Magnetic resonance white matter changes in patients with obstructive sleep apnoea. The subset of the PURE-MIND...

Changes typical for cerebral small vessel disease (i.a. white matter hyperintensities - WMHs) are often found accidentally in neuroimaging studies. Although asymptomatic, this condition increases the risk of future ischaemic incidents and neurodegenerative disorders. Sleep apnoea is a recognised risk factor for vascular diseases. The aim of our study was to assess the prevalence of, and association between, obstructive sleep apnea (OSA) and cerebral small vessel disease in the studied population.

Two hundred and seven patients (participants of Prospective Urban Rural Epidemiology Study) took part in our study. The study group consisted of 31 patients with OSA (11 women and 20 men). Nine of them were diagnosed with mild OSA, 9 with moderate OSA, and 13 with severe OSA. The control group consisted of 176 patients (133 women and 43 men) who scored 0-2 points in the STOP-BANG questionnaire. All patients underwent brain magnetic resonance imaging. We evaluated the occurrence and severity of WMHs.

Significantly higher incidence of WMHs was found in the study group compared to controls. Magnetic resonance imaging showed WMHs in periventricular area in 10 (32.25%) subjects in the OSA group and 19 (10.79%) subjects in the control group (p = 0.00382). The prevalence of subcortical lesions was also higher in OSA patients (n = 13; 41.94%) than in the control group (n = 29; 16.48%; p = 0.00580). In univariate analyses, age was a significant predictor of periventricular white matter changes. For subcortical area, age and waist-to-hip ratio were significant predictors.

Significantly higher incidence of WMHs in the studied group suggests that patients with OSA may have a higher risk of neurodegeneration.