Ruo-Lin Zhu1,2,3, Chao Ouyang4, Ruo-Lin Ma1,2,3, Kai Wang5,6,7. 1. Department of Neurology, The First Affiliated Hospital of Anhui Medical University, No. 218 Jixi Road, 230022, Hefei, People's Republic of China. 2. Department of Medical Psychology, Anhui Medical University, Hefei, 230022, China. 3. Collaborative Innovation Centre of Neuropsychiatric Disorders and Mental Health, Hefei, 230022, China. 4. Department of Neurology, The Lu'an Civily Hospital, Lu'an 237010, Anhui Province, China. 5. Department of Neurology, The First Affiliated Hospital of Anhui Medical University, No. 218 Jixi Road, 230022, Hefei, People's Republic of China. wangkai1964@126.com. 6. Department of Medical Psychology, Anhui Medical University, Hefei, 230022, China. wangkai1964@126.com. 7. Collaborative Innovation Centre of Neuropsychiatric Disorders and Mental Health, Hefei, 230022, China. wangkai1964@126.com.
Abstract
OBJECTIVES: Obstructive sleep apnea (OSA) is commonly seen in stroke patients, and its relationship with cognitive impairment remains poorly understood. This study aimed to explore the roles of OSA in cognition impairment in patients with minor ischemic stroke. METHODS: Patients with minor ischemic stroke were consecutively enrolled from January 2020 to May 2021. Every patient underwent polysomnography (PSG) to assess for OSA. Based on the apnea hypopnea index (AHI), patients were grouped into the no OSA (AHI < 5), mild OSA (5 ≤ AHI < 15), and moderate-to-severe OSA (MS OSA, AHI ≥ 15) groups. Neuropsychological assessments were performed to evaluate cognitive function, and the correlations between cognitive function and OSA were investigated. RESULTS: Of 94 patients, 35 had no OSA, 32 had mild OSA, and 27 had moderate-to-severe OSA. Compared to the no or mild OSA groups, the moderate-to-severe OSA group performed worse on the Chinese version of the Auditory Verbal Learning Test (CAVLT)-Recognition (p < 0.001), Digital Span Test (DST)-Backward (p < 0.001), Montreal Cognitive Assessment (MoCA) (p < 0.001), and Stroop Color and Word Test (SCWT)-Interference (p < 0.001). The severity of cognitive impairment was assessed using the MoCA, which was negatively related to the AHI (p = 0.041) and lowest SpO2 (p = 0.048). CONCLUSIONS: The findings suggest that OSA has significant effects on cognition impairment in patients with minor ischemic stroke and that hypoxemia may be a potential pathophysiological mechanism of OSA-induced cognitive impairment.
OBJECTIVES: Obstructive sleep apnea (OSA) is commonly seen in stroke patients, and its relationship with cognitive impairment remains poorly understood. This study aimed to explore the roles of OSA in cognition impairment in patients with minor ischemic stroke. METHODS: Patients with minor ischemic stroke were consecutively enrolled from January 2020 to May 2021. Every patient underwent polysomnography (PSG) to assess for OSA. Based on the apnea hypopnea index (AHI), patients were grouped into the no OSA (AHI < 5), mild OSA (5 ≤ AHI < 15), and moderate-to-severe OSA (MS OSA, AHI ≥ 15) groups. Neuropsychological assessments were performed to evaluate cognitive function, and the correlations between cognitive function and OSA were investigated. RESULTS: Of 94 patients, 35 had no OSA, 32 had mild OSA, and 27 had moderate-to-severe OSA. Compared to the no or mild OSA groups, the moderate-to-severe OSA group performed worse on the Chinese version of the Auditory Verbal Learning Test (CAVLT)-Recognition (p < 0.001), Digital Span Test (DST)-Backward (p < 0.001), Montreal Cognitive Assessment (MoCA) (p < 0.001), and Stroop Color and Word Test (SCWT)-Interference (p < 0.001). The severity of cognitive impairment was assessed using the MoCA, which was negatively related to the AHI (p = 0.041) and lowest SpO2 (p = 0.048). CONCLUSIONS: The findings suggest that OSA has significant effects on cognition impairment in patients with minor ischemic stroke and that hypoxemia may be a potential pathophysiological mechanism of OSA-induced cognitive impairment.
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