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Effects of CPAP-Therapy on Brain Electrical Activity in Obstructive Sleep Apneic Patients: A Combined EEG Study Using LORETA and Omega Complexity

Reversible Alterations of Brain Activity in OSAS

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Abstract

Effects of initiation of continuous positive airway pressure (CPAP) therapy on EEG background activity were investigated in patients with obstructive sleep apnea syndrome (OSAS, N = 25) to test possible reversibility of alterations of brain electrical activity caused by chronic hypoxia. Normal control group (N = 14) was also examined. Two EEG examinations were done in each groups: at night and in the next morning. Global and regional (left vs. right, anterior vs. posterior) measures of spatial complexity (Omega complexity) were used to characterize the degree of spatial synchrony of EEG. Low resolution electromagnetic tomography (LORETA) was used to localize generators of EEG activity in separate frequency bands. Before CPAP-treatment, a significantly lower Omega complexity was found globally and over the right hemisphere. Due to CPAP-treatment, these significant differences vanished. Significantly decreased Omega complexity was found in the anterior region after treatment. LORETA showed a decreased activity in all of the beta bands after therapy in the right hippocampus, premotor and temporo-parietal cortex, and bilaterally in the precuneus, paracentral and posterior cingulate cortex. No significant changes were seen in control group. Comparing controls and patients before sleep, an increased alpha2 band activity was seen bilaterally in the precuneus, paracentral and posterior cingulate cortex, while in the morning an increased beta3 band activity in the left precentral and bilateral premotor cortex and a decreased delta band activity in the right temporo-parietal cortex and insula were observed. These findings indicate that effect of sleep on EEG background activity is different in OSAS patients and normal controls. In OSAS patients, significant changes lead to a more normal EEG after a night under CPAP-treatment. Compensatory alterations of brain electrical activity in regions associated with influencing sympathetic outflow, visuospatial abilities, long-term memory and motor performances caused by chronic hypoxia could be reversed by CPAP-therapy.

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Acknowledgments

The authors this way would like to express their gratitude to Dr. Pascual-Marqui (who works at the KEY Institute for Brain-Mind Research, in Zurich, in Switzerland) for letting available the LORETA-Key software, Dr. Wackermann at Department of Empirical and Analytical Psychophysics, Institute for Frontier Areas of Psychology and Mental Health, Freiburg, Germany also letting us accessible the Omega complexity software. Finally, the authors would like to thank for providing their help in the use of these programs.

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  1. Department of Neurology, University of Pécs, Pécs, Rét utca 2, 7623, Hungary

    Marton Toth & Bela Faludi

  2. Department of Neurology, Teaching County Hospital Bács-Kiskun, Kecskemét, Nyíri út 38, 6000, Hungary

    Istvan Kondakor

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  1. Marton Toth
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  2. Bela Faludi
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Correspondence to Marton Toth.

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Toth, M., Faludi, B. & Kondakor, I. Effects of CPAP-Therapy on Brain Electrical Activity in Obstructive Sleep Apneic Patients: A Combined EEG Study Using LORETA and Omega Complexity. Brain Topogr 25, 450–460 (2012). https://doi.org/10.1007/s10548-012-0243-0

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