David R Busch1,2, Jennifer M Lynch2, Madeline E Winters1, Ann L McCarthy3, John J Newland1, Tiffany Ko4, Mary Anne Cornaglia5, Jerilynn Radcliffe6, Joseph M McDonough5, John Samuel5, Edward Matthews5, Rui Xiao7, Arjun G Yodh2, Carole L Marcus5, Daniel J Licht1, Ignacio E Tapia5. 1. Division of Neurology, Children's Hospital of Philadelphia, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA. 2. Department of Physics and Astronomy, University of Pennsylvania, Philadelphia, PA. 3. Temple University School of Medicine, Philadelphia, PA. 4. Department of Biomedical Engineering, University of Pennsylvania, Philadelphia, PA. 5. The Sleep Center, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA. 6. Clinical and Translational Research Center, Children's Hospital of Philadelphia, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA. 7. Department of Biostatistics and Epidemiology, University of Pennsylvania, Philadelphia, PA.
Abstract
STUDY OBJECTIVES: Children with obstructive sleep apnea syndrome (OSAS) often experience periods of hypercapnia during sleep, a potent stimulator of cerebral blood flow (CBF). Considering this hypercapnia exposure during sleep, it is possible that children with OSAS have abnormal CBF responses to hypercapnia even during wakefulness. Therefore, we hypothesized that children with OSAS have blunted CBF response to hypercapnia during wakefulness, compared to snorers and controls. METHODS: CBF changes during hypercapnic ventilatory response (HCVR) were tested in children with OSAS, snorers, and healthy controls using diffuse correlation spectroscopy (DCS). Peak CBF changes with respect to pre-hypercapnic baseline were measured for each group. The study was conducted at an academic pediatric sleep center. RESULTS: Twelve children with OSAS (aged 10.1 ± 2.5 [mean ± standard deviation] y, obstructive apnea hypopnea index [AHI] = 9.4 [5.1-15.4] [median, interquartile range] events/hour), eight snorers (11 ± 3 y, 0.5 [0-1.3] events/hour), and 10 controls (11.4 ± 2.6 y, 0.3 [0.2-0.4] events/hour) were studied. The fractional CBF change during hypercapnia, normalized to the change in end-tidal carbon dioxide, was significantly higher in controls (9 ± 1.8 %/mmHg) compared to OSAS (7.1 ± 1.5, P = 0.023) and snorers (6.7 ± 1.9, P = 0.025). CONCLUSIONS: Children with OSAS and snorers have blunted CBF response to hypercapnia during wakefulness compared to controls. Noninvasive DCS blood flow measurements of hypercapnic reactivity offer insights into physiopathology of OSAS in children, which could lead to further understanding about the central nervous system complications of OSAS.
STUDY OBJECTIVES:Children with obstructive sleep apnea syndrome (OSAS) often experience periods of hypercapnia during sleep, a potent stimulator of cerebral blood flow (CBF). Considering this hypercapnia exposure during sleep, it is possible that children with OSAS have abnormal CBF responses to hypercapnia even during wakefulness. Therefore, we hypothesized that children with OSAS have blunted CBF response to hypercapnia during wakefulness, compared to snorers and controls. METHODS: CBF changes during hypercapnic ventilatory response (HCVR) were tested in children with OSAS, snorers, and healthy controls using diffuse correlation spectroscopy (DCS). Peak CBF changes with respect to pre-hypercapnic baseline were measured for each group. The study was conducted at an academic pediatric sleep center. RESULTS: Twelve children with OSAS (aged 10.1 ± 2.5 [mean ± standard deviation] y, obstructive apnea hypopnea index [AHI] = 9.4 [5.1-15.4] [median, interquartile range] events/hour), eight snorers (11 ± 3 y, 0.5 [0-1.3] events/hour), and 10 controls (11.4 ± 2.6 y, 0.3 [0.2-0.4] events/hour) were studied. The fractional CBF change during hypercapnia, normalized to the change in end-tidal carbon dioxide, was significantly higher in controls (9 ± 1.8 %/mmHg) compared to OSAS (7.1 ± 1.5, P = 0.023) and snorers (6.7 ± 1.9, P = 0.025). CONCLUSIONS:Children with OSAS and snorers have blunted CBF response to hypercapnia during wakefulness compared to controls. Noninvasive DCS blood flow measurements of hypercapnic reactivity offer insights into physiopathology of OSAS in children, which could lead to further understanding about the central nervous system complications of OSAS.
Authors: Guoqiang Yu; Turgut Durduran; Chao Zhou; Timothy C Zhu; Jarod C Finlay; Theresa M Busch; S Bruce Malkowicz; Stephen M Hahn; Arjun G Yodh Journal: Photochem Photobiol Date: 2006 Sep-Oct Impact factor: 3.421
Authors: Denise M O'Driscoll; Rosemary S C Horne; Margot J Davey; Sarah A Hope; Vicki Anderson; John Trinder; Adrian M Walker; Gillian M Nixon Journal: Sleep Med Date: 2011-05 Impact factor: 3.492
Authors: Carole L Marcus; Reneé H Moore; Carol L Rosen; Bruno Giordani; Susan L Garetz; H Gerry Taylor; Ron B Mitchell; Raouf Amin; Eliot S Katz; Raanan Arens; Shalini Paruthi; Hiren Muzumdar; David Gozal; Nina Hattiangadi Thomas; Janice Ware; Dean Beebe; Karen Snyder; Lisa Elden; Robert C Sprecher; Paul Willging; Dwight Jones; John P Bent; Timothy Hoban; Ronald D Chervin; Susan S Ellenberg; Susan Redline Journal: N Engl J Med Date: 2013-05-21 Impact factor: 91.245
Authors: Jingtao Huang; Carole L Marcus; Paul W Davenport; Ian M Colrain; Paul R Gallagher; Ignacio E Tapia Journal: Am J Respir Crit Care Med Date: 2013-10-01 Impact factor: 21.405
Authors: Lars Eichhorn; Florian Kessler; Volker Böhnert; Felix Erdfelder; Anja Reckendorf; Rainer Meyer; Richard K Ellerkmann Journal: J Vis Exp Date: 2016-12-22 Impact factor: 1.355
Authors: Jordan W Squair; Amanda H X Lee; Zoe K Sarafis; Geoff Coombs; Otto Barak; Jacquelyn J Cragg; Tanja Mijacika; Renata Pecotic; Andrei V Krassioukov; Zoran Dogas; Zeljko Dujic; Aaron A Phillips Journal: Neurology Date: 2019-11-06 Impact factor: 9.910
Authors: Hasan Ayaz; Wesley B Baker; Giles Blaney; David A Boas; Heather Bortfeld; Kenneth Brady; Joshua Brake; Sabrina Brigadoi; Erin M Buckley; Stefan A Carp; Robert J Cooper; Kyle R Cowdrick; Joseph P Culver; Ippeita Dan; Hamid Dehghani; Anna Devor; Turgut Durduran; Adam T Eggebrecht; Lauren L Emberson; Qianqian Fang; Sergio Fantini; Maria Angela Franceschini; Jonas B Fischer; Judit Gervain; Joy Hirsch; Keum-Shik Hong; Roarke Horstmeyer; Jana M Kainerstorfer; Tiffany S Ko; Daniel J Licht; Adam Liebert; Robert Luke; Jennifer M Lynch; Jaume Mesquida; Rickson C Mesquita; Noman Naseer; Sergio L Novi; Felipe Orihuela-Espina; Thomas D O'Sullivan; Darcy S Peterka; Antonio Pifferi; Luca Pollonini; Angelo Sassaroli; João Ricardo Sato; Felix Scholkmann; Lorenzo Spinelli; Vivek J Srinivasan; Keith St Lawrence; Ilias Tachtsidis; Yunjie Tong; Alessandro Torricelli; Tara Urner; Heidrun Wabnitz; Martin Wolf; Ursula Wolf; Shiqi Xu; Changhuei Yang; Arjun G Yodh; Meryem A Yücel; Wenjun Zhou Journal: Neurophotonics Date: 2022-08-30 Impact factor: 4.212
Authors: David R Busch; Craig G Rusin; Wanda Miller-Hance; Kathy Kibler; Wesley B Baker; Jeffrey S Heinle; Charles D Fraser; Arjun G Yodh; Daniel J Licht; Kenneth M Brady Journal: Biomed Opt Express Date: 2016-08-15 Impact factor: 3.732
Authors: Tiffany S Ko; Constantine D Mavroudis; Wesley B Baker; Vincent C Morano; Kobina Mensah-Brown; Timothy W Boorady; Alexander L Schmidt; Jennifer M Lynch; David R Busch; Javier Gentile; George Bratinov; Yuxi Lin; Sejin Jeong; Richard W Melchior; Tami M Rosenthal; Brandon C Shade; Kellie L Schiavo; Rui Xiao; J William Gaynor; Arjun G Yodh; Todd J Kilbaugh; Daniel J Licht Journal: J Cereb Blood Flow Metab Date: 2018-10-30 Impact factor: 6.200
Authors: Christopher G Favilla; Rodrigo M Forti; Ahmad Zamzam; John A Detre; Michael T Mullen; Arjun G Yodh; Scott E Kasner; David R Busch; Wesley B Baker; Rickson C Mesquita; David Kung; Steven R Messé Journal: Neurotherapeutics Date: 2019-10 Impact factor: 6.088
Authors: Clara Gregori-Pla; Gianluca Cotta; Igor Blanco; Peyman Zirak; Martina Giovannella; Anna Mola; Ana Fortuna; Turgut Durduran; Mercedes Mayos Journal: PLoS One Date: 2018-03-14 Impact factor: 3.240
Authors: L Eichhorn; J Doerner; J A Luetkens; J M Lunkenheimer; R C Dolscheid-Pommerich; F Erdfelder; R Fimmers; J Nadal; B Stoffel-Wagner; H H Schild; A Hoeft; B Zur; C P Naehle Journal: J Cardiovasc Magn Reson Date: 2018-06-18 Impact factor: 5.364