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Updated: May 29, 2025

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Reduced Oxygen Extraction Fraction as a Biomarker for Cognitive Deficits in Obstructive Sleep Apnea.

Mahdi Mohammadi1,2, Shahram Samadi3,4, Seyed Amir Hossein Batouli5

  • 1Department of Medical Physics and Biomedical Engineering, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran.

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Obstructive sleep apnea (OSA) is linked to lower oxygen extraction fraction (OEF) in the brain, which correlates with cognitive decline. Reduced OEF may serve as a biomarker for OSA-related cognitive impairments.

Keywords:
CognitionMRIObstructive sleep apneaOxygen extraction fractionQuantitative susceptibility mapping

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Area of Science:

  • Neuroimaging
  • Sleep Medicine
  • Cognitive Neuroscience

Background:

  • Obstructive sleep apnea (OSA) disrupts breathing, leading to cognitive deficits.
  • Investigating physiological markers like oxygen extraction fraction (OEF) and quantitative susceptibility mapping (QSM) is crucial for understanding OSA's impact on cognition.

Purpose of the Study:

  • To explore the relationship between OEF, QSM, and cognitive performance in patients with OSA.
  • To identify potential neuroimaging biomarkers for OSA-related cognitive impairment.

Main Methods:

  • 15 OSA patients and 16 controls underwent polysomnography and 3T brain MRI.
  • Oxygen extraction fraction (OEF) was measured using a two-step MRI analysis; quantitative susceptibility mapping (QSM) was also performed.
  • Neuropsychological tests assessed cognitive function, and volumetric analysis evaluated brain volume.

Main Results:

  • OSA patients exhibited significantly lower OEF in multiple cerebral cortical regions compared to controls.
  • Reduced OEF correlated negatively with stage N2 sleep duration and poorer performance on cognitive tests, particularly in left-hemisphere regions.
  • No significant differences were found in QSM or brain volume between groups.

Conclusions:

  • Decreased OEF is a potential biomarker for cognitive deficits in OSA.
  • Disturbances in cerebral oxygen metabolism likely underlie OSA-related cognitive impairments.
  • Further research into physiological markers is essential for understanding and managing OSA-induced cognitive dysfunction.