sensorimotor areas and a central motor output disorder in OSA.