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Assessing cognitive impairment in OSAHS patients through NODDI-based gray matter analysis.
Ke Ning1, Dechao Fan2, Yuzhu Liu3
1Department of International Medical, Affiliated Zhongshan Hospital of Dalian University, No. 6 Jiefang Street, Dalian, 116001, China. ningke0801@163.com.
BMC Neurology
|December 19, 2025
Summary
Neurite orientation dispersion and density imaging (NODDI) shows potential for diagnosing gray matter changes in obstructive sleep apnea hypopnea syndrome (OSAHS) patients with cognitive impairment. These microstructural changes correlate with cognitive test scores.
Area of Science:
- Neuroimaging
- Sleep Medicine
- Cognitive Neuroscience
Background:
- Obstructive Sleep Apnea Hypopnea Syndrome (OSAHS) is linked to cognitive impairment.
- Gray matter microstructural alterations are suspected in OSAHS patients with cognitive deficits.
Purpose of the Study:
- To investigate gray matter microstructural changes in OSAHS patients with and without cognitive impairment using NODDI.
- To assess the early diagnostic potential of NODDI parameters for cognitive impairment in OSAHS.
Main Methods:
- Employed neurite orientation dispersion and density imaging (NODDI) on 23 OSAHS patients without cognitive impairment (OSA-NCI), 43 OSAHS patients with cognitive impairment (OSA-CI), and 15 healthy controls (HC).
- Calculated fractional anisotropy (FA), neurite density index (NDI), orientation dispersion index (ODI), and volume fraction of isotropic water molecules (Viso) in regions of interest.
- Correlated NODDI parameters with Montreal Cognitive Assessment (MoCA) and Mini-Mental State Examination (MMSE) scores and used receiver operating characteristic (ROC) analysis for diagnostic evaluation.
Main Results:
- Significant differences in NDI, ODI, and Viso were found between groups; OSA-NCI showed decreased NDI/ODI and increased Viso compared to HCs.
- OSA-CI patients exhibited increased Viso and slightly increased NDI/ODI compared to HCs, but these remained below HC levels.
- NDI, ODI, and Viso correlated significantly with MoCA scores, indicating a link between microstructural integrity and cognitive function; FA showed weak correlations.
Conclusions:
- NODDI parameters, particularly Viso and ODI, show potential for detecting gray matter pathology associated with cognitive impairment in OSAHS.
- The findings suggest NODDI's utility as an early diagnostic tool for cognitive impairment in OSAHS patients.
- Further validation in larger, independent cohorts is recommended to confirm the diagnostic efficacy of NODDI.
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