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Glymphatic system dysfunction in obstructive sleep apnea evidenced by DTI-ALPS.

Ho-Joon Lee1, Dong Ah Lee2, Kyong Jin Shin2

  • 1Department of Radiology, Haeundae Paik Hospital, Inje University College of Medicine, Busan, Republic of Korea.

Sleep Medicine
|January 14, 2022
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Summary

Patients with obstructive sleep apnea (OSA) show impaired glymphatic system function, as measured by diffusion tensor imaging (DTI-ALPS). This dysfunction correlates with OSA severity, suggesting a link to increased dementia risk.

Keywords:
Diffusion tensor imagingGlymphatic systemSleep apnea

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Area of Science:

  • Neuroimaging
  • Sleep Medicine
  • Cerebrovascular Health

Background:

  • Obstructive sleep apnea (OSA) is a prevalent condition associated with various health risks.
  • The glymphatic system is crucial for waste clearance in the brain.
  • Potential links between OSA and neurodegenerative diseases are under investigation.

Purpose of the Study:

  • To evaluate glymphatic system function in patients with OSA compared to healthy controls.
  • To investigate the correlation between glymphatic system function and OSA severity.

Main Methods:

  • Diffusion tensor imaging (DTI) with the perivascular space (DTI-ALPS) method was used.
  • 24 patients with OSA and 24 healthy controls underwent 3T MRI.
  • The DTI-ALPS index was calculated and compared between groups.

Main Results:

  • Patients with OSA exhibited a significantly lower DTI-ALPS index compared to healthy controls (1.30 vs. 1.62, p=0.0006).
  • The DTI-ALPS index showed a significant negative correlation with the apnea-hypopnea index (r=-0.427, p=0.042) and oxygen desaturation index (r=-0.497, p=0.036) during sleep stage N.

Conclusions:

  • Glymphatic system dysfunction is present in patients with OSA.
  • This dysfunction is correlated with OSA severity, particularly during sleep stage N.
  • Findings suggest a mechanism for OSA's contribution to dementia risk and underscore the importance of OSA treatment.