Childhood obstructive sleep apnea associates with neuropsychological deficits and neuronal brain injury

被引:248
作者
Halbower, Ann C. [1 ]
Degaonkar, Mahaveer
Barker, Peter B.
Earley, Christopher J.
Marcus, Carole L.
Smith, Philip L.
Prahme, M. Cristine
Mahone, E. Mark
机构
[1] Johns Hopkins Univ, Sch Med, Dept Pediat, Baltimore, MD 21205 USA
[2] Johns Hopkins Univ, Sch Med, Dept Radiol, Baltimore, MD 21205 USA
[3] Kennedy Krieger Inst, FM Kirby Ctr Funct Brain Imaging, Baltimore, MD 21205 USA
[4] Johns Hopkins Univ, Sch Med, Dept Neurol, Baltimore, MD 21205 USA
[5] Univ Penn, Dept Pediat, Philadelphia, PA 19104 USA
[6] Johns Hopkins Univ, Sch Med, Dept Med, Baltimore, MD 21205 USA
[7] Kennedy Krieger Inst, Dept Neuropsychol, Baltimore, MD USA
[8] Johns Hopkins Univ, Sch Med, Dept Psychiat, Baltimore, MD 21205 USA
关键词
D O I
10.1371/journal.pmed.0030301
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Background Childhood obstructive sleep apnea (OSA) is associated with neuropsychological deficits of memory, learning, and executive function. There is no evidence of neuronal brain injury in children with OSA. We hypothesized that childhood OSA is associated with neuropsychological performance dysfunction, and with neuronal metabolite alterations in the brain, indicative of neuronal injury in areas corresponding to neuropsychological function. Methods and Findings We conducted a cross-sectional study of 31 children ( 19 with OSA and 12 healthy controls, aged 6 - 16 y) group-matched by age, ethnicity, gender, and socioeconomic status. Participants underwent polysomnography and neuropsychological assessments. Proton magnetic resonance spectroscopic imaging was performed on a subset of children with OSA and on matched controls. Neuropsychological test scores and mean neuronal metabolite ratios of target brain areas were compared. Relative to controls, children with severe OSA had significant deficits in IQ and executive functions ( verbal working memory and verbal fluency). Children with OSA demonstrated decreases of the mean neuronal metabolite ratio N-acetyl aspartate/choline in the left hippocampus ( controls: 1.29, standard deviation [SD] 0.21; OSA: 0.91, SD 0.05; p = 0.001) and right frontal cortex (controls: 2.2, SD 0.4; OSA: 1.6, SD 0.4; p = 0.03). Conclusions Childhood OSA is associated with deficits of IQ and executive function and also with possible neuronal injury in the hippocampus and frontal cortex. We speculate that untreated childhood OSA could permanently alter a developing child's cognitive potential.
引用
收藏
页码:1391 / 1402
页数:12
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