Relationships between brain tissue damage, oxygen desaturation, and disease severity in obstructive sleep apnea evaluated by diffusion tensor imaging

Ashish Sahib; Bhaswati Roy; Daniel Kang; Ravi S Aysola; Eugenia Wen; Rajesh Kumar

doi:10.5664/jcsm.10192

Relationships between brain tissue damage, oxygen desaturation, and disease severity in obstructive sleep apnea evaluated by diffusion tensor imaging

J Clin Sleep Med. 2022 Dec 1;18(12):2713-2721. doi: 10.5664/jcsm.10192.

Authors

Ashish Sahib¹, Bhaswati Roy¹, Daniel Kang², Ravi S Aysola², Eugenia Wen², Rajesh Kumar^{1

3

4

5}

Affiliations

¹ Department of Anesthesiology, University of California Los Angeles, Los Angeles, California.
² Department of Medicine, University of California Los Angeles, Los Angeles, California.
³ Department of Radiological Sciences, University of California Los Angeles, Los Angeles, California.
⁴ Department of Bioengineering, University of California Los Angeles, Los Angeles, California.
⁵ Brain Research Institute, University of California Los Angeles, Los Angeles, California.

Abstract

Study objectives: Patients with obstructive sleep apnea (OSA) show brain injury in sites responsible for autonomic, cognitive, and respiratory functions. Brain changes in OSA may vary with disease severity as assessed by the apnea-hypopnea index (AHI), which does not provide information about the apnea depth and length in contrast to oxygen desaturation. Although significant associations with brain injury and AHI are known in OSA, it is unclear whether AHI or the extent of oxygen desaturations better correlate with brain damage. We evaluated associations between brain changes, AHI, and oxygen desaturation using diffusion tensor imaging-based measures.

Methods: We acquired diffusion tensor imaging data from 19 patients with OSA using a 3.0-Tesla MRI scanner and calculated, normalized, and smoothed mean, axial, and radial diffusivity maps that were used for correlations between brain changes, oxygen desaturation, and AHI values.

Results: Positive correlations with extent of injury (mean, axial, and radial diffusivity values) and AHI appeared in the frontal areas, cingulate and insula, amygdala, hippocampus, and basal pons, and negative associations emerged in the putamen, internal-capsule, globus-pallidus, and cerebellar cortices. Regional diffusivity values and oxygen desaturation showed positive correlations in the cingulate, frontal, putamen, and cerebellar sites, and negative relationships in several areas, including the occipital cortex.

Conclusions: Patients with OSA show negative and positive correlations, indicated by increased and decreased diffusivity values, resulting from chronic and acute changes in those areas. The extent of injury in OSA partially depends on the extent of AHI and oxygen desaturation, with the effects representing continued development from acute to chronic processes.

Citation: Sahib A, Roy B, Kang D, Aysola RS, Wen E, Kumar R. Relationships between brain tissue damage, oxygen desaturation, and disease severity in obstructive sleep apnea evaluated by diffusion tensor imaging. J Clin Sleep Med. 2022;18(12):2713-2721.

Keywords: autonomic; cognition; disease severity; hippocampus; issue injury; mood.

Publication types

Research Support, N.I.H., Extramural

MeSH terms

Brain / diagnostic imaging
Brain Injuries* / complications
Diffusion Tensor Imaging
Humans
Oxygen
Severity of Illness Index
Sleep Apnea, Obstructive* / complications
Sleep Apnea, Obstructive* / diagnostic imaging

Substances

Oxygen

Abstract

Publication types

MeSH terms

Substances

Grants and funding