Proton Magnetic Resonance Spectroscopy of Periventricular White Matter and Hippocampus in Obstructive Sleep Apnea Patients

Overview

Journal Pol J Radiol

Publisher Termedia

Specialty Radiology

Date 2014 Feb 8

PMID 24505219

Citations 6

Authors

Volkan Kizilgoz

Hasan Aydin

Idil Gunes Tatar

Baki Hekimoglu

Sadik Ardic

Hikmet Firat

Cem Donmez

Affiliations

Soon will be listed here.

Abstract

Background: The purpose of this study was to diagnose the hypoxic impairment by Magnetic resonance spectroscopy (MRS), an advanced MR imaging technique, which could not be visualised by routine imaging methods in patients with obstructive sleep apnea (OSA).

Material/methods: 20 OSA patients and 5 controls were included in this prospective research. MRS was performed on these 25 subjects to examine cerebral hypoxemia in specific regions (periventricular white matter and both hippocampi). Polysomnography was assumed as the gold standard. Statistical analysis was assessed by Mann-Whitney U test and Receiver operating characteristics (ROC) curve for NAA/Cho, NAA/Cr and Cho/Cr ratios.

Results: In the periventricular white matter, NAA/Cho ratio in OSA patients was significantly lower than in the control group (p<0.05). There were no statistical differences between the OSA and the control group for NAA/Cho, NAA/Cr and Cho/Cr ratios for both hippocampal regions. Additionally, Cho/Cr ratio in the periventricular white matter region of OSA group was higher than in the control group (p<0.05).

Conclusions: Hypoxic impairment induced by repeated episodes of apnea leads to significant neuronal damage in OSA patients. MRS provides valuable information in the assessment of hypoxic ischemic impairment by revealing important metabolite ratios for the specific areas of the brain.

Citing Articles

Summary of drug therapy to treat cognitive impairment-induced obstructive sleep apnea.

He D, Chen J, Du X, Xu L Front Cell Neurosci. 2023; 17:1222626.

PMID: 37731463 PMC: 10507626. DOI: 10.3389/fncel.2023.1222626.

White matter structural differences in OSA patients experiencing residual daytime sleepiness with high CPAP use: a non-Gaussian diffusion MRI study.

Zhang J, Weaver T, Zhong Z, Nisi R, Martin K, Steffen A Sleep Med. 2018; 53:51-59.

PMID: 30445240 PMC: 6360120. DOI: 10.1016/j.sleep.2018.09.011.

Sex-specific hippocampus volume changes in obstructive sleep apnea.

Macey P, Prasad J, Ogren J, Moiyadi A, Aysola R, Kumar R Neuroimage Clin. 2018; 20:305-317.

PMID: 30101062 PMC: 6083433. DOI: 10.1016/j.nicl.2018.07.027.

Obstructive sleep apnea is associated with altered midbrain chemical concentrations.

Macey P, Sarma M, Prasad J, Ogren J, Aysola R, Harper R Neuroscience. 2017; 363:76-86.

PMID: 28893651 PMC: 5983363. DOI: 10.1016/j.neuroscience.2017.09.001.

Global brain metabolic quantification with whole-head proton MRS at 3 T.

Kirov I, Wu W, Soher B, Davitz M, Huang J, Babb J NMR Biomed. 2017; 30(10).

PMID: 28678429 PMC: 5609859. DOI: 10.1002/nbm.3754.

References

Bartlett D, Rae C, Thompson C, Byth K, Joffe D, Enright T . Hippocampal area metabolites relate to severity and cognitive function in obstructive sleep apnea. Sleep Med. 2004; 5(6):593-6. DOI: 10.1016/j.sleep.2004.08.004. View

Moller-Hartmann W, Herminghaus S, Krings T, Marquardt G, Lanfermann H, Pilatus U . Clinical application of proton magnetic resonance spectroscopy in the diagnosis of intracranial mass lesions. Neuroradiology. 2002; 44(5):371-81. DOI: 10.1007/s00234-001-0760-0. View

Pantoni L, Garcia J . Pathogenesis of leukoaraiosis: a review. Stroke. 1997; 28(3):652-9. DOI: 10.1161/01.str.28.3.652. View

. Sleep-related breathing disorders in adults: recommendations for syndrome definition and measurement techniques in clinical research. The Report of an American Academy of Sleep Medicine Task Force. Sleep. 1999; 22(5):667-89. View

Callot V, Galanaud D, Fur Y, Confort-Gouny S, Ranjeva J, Cozzone P . (1)H MR spectroscopy of human brain tumours: a practical approach. Eur J Radiol. 2008; 67(2):268-274. DOI: 10.1016/j.ejrad.2008.02.036. View

Majos C, Aguilera C, Alonso J, Julia-Sape M, Castaner S, Sanchez J . Proton MR spectroscopy improves discrimination between tumor and pseudotumoral lesion in solid brain masses. AJNR Am J Neuroradiol. 2008; 30(3):544-51. PMC: 7051434. DOI: 10.3174/ajnr.A1392. View

Duran J, Esnaola S, Rubio R, Iztueta A . Obstructive sleep apnea-hypopnea and related clinical features in a population-based sample of subjects aged 30 to 70 yr. Am J Respir Crit Care Med. 2001; 163(3 Pt 1):685-9. DOI: 10.1164/ajrccm.163.3.2005065. View

Desseilles M, Dang-Vu T, Schabus M, Sterpenich V, Maquet P, Schwartz S . Neuroimaging insights into the pathophysiology of sleep disorders. Sleep. 2008; 31(6):777-94. PMC: 2442420. DOI: 10.1093/sleep/31.6.777. View

Leung R, Bradley T . Sleep apnea and cardiovascular disease. Am J Respir Crit Care Med. 2001; 164(12):2147-65. DOI: 10.1164/ajrccm.164.12.2107045. View

10.

Zimmerman M, Aloia M . A review of neuroimaging in obstructive sleep apnea. J Clin Sleep Med. 2007; 2(4):461-71. View

11.

Algin O, Gokalp G, Ocakoglu G, Ursavas A, Taskapilioglu O, Hakyemez B . Neurochemical-structural changes evaluation of brain in patients with obstructive sleep apnea syndrome. Eur J Radiol. 2011; 81(3):491-5. DOI: 10.1016/j.ejrad.2010.12.092. View

12.

Kamba M, Inoue Y, Higami S, Suto Y . Age-related changes in cerebral lactate metabolism in sleep-disordered breathing. Neurobiol Aging. 2003; 24(5):753-60. DOI: 10.1016/s0197-4580(02)00191-4. View

13.

Sibtain N, Howe F, Saunders D . The clinical value of proton magnetic resonance spectroscopy in adult brain tumours. Clin Radiol. 2007; 62(2):109-19. DOI: 10.1016/j.crad.2006.09.012. View

14.

Decary A, Rouleau I, Montplaisir J . Cognitive deficits associated with sleep apnea syndrome: a proposed neuropsychological test battery. Sleep. 2000; 23(3):369-81. View

15.

Papanagiotou P, Grunwald I, Farmakis G, Hartmann K, Politi M, Roth C . [Magnetic resonance spectroscopy for inflammatory brain diseases]. Radiologe. 2008; 48(6):582-7. DOI: 10.1007/s00117-008-1696-8. View

16.

Engleman H, Kingshott R, Martin S, Douglas N . Cognitive function in the sleep apnea/hypopnea syndrome (SAHS). Sleep. 2000; 23 Suppl 4:S102-8. View

17.

Mader I, Rauer S, Gall P, Klose U . (1)H MR spectroscopy of inflammation, infection and ischemia of the brain. Eur J Radiol. 2008; 67(2):250-257. DOI: 10.1016/j.ejrad.2008.02.033. View

18.

Young T, Palta M, Dempsey J, Skatrud J, Weber S, Badr S . The occurrence of sleep-disordered breathing among middle-aged adults. N Engl J Med. 1993; 328(17):1230-5. DOI: 10.1056/NEJM199304293281704. View

19.

Nagae-Poetscher L, Bonekamp D, Barker P, Brant L, Kaufmann W, Horska A . Asymmetry and gender effect in functionally lateralized cortical regions: a proton MRS imaging study. J Magn Reson Imaging. 2003; 19(1):27-33. DOI: 10.1002/jmri.10429. View

20.

Roitberg B, Khan N, Tuccar E, Kompoliti K, Chu Y, Alperin N . Chronic ischemic stroke model in cynomolgus monkeys: behavioral, neuroimaging and anatomical study. Neurol Res. 2003; 25(1):68-78. DOI: 10.1179/016164103101200950. View