White Matter Microstructure and Connectivity Changes After Surgery in Male Adults with Obstructive Sleep Apnea: Recovery or Reorganization?

Overview

Journal Front Neurosci

Date 2023 Oct 16

PMID 37841681

Authors

Yaqiong Chai

Hea Ree Park

Hyunjin Jo

Min Young Seo

Hyo Yeol Kim

Eun Yeon Joo

Hosung Kim

Affiliations

Soon will be listed here.

Abstract

Study Objectives: Obstructive sleep apnea (OSA) is a prevalent clinical problem significantly affecting cognitive functions. Surgical treatment is recommended for those unable to use continuous positive airway pressure. We aimed to investigate the therapeutic effect of upper airway surgery on the white matter (WM) microstructure and brain connectivity in patients with OSA.

Methods: Twenty-one male patients with moderate-to-severe OSA were recruited for multi-level upper airway surgery. Overnight polysomnography (PSG), neuropsychiatric tests, and brain MRI scans were acquired before and 6.1 ± 0.8 months after surgery. Nineteen male patients with untreated OSA were also included as a reference group. We calculated the longitudinal changes of diffusion tensor imaging (DTI) parameters, including fractional anisotropy (ΔFA) and mean/axial/radial diffusivity (ΔMD/AD/RD). We also assessed changes in network properties based on graph theory.

Results: Surgically treated patients showed improvement in PSG parameters and verbal memory after surgery. Globally, ΔFA was significantly higher and ΔRD was lower in the surgery group than in the untreated group. Especially ΔFA of the tracts involved in the limbic system was higher after surgery. In network analysis, higher Δbetweenness and lower Δclustering coefficients were observed in the surgical group than in the untreated group. Finally, the improvement of verbal memory after surgery positively correlated with ΔFA in superior thalamic radiation ( = 0.021), fronto aslant tracts ( = 0.027), and forceps minor tracts ( = 0.032).

Conclusion: Surgical treatment of OSA can alleviate alterations in WM integrity and disruptions in local networks, particularly for the tracts involved in the limbic system. These findings may further explain the cognitive improvement observed after the treatment of OSA.

Citing Articles

Potential mechanism of impaired perceptual reasoning in children with obstructive sleep apnea syndrome: topological analysis of brain white matter network employing graph theory.

Tan W, Zhang S, Wang X, Lin G, Ye W, Zeng H Brain Imaging Behav. 2025; .

PMID: 40053277 DOI: 10.1007/s11682-025-00988-w.

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