Effect of obstructive sleep apnea on cerebrovascular compliance and cerebral small vessel disease.

Reduced cerebrovascular compliance is the major mechanism of cerebral small vessel disease (SVD). Obstructive sleep apnea (OSA) also promotes SVD development, but the underlying mechanism was not elucidated. We investigated the association among OSA, cerebrovascular compliance, and SVD parameters. T...

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Autores principales:	Woo-Jin Lee, Keun-Hwa Jung, Hyun-Woo Nam, Yong-Seok Lee
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/624b34aeed4f44ef925399ed71d38fa7
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spelling	oai:doaj.org-article:624b34aeed4f44ef925399ed71d38fa72021-12-02T20:13:15ZEffect of obstructive sleep apnea on cerebrovascular compliance and cerebral small vessel disease.1932-620310.1371/journal.pone.0259469https://doaj.org/article/624b34aeed4f44ef925399ed71d38fa72021-01-01T00:00:00Zhttps://doi.org/10.1371/journal.pone.0259469https://doaj.org/toc/1932-6203Reduced cerebrovascular compliance is the major mechanism of cerebral small vessel disease (SVD). Obstructive sleep apnea (OSA) also promotes SVD development, but the underlying mechanism was not elucidated. We investigated the association among OSA, cerebrovascular compliance, and SVD parameters. This study retrospectively included individuals ≥ 50 years of age, underwent overnight polysomnographic (PSG) for the evaluation of OSA, and performed MRI and transcranial Doppler (TCD) within 12 months of interval without a neurological event between the evaluations. TCD parameters for the cerebrovascular compliance included middle cerebral artery pulsatility index (MCA PI) and mean MCA resistance index ratio (MRIR). SVD parameters included white matter hyperintensity (WMH) volume, number of lacunes, enlarged perivascular space (ePVS) score, and the presence of microbleeds or lacunes. Ninety-seven individuals (60.8% male, mean age 70.0±10.5 years) were included. MRIR was associated with higher respiratory distress index (B = 0.003; 95% confidence interval [CI] 0.001-0.005; P = 0.021), while MCA PI was not associated with any of the PSG markers for OSA severity. Apnea-hypopnea index was associated with the log-transformed total WMH volume (B = 0.008; 95% confidence interval [CI] 0.001-0.016; P = 0.020), subcortical WMH volume (B = 0.015; 95% CI 0.007-0.022; P<0.001), total ePVS score (B = 0.024; 95% CI 0.003-0.045; P = 0.026), and centrum semiovale ePVS score (B = 0.026; 95% CI 0.004-0.048; P = 0.019), and oxygen-desaturation index with periventricular WMH volume, independently from age, MCA PI, and MRIR. This study concluded that OSA is associated with reduced cerebrovascular compliance and also with SVD independently from cerebrovascular compliance. Underlying pathomechanistic link might be region specific.Woo-Jin LeeKeun-Hwa JungHyun-Woo NamYong-Seok LeePublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 16, Iss 11, p e0259469 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Woo-Jin Lee Keun-Hwa Jung Hyun-Woo Nam Yong-Seok Lee Effect of obstructive sleep apnea on cerebrovascular compliance and cerebral small vessel disease.
description	Reduced cerebrovascular compliance is the major mechanism of cerebral small vessel disease (SVD). Obstructive sleep apnea (OSA) also promotes SVD development, but the underlying mechanism was not elucidated. We investigated the association among OSA, cerebrovascular compliance, and SVD parameters. This study retrospectively included individuals ≥ 50 years of age, underwent overnight polysomnographic (PSG) for the evaluation of OSA, and performed MRI and transcranial Doppler (TCD) within 12 months of interval without a neurological event between the evaluations. TCD parameters for the cerebrovascular compliance included middle cerebral artery pulsatility index (MCA PI) and mean MCA resistance index ratio (MRIR). SVD parameters included white matter hyperintensity (WMH) volume, number of lacunes, enlarged perivascular space (ePVS) score, and the presence of microbleeds or lacunes. Ninety-seven individuals (60.8% male, mean age 70.0±10.5 years) were included. MRIR was associated with higher respiratory distress index (B = 0.003; 95% confidence interval [CI] 0.001-0.005; P = 0.021), while MCA PI was not associated with any of the PSG markers for OSA severity. Apnea-hypopnea index was associated with the log-transformed total WMH volume (B = 0.008; 95% confidence interval [CI] 0.001-0.016; P = 0.020), subcortical WMH volume (B = 0.015; 95% CI 0.007-0.022; P<0.001), total ePVS score (B = 0.024; 95% CI 0.003-0.045; P = 0.026), and centrum semiovale ePVS score (B = 0.026; 95% CI 0.004-0.048; P = 0.019), and oxygen-desaturation index with periventricular WMH volume, independently from age, MCA PI, and MRIR. This study concluded that OSA is associated with reduced cerebrovascular compliance and also with SVD independently from cerebrovascular compliance. Underlying pathomechanistic link might be region specific.
format	article
author	Woo-Jin Lee Keun-Hwa Jung Hyun-Woo Nam Yong-Seok Lee
author_facet	Woo-Jin Lee Keun-Hwa Jung Hyun-Woo Nam Yong-Seok Lee
author_sort	Woo-Jin Lee
title	Effect of obstructive sleep apnea on cerebrovascular compliance and cerebral small vessel disease.
title_short	Effect of obstructive sleep apnea on cerebrovascular compliance and cerebral small vessel disease.
title_full	Effect of obstructive sleep apnea on cerebrovascular compliance and cerebral small vessel disease.
title_fullStr	Effect of obstructive sleep apnea on cerebrovascular compliance and cerebral small vessel disease.
title_full_unstemmed	Effect of obstructive sleep apnea on cerebrovascular compliance and cerebral small vessel disease.
title_sort	effect of obstructive sleep apnea on cerebrovascular compliance and cerebral small vessel disease.
publisher	Public Library of Science (PLoS)
publishDate	2021
url	https://doaj.org/article/624b34aeed4f44ef925399ed71d38fa7
work_keys_str_mv	AT woojinlee effectofobstructivesleepapneaoncerebrovascularcomplianceandcerebralsmallvesseldisease AT keunhwajung effectofobstructivesleepapneaoncerebrovascularcomplianceandcerebralsmallvesseldisease AT hyunwoonam effectofobstructivesleepapneaoncerebrovascularcomplianceandcerebralsmallvesseldisease AT yongseoklee effectofobstructivesleepapneaoncerebrovascularcomplianceandcerebralsmallvesseldisease
_version_	1718374769234018304

Effect of obstructive sleep apnea on cerebrovascular compliance and cerebral small vessel disease.

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