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The Impacts of Obstructive Sleep Apnea Severity on Brain White Matter Integrity and Cognitive Functions in Children:
Lin Mei1, Xiaodan Li1, Shengcai Wang1
1Department of Otolaryngology, Head and Surgery, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, People's Republic of China.
Insights
Moderate-to-severe obstructive sleep apnea (OSA) in children significantly impacts white matter integrity and cognitive function, unlike mild OSA. This highlights the need for brain assessments in severe pediatric OSA cases.
Area of Science:
- Neurology
- Pediatric Sleep Medicine
- Neuroimaging
Background:
- Obstructive sleep apnea (OSA) is a common sleep disorder in children.
- The effects of varying OSA severity on white matter (WM) integrity and cognitive function require further investigation.
Purpose of the Study:
- To investigate the impacts of obstructive sleep apnea (OSA) on white matter (WM) integrity and cognitive functions of pediatric patients with different levels of OSA severity.
Main Methods:
- Fifty-eight children with OSA and thirty-four healthy controls (HC) underwent diffusion tensor imaging (DTI), polysomnography (PSG), and neurocognitive assessments.
- Patients were categorized into mild OSA (MG) and moderate-severe OSA (SG) groups for comparative analysis.
Main Results:
- The moderate-severe OSA group (SG) exhibited worse apnea-hypopnea index, arousal index, SpO2 nadir, attention, and intelligence compared to mild OSA (MG) and HC groups.
- Impaired WM integrity was observed in multiple tracts (e.g., anterior thalamic radiation, inferior fronto-occipital fasciculus) in the SG compared to HC.
- WM integrity correlated with OSA severity and cognitive scores in the SG, but not in the MG.
Conclusions:
- Moderate-to-severe OSA in children is associated with decreased baseline SpO2, WM impairment, and cognitive decline, particularly in intelligence.
- These findings suggest a link between reduced SpO2, WM integrity, and cognitive deficits in pediatric OSA.
- Additional brain damage and cognitive function assessments are recommended for prognostic evaluation in children with moderate-to-severe OSA.
Objective:
To investigate the impacts of obstructive sleep apnea (OSA) on white matter (WM) integrity and cognitive functions of pediatric patients with different levels of OSA severity.
Methods:
Fifty-eight children with OSA and thirty-four healthy controls (HC) were recruited. All participants underwent diffusion tensor imaging (DTI) examination, polysomnography (PSG), and neurocognitive assessments. Patients were divided into mild OSA (MG) and moderate-severe OSA (SG) groups. WM integrity, PSG data, and neurocognitive assessment scores were compared among those groups.
Results:
For apnea hypopnea index (AHI), obstructive apnea hypopnea index (OAHI), arousal index, SpO2 nadir, and attention, SG was worse than both MG and HC with MG worse than HC. For baseline SpO2 and intelligence, SG was worse than both MG and HC with no significant difference between MG and HC. Impaired WM integrity was observed in bilateral anterior thalamic radiation, bilateral inferior fronto-occipital fasciculus, bilateral inferior longitudinal fasciculus, right superior longitudinal fasciculus, right hippocampus, left cingulate gyrus, right uncinate fasciculus, callosum forceps major, and callosum forceps minor only for SG than for HC. WM integrity was significantly correlated with OSA severity and neurocognitive assessment scores only for SG, but not for MG.
Conclusion:
Decreased baseline SpO2, WM impairment, and intelligence decline were all observed only for SG, but not for MG, implying an associated relationship among decreased SpO2, WM impairment and WM impairment. Thus, for SG, additional assessments of brain damage and cognitive function decline are needed for prognostic evaluation of OSA.
