Brainstem lesions are associated with sleep apnea in multiple sclerosis

Area of Science:

• Neurology
• Sleep Medicine
• Radiology

Background:

• Limited research exists on MRI findings in multiple sclerosis (MS) patients with obstructive sleep apnea (OSA).
• Investigating the relationship between OSA severity and neurological changes in MS is crucial.

Purpose of the Study:

• To assess MRI abnormalities associated with obstructive sleep apnea (OSA) in patients with multiple sclerosis (MS).
• To explore correlations between OSA severity and brainstem lesion burden, brain atrophy, and disability in MS patients.

Main Methods:

• Retrospective chart review of 65 MS patients who underwent polysomnography (PSG) and brain MRI.
• Quantified brainstem lesion counts and standardized third ventricular width (sTVW) for brain atrophy.
• Correlated apnea-hypopnea index (AHI) with lesion location, sTVW, and Expanded Disability Status Scale (EDSS).

Main Results:

• MS patients with OSA were older, had higher BMI, and higher AHI than those without OSA.
• Significant associations found between AHI and lesion burden in the midbrain (p < 0.01) and pons (p = 0.05).
• No significant association was observed between AHI and medullary lesions.

Conclusions:

• Midbrain and pontine lesion burden in MS patients correlates with OSA severity (AHI).
• These findings suggest that the location of MS lesions may contribute to the development of OSA.
• Further research is warranted to elucidate the mechanisms underlying this association.