Association Between Brain-derived Neurotrophic Factor Levels and Obstructive Sleep Apnea: a Systematic Review and Meta-analysis

Overview

Journal Sleep Breath

Publisher Springer

Date 2022 Sep 17

PMID 36115874

Authors

Amirmohammad Khalaji

Amir Hossein Behnoush

Parnian Shobeiri

Behrad Saeedian

Antonio L Teixeira

Nima Rezaei

Affiliations

Soon will be listed here.

Abstract

Purpose: Chronic intermittent hypoxia associated with obstructive sleep apnea (OSA) can affect neurons and glial cells, leading to cell stress and damage, and changes in brain-derived neurotrophic factor (BDNF) levels. This study investigated the relation between BDNF, OSA, and continuous positive airway pressure (CPAP) - the standard of care in patients with OSA.

Methods: Five databases were searched for studies that evaluated BDNF serum and/or plasma levels in patients with OSA and controls or publications assessing the effect of CPAP treatment on BDNF levels. We used standardized mean difference (SMD) with its 95% confidence interval (CI) comparison between patients with OSA and controls.

Results: Ten studies were included in our study assessing the relation between BDNF levels, OSA, and CPAP treatment. Five studies of BDNF levels in OSA compared to controls showed no significant difference (SMD = - 0.52, 95% CI [- 1.93; 0.89], p-value = 0.47). No statistically significant difference was found between CPAP treatment in patients with OSA and BDNF levels (SMD = - 0.78, 95% CI [- 1.77; 0.21], p-value = 0.12).

Conclusion: BDNF peripheral levels are not significantly altered in OSA or by its related treatment, preventing its use as a biomarker.

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References

Franklin K, Lindberg E . Obstructive sleep apnea is a common disorder in the population-a review on the epidemiology of sleep apnea. J Thorac Dis. 2015; 7(8):1311-22. PMC: 4561280. DOI: 10.3978/j.issn.2072-1439.2015.06.11. View

Fietze I, Laharnar N, Obst A, Ewert R, Felix S, Garcia C . Prevalence and association analysis of obstructive sleep apnea with gender and age differences - Results of SHIP-Trend. J Sleep Res. 2018; 28(5):e12770. DOI: 10.1111/jsr.12770. View

Benjafield A, Ayas N, Eastwood P, Heinzer R, Ip M, Morrell M . Estimation of the global prevalence and burden of obstructive sleep apnoea: a literature-based analysis. Lancet Respir Med. 2019; 7(8):687-698. PMC: 7007763. DOI: 10.1016/S2213-2600(19)30198-5. View

Boyd S, Walters A . Effectiveness of treatment apnea-hypopnea index: a mathematical estimate of the true apnea-hypopnea index in the home setting. J Oral Maxillofac Surg. 2012; 71(2):351-7. PMC: 3488138. DOI: 10.1016/j.joms.2012.05.009. View

Bagai K, Muldowney 3rd J, Song Y, Wang L, Bagai J, Artibee K . Circadian variability of fibrinolytic markers and endothelial function in patients with obstructive sleep apnea. Sleep. 2014; 37(2):359-67. PMC: 3900618. DOI: 10.5665/sleep.3414. View

Papaioannou I, Twigg G, Kemp M, Roughton M, Hooper J, Morrell M . Melatonin concentration as a marker of the circadian phase in patients with obstructive sleep apnoea. Sleep Med. 2011; 13(2):167-71. DOI: 10.1016/j.sleep.2011.01.020. View

Azagra-Calero E, Espinar-Escalona E, Barrera-Mora J, Llamas-Carreras J, Solano-Reina E . Obstructive sleep apnea syndrome (OSAS). Review of the literature. Med Oral Patol Oral Cir Bucal. 2012; 17(6):e925-9. PMC: 3505711. DOI: 10.4317/medoral.17706. View

Flores K, Viccaro F, Aquilini M, Scarpino S, Ronchetti F, Mancini R . Protective role of brain derived neurotrophic factor (BDNF) in obstructive sleep apnea syndrome (OSAS) patients. PLoS One. 2020; 15(1):e0227834. PMC: 6968866. DOI: 10.1371/journal.pone.0227834. View

Beebe D, Gozal D . Obstructive sleep apnea and the prefrontal cortex: towards a comprehensive model linking nocturnal upper airway obstruction to daytime cognitive and behavioral deficits. J Sleep Res. 2002; 11(1):1-16. DOI: 10.1046/j.1365-2869.2002.00289.x. View

10.

Staats R, Stoll P, Zingler D, Virchow J, Lommatzsch M . Regulation of brain-derived neurotrophic factor (BDNF) during sleep apnoea treatment. Thorax. 2005; 60(8):688-92. PMC: 1747491. DOI: 10.1136/thx.2004.038208. View

11.

Ning Y, Zhang T, Wen W, Li K, Yang Y, Qin Y . Effects of continuous positive airway pressure on cardiovascular biomarkers in patients with obstructive sleep apnea: a meta-analysis of randomized controlled trials. Sleep Breath. 2018; 23(1):77-86. DOI: 10.1007/s11325-018-1662-2. View

12.

Autry A, Monteggia L . Brain-derived neurotrophic factor and neuropsychiatric disorders. Pharmacol Rev. 2012; 64(2):238-58. PMC: 3310485. DOI: 10.1124/pr.111.005108. View

13.

Binder D, Scharfman H . Brain-derived neurotrophic factor. Growth Factors. 2004; 22(3):123-31. PMC: 2504526. DOI: 10.1080/08977190410001723308. View

14.

Cunha C, Brambilla R, Thomas K . A simple role for BDNF in learning and memory?. Front Mol Neurosci. 2010; 3:1. PMC: 2821174. DOI: 10.3389/neuro.02.001.2010. View

15.

Duman R, Malberg J, Nakagawa S, DSa C . Neuronal plasticity and survival in mood disorders. Biol Psychiatry. 2000; 48(8):732-9. DOI: 10.1016/s0006-3223(00)00935-5. View

16.

Faraguna U, Vyazovskiy V, Nelson A, Tononi G, Cirelli C . A causal role for brain-derived neurotrophic factor in the homeostatic regulation of sleep. J Neurosci. 2008; 28(15):4088-95. PMC: 2597531. DOI: 10.1523/JNEUROSCI.5510-07.2008. View

17.

Brzecka A . Brain preconditioning and obstructive sleep apnea syndrome. Acta Neurobiol Exp (Wars). 2005; 65(2):213-20. DOI: 10.55782/ane-2005-1558. View

18.

Egan M, Kojima M, Callicott J, Goldberg T, Kolachana B, Bertolino A . The BDNF val66met polymorphism affects activity-dependent secretion of BDNF and human memory and hippocampal function. Cell. 2003; 112(2):257-69. DOI: 10.1016/s0092-8674(03)00035-7. View

19.

Chen B, Dowlatshahi D, MacQueen G, Wang J, Young L . Increased hippocampal BDNF immunoreactivity in subjects treated with antidepressant medication. Biol Psychiatry. 2001; 50(4):260-5. DOI: 10.1016/s0006-3223(01)01083-6. View

20.

Tsai J . Neurological and neurobehavioral sequelae of obstructive sleep apnea. NeuroRehabilitation. 2010; 26(1):85-94. DOI: 10.3233/NRE-2010-0538. View