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Associations between hypoxia parameters in obstructive sleep apnea and cognition, cortical thickness, and white matter integrity in middle-aged and older adults

  • Neurology • Original Article
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Abstract

Objective

This study aimed to investigate the association between each parameter of intermittent hypoxia in obstructive sleep apnea (OSA) and the cognitive profile, cortical thickness, and white matter integrity in middle-aged and older adults.

Methodology

Participants were newly diagnosed with moderate or severe OSA from the King Chulalongkorn Memorial Hospital, Bangkok, Thailand. Respiratory parameters from polysomnography were extracted. Each participant was tested on a battery of neuropsychological tests and underwent an MRI scan of the brain. Cortical thickness analysis and diffusion tensor imaging analysis were performed. Participants were classified as having either severe or mild hypoxia based on parameters of hypoxia, i.e., oxygen desaturation index, lowest oxygen saturation, and the percentage of total sleep time spent below 90% oxygen saturation.

Results

Of 17 patients with OSA, there were 8 men (47%). Median age was 57 years and median AHI was 60.6. Comparison of cortical thickness between the severe and the mild group of each hypoxic parameter revealed two clusters of cortical thinning at the right inferior frontal gyrus (p-value = 0.008) and right inferior parietal gyrus (p-value = 0.006) in the severe desaturation group and a cluster of cortical thinning at the superior parietal gyrus (p-value = 0.008) in the high oxygen desaturation index group. There was no difference in cognitive function or white matter integrity between groups.

Conclusions

The magnitude of the degree and frequency of desaturations in OSA are associated with a decrease in cortical thickness at the frontal and parietal regions.

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Funding

This study was funded by Ratchadapisek Sompotch Endowment Fund, Faculty of Medicine, Chulalongkorn University, Grant No. RA 62/065.

Author information

Authors and Affiliations

  1. Division of Neurology, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Bangkok, Thailand

    Anthipa Chokesuwattanaskul, Yuttachai Sarutikriangkri, Chaipat Chunharas, Kammant Phanthumchinda & Yuttachai Likitjaroen

  2. King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok, Thailand

    Anthipa Chokesuwattanaskul & Chaipat Chunharas

  3. Chulalongkorn Cognitive Clinical and Computational Research Group, Chulalongkorn University, Bangkok, Thailand

    Anthipa Chokesuwattanaskul & Chaipat Chunharas

  4. Division of Pulmonary and Critical Care Medicine, Department of Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand

    Naricha Chirakalwasan & Nattapong Jaimchariyatam

  5. Excellence Center for Sleep Disorders, King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok, Thailand

    Naricha Chirakalwasan & Nattapong Jaimchariyatam

  6. Department of Radiology, King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok, Thailand

    Nantaporn Pitakvej

Authors
  1. Anthipa Chokesuwattanaskul
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  2. Naricha Chirakalwasan
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Contributions

Conception and design of the study: A.C., N.C., Y.L., K.P.

Acquisition and analysis of the data: A.C., N.C., N.J., N.P., Y.S., C.C.

Drafting and revision of the manuscript: A.C., N.C., Y.L.

All authors reviewed and approved the final version of the manuscript.

Corresponding author

Correspondence to Anthipa Chokesuwattanaskul.

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Conflict of interest

All authors declare that they do not have any financial or non-financial potential conflicts of interest.

Ethics approval

All procedures performed in this study were in accordance with the ethical standards of the Faculty of Medicine, Chulalongkorn University Institutional Review Board, and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study.

Data and code availability

Not applicable.

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Chokesuwattanaskul, A., Chirakalwasan, N., Jaimchariyatam, N. et al. Associations between hypoxia parameters in obstructive sleep apnea and cognition, cortical thickness, and white matter integrity in middle-aged and older adults. Sleep Breath 25, 1559–1570 (2021). https://doi.org/10.1007/s11325-020-02215-w

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  • DOI: https://doi.org/10.1007/s11325-020-02215-w

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