Brain microstructural alterations and cognitive impairment in obstructive sleep apnea: a diffusion kurtosis imaging...

Area of Science:

• Neuroimaging
• Neurology
• Sleep Medicine

Background:

• Obstructive sleep apnea (OSA) is linked to neurocognitive impairment.
• Understanding the underlying neuropathological mechanisms is crucial.

Purpose of the Study:

• Investigate brain microstructural alterations in moderate to severe OSA using diffusion kurtosis imaging (DKI).
• Assess the association between these alterations and neurocognitive impairment.

Main Methods:

• 40 OSA patients and 40 healthy controls (HCs) underwent cognitive tests (MoCA) and MRI (DKI, 3D T1).
• DKI data processed for axial kurtosis (AK) and radial kurtosis (RK) maps.
• Statistical analyses included group comparisons, ROC curves, and partial correlations.

Main Results:

• OSA patients exhibited increased AK and decreased RK in specific brain regions.
• Lower MoCA scores were observed in OSA patients, particularly in visual space, executive function, abstraction, and delayed recall.
• Radial kurtosis (RK) demonstrated strong diagnostic accuracy for OSA (AUC=0.817), and was correlated with cognitive function and oxygen saturation.

Conclusions:

• DKI is effective in detecting microstructural brain changes in OSA.
• These changes are associated with cognitive decline, offering insights into OSA's neuropathology.