Olga Prilipko1, Nelly Huynh2, Moriah E Thomason3, Clete A Kushida2, Christian Guilleminault2. 1. Stanford University Sleep Clinic and Center for Human Sleep Research, Redwood City, CA, USA. Electronic address: olga.prilipko@gmail.com. 2. Stanford University Sleep Clinic and Center for Human Sleep Research, Redwood City, CA, USA. 3. Department of Pediatrics, Wayne State University School of Medicine, Detroit, MI, USA; Merrill Palmer Skillman Institute for Child and Family Development, Wayne State University, Detroit, MI, USA.
Abstract
OBJECTIVE: Cerebrovascular reactivity is impaired in patients suffering from obstructive sleep apnea syndrome (OSAS) as demonstrated by transcranial Doppler studies. We use magnetic resonance imaging techniques to investigate the anatomical distribution of cerebrovascular reactivity changes in patients with OSAS, as well as their evolution after therapeutic and sham continuous positive airway pressure (CPAP) treatment. METHODS: Twenty-three men with moderate or severe obstructive sleep apnea were compared to a healthy control group (n=7) using a breath-holding functional magnetic resonance imaging task and the flow-sensitive alternating inversion recovery (FAIR) imaging before and after 2 months of therapeutic (active) or sub-therapeutic (sham) CPAP treatment. RESULTS: Significantly higher cerebrovascular reactivity was found in healthy controls as compared to patients in bilateral cortical and subcortical brain regions. Cerebrovascular reactivity increased with therapeutic CPAP in the thalamus and decreased with sham CPAP in medial frontal regions in OSAS patients. Duration of nocturnal hypoxemia and body mass index negatively correlated with cerebrovascular reactivity, particularly in the medial temporal lobe structures, suggesting a possible pathophysiological mechanism for hippocampal injury. There was no difference in perfusion between patients and control group, and no effect of CPAP or sham-CPAP treatment on perfusion in patients. CONCLUSIONS: Observed cerebrovascular reactivity changes were neither homogeneous throughout the brain nor followed vascular territories, but rather corresponded to underlying neuronal networks, establishing a relationship between cerebrovascular reactivity and surrounding neuronal activity.
OBJECTIVE: Cerebrovascular reactivity is impaired in patients suffering from obstructive sleep apnea syndrome (OSAS) as demonstrated by transcranial Doppler studies. We use magnetic resonance imaging techniques to investigate the anatomical distribution of cerebrovascular reactivity changes in patients with OSAS, as well as their evolution after therapeutic and sham continuous positive airway pressure (CPAP) treatment. METHODS: Twenty-three men with moderate or severe obstructive sleep apnea were compared to a healthy control group (n=7) using a breath-holding functional magnetic resonance imaging task and the flow-sensitive alternating inversion recovery (FAIR) imaging before and after 2 months of therapeutic (active) or sub-therapeutic (sham) CPAP treatment. RESULTS: Significantly higher cerebrovascular reactivity was found in healthy controls as compared to patients in bilateral cortical and subcortical brain regions. Cerebrovascular reactivity increased with therapeutic CPAP in the thalamus and decreased with sham CPAP in medial frontal regions in OSAS patients. Duration of nocturnal hypoxemia and body mass index negatively correlated with cerebrovascular reactivity, particularly in the medial temporal lobe structures, suggesting a possible pathophysiological mechanism for hippocampal injury. There was no difference in perfusion between patients and control group, and no effect of CPAP or sham-CPAP treatment on perfusion in patients. CONCLUSIONS: Observed cerebrovascular reactivity changes were neither homogeneous throughout the brain nor followed vascular territories, but rather corresponded to underlying neuronal networks, establishing a relationship between cerebrovascular reactivity and surrounding neuronal activity.
Authors: Pei-Hsin Wu; Ana E Rodríguez-Soto; Andrew Wiemken; Erin K Englund; Zachary B Rodgers; Michael C Langham; Richard J Schwab; John A Detre; Wensheng Guo; Felix W Wehrli Journal: J Cereb Blood Flow Metab Date: 2022-01-07 Impact factor: 6.960
Authors: Zachary B Rodgers; Sarah E Leinwand; Brendan T Keenan; Lohith G Kini; Richard J Schwab; Felix W Wehrli Journal: J Cereb Blood Flow Metab Date: 2015-09-30 Impact factor: 6.200