MRI evaluation of cerebrovascular reactivity in obstructive sleep apnea
Autor: | Wensheng Guo, Zachary B. Rodgers, Ana E. Rodríguez-Soto, Michael C. Langham, Pei-Hsin Wu, A S Wiemken, Felix W. Wehrli, Erin K. Englund, John A. Detre, Richard Schwab |
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Rok vydání: | 2019 |
Předmět: |
Adult
Male medicine.medical_specialty Intermittent obstruction 030204 cardiovascular system & hematology Breath Holding 03 medical and health sciences 0302 clinical medicine Cerebrovascular reactivity Internal medicine Medicine Humans Aged Sleep Apnea Obstructive business.industry Brain Original Articles Middle Aged medicine.disease Sleep in non-human animals Magnetic Resonance Imaging Obstructive sleep apnea Neurology Cerebrovascular Circulation Cardiology Female Neurology (clinical) Cardiology and Cardiovascular Medicine business 030217 neurology & neurosurgery |
Zdroj: | J Cereb Blood Flow Metab |
ISSN: | 1559-7016 |
Popis: | Obstructive sleep apnea (OSA) is characterized by intermittent obstruction of the airways during sleep. Cerebrovascular reactivity (CVR) is an index of cerebral vessels' ability to respond to a vasoactive stimulus, such as increased CO2. We hypothesized that OSA alters CVR, expressed as a breath-hold index (BHI) defined as the rate of change in CBF or BOLD signal during a controlled breath-hold stimulus mimicking spontaneous apneas by being both hypercapnic and hypoxic. In 37 OSA and 23 matched non sleep apnea (NSA) subjects, we obtained high temporal resolution CBF and BOLD MRI data before, during, and between five consecutive BH stimuli of 24 s, each averaged to yield a single BHI value. Greater BHI was observed in OSA relative to NSA as derived from whole-brain CBF (78.6 ± 29.6 vs. 60.0 ± 20.0 mL/min2/100 g, P = 0.010) as well as from flow velocity in the superior sagittal sinus (0.48 ± 0.18 vs. 0.36 ± 0.10 cm/s2, P = 0.014). Similarly, BOLD-based BHI was greater in OSA in whole brain (0.19 ± 0.08 vs. 0.15 ± 0.03%/s, P = 0.009), gray matter (0.22 ± 0.09 vs. 0.17 ± 0.03%/s, P = 0.011), and white matter (0.14 ± 0.06 vs. 0.10 ± 0.02%/s, P = 0.010). The greater CVR is not currently understood but may represent a compensatory mechanism of the brain to maintain oxygen supply during intermittent apneas. |
Databáze: | OpenAIRE |
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