Changes of serum brain-derived neurotrophic factor in children with obstructive sleep apnoea-hypopnoea syndrome following adenotonsillectomy.

Children with obstructive sleep apnoea syndrome (OSAS) have substantial cognitive functional morbidity. Brain-derived neurotrophic factor (BDNF) is a key mediator of memory and cognition, but its regulation in OSAS is unknown. Circulating BDNF, transforming growth factor-β(1) and 5-hydroxytryptamine levels, cognitive ability and overnight polysomnography were evaluated in 44 children with newly-diagnosed OSAS and in 26 healthy children. All parameters were monitored pre-operatively and at 3, 6 and 12 months after adenotonsillectomy. Pre-operative cognitive ability and sleep parameters were significantly poorer in children with OSAS compared with controls, but BDNF levels were similar. At 3 months post-operation, serum BDNF concentrations decreased, but cognitive ability and sleep parameters remained deficient. At 6 months post-operation, serum BDNF levels, sleep parameters and cognitive ability had improved and, by 12 months, there were no differences between the two groups. It is concluded that adenotonsillectomy can rapidly normalize sleep parameters and improve the cognitive ability of children with OSAS, by regulating the circulating level of BDNF.