阻塞性睡眠呼吸暂停与总脑小血管病负担之间的关联——OSA的神经血管洞察
The association between obstructive sleep apnea and total cerebral small vessel disease burden-Neurovascular insights of OSA.
文献信息
| PMID | 42761555 |
|---|---|
| 原文 | 在 PubMed 查看原文 ↗ |
| 发表日期 | 2026 |
| 作者 | Rui Zhao |
| 作者单位 | Department of Sleep Medicine, Inner Mongolia Autonomous Region Mental Health Center, Hohhot, China. |
| 期刊 | Frontiers in neuroscience |
| SCI 分区 | Q2 |
| IF | 4.5 |
| 研究类型 | 临床研究 · 临床 |
| 所属专科 | 鼻科 |
中文摘要
目的： 本研究旨在评估阻塞性睡眠呼吸暂停（OSA）严重程度与脑小血管病（CSVD）总负担评分、全脑脑血流量（CBF）及认知功能之间的关系。此外，本研究还确定了OSA通过影响脑灌注和整体脑小血管病变导致认知障碍的内部通路。
方法： 本研究共纳入2024年10月至2026年2月在内蒙古自治区精神卫生中心接受多导睡眠监测（PSG）的94例患者。根据呼吸暂停低通气指数（AHI），将所有个体分为对照组和轻度组（AHI < 15次/小时，n = 26）、中度OSA组（15 ≤ AHI < 30次/小时，n = 27）和重度OSA组（AHI ≥ 30次/小时，n = 41）。收集所有患者的人口学信息，并使用简易精神状态检查（MMSE）、连线测验（TMT）、选择反应时任务（CRT）、数字符号替换任务（DSST）以及类似于连线测验B部分的范式连线测验评估其认知表现。每位患者均接受3.0T磁共振成像，包括常规序列、磁敏感加权成像（SWI）和动脉自旋标记（ASL）。最后，评估总CSVD负担评分。
结果： 重度OSA组的总CSVD负担和血管周围间隙（PVS）评分显著高于中度组和对照组（P < 0.05）。总CSVD负担与平均全脑CBF呈显著正相关（P < 0.05）。调整BMI后，OSA严重程度仍与平均全脑CBF独立相关（P < 0.05）。总CSVD负担、PVS、腔隙性梗死和全脑CBF与认知功能域显著相关（P < 0.05），这表明CSVD和全脑CBF异常可能共同参与OSA相关的认知功能。
结论： OSA的严重程度可能与CSVD负担评分相关。与OSA患者认知功能密切相关的神经影像学特征，以及异常的全脑CBF可能作为评估神经认知损伤的无创影像学标志物。
英文摘要
OBJECTIVE: This study was conducted to assess the relationship between the severity of obstructive sleep apnea (OSA) and the total burden score of cerebral small vessel disease (CSVD), global cerebral blood flow (CBF), and cognitive function. Moreover, the internal pathway through which OSA induces cognitive impairment by affecting cerebral perfusion, and overall cerebral small vessel lesions was determined in this study.
METHODS: In total, 94 patients who received polysomnography (PSG) at the Mental Health Center of Inner Mongolia Autonomous Region from October 2024 to February 2026 were included in this study. Based on the apnea-hypopnea index (AHI), all individuals were classified into the control and the mild group (AHI < 15 times/h, n = 26), the moderate OSA group (15 ≤ AHI < 30 times/h, n = 27), and the severe OSA group (AHI ≥ 30 times/h, n = 41). Demographic information was collected from all patients, and their cognitive performance was evaluated using the Mini-Mental State Examination (MMSE), Trail Making Test (TMT), Choice Reaction Time task (CRT), Digit Symbol Substitution Task (DSST), and the Trails test with a paradigm similar to Part B of the Trail Making Test. Each patient underwent 3.0T magnetic resonance imaging, including conventional sequences, susceptibility weighted imaging (SWI), and arterial spin labeling (ASL). Finally, the total CSVD burden score was assessed.
RESULTS: The total CSVD burden and perivascular space (PVS) score in the severe OSA group were significantly higher than those in the moderate group and the control group (P < 0.05). The total CSVD burden was significantly positively correlated with the mean global CBF (P < 0.05). After the BMI was adjusted, the severity of OSA remained independently associated with the mean global CBF (P < 0.05). Total CSVD burden, PVS, lacunes, and global CBF were significantly associated with cognitive function domains (P < 0.05), which indicated that CSVD and global CBF abnormalities may jointly participate in OSA-related cognitive function.
CONCLUSION: The severity of OSA might be related to the CSVD burden score. Neuroimaging characteristics strongly related to cognitive function in patients suffering from OSA, and abnormal global CBF may serve as a non-invasive imaging marker for evaluating neurocognitive damage.