Global brain blood-oxygen level responses to autonomic challenges in obstructive sleep apnea

Obstructive sleep apnea (OSA) is accompanied by brain injury, perhaps resulting from apnea-related hypoxia or periods of impaired cerebral perfusion. Perfusion changes can be determined indirectly by evaluation of cerebral blood volume and oxygenation alterations, which can be measured rapidly and n...

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Bibliographic Details
Published in:	PloS one 2014-08, Vol.9 (8), p.e105261-e105261
Main Authors:	Macey, Paul M, Kumar, Rajesh, Ogren, Jennifer A, Woo, Mary A, Harper, Ronald M
Format:	Article
Language:	eng
Subjects:	Adult Age Apnea Autonomic Nervous System - metabolism Autonomic Nervous System - physiopathology Biology and Life Sciences Blood Blood flow Blood pressure Blood Pressure - physiology Blood volume Brain Brain - metabolism Brain - physiopathology Brain injury Brain research Cerebral blood flow Cerebrovascular Circulation - physiology Circulatory system Cold pressing Female Females Functional magnetic resonance imaging Head injuries Heart Rate - physiology Humans Hypoxia Magnetic resonance Magnetic Resonance Imaging Male Males Medicine and Health Sciences Middle Aged Neuroimaging NMR Nuclear magnetic resonance Oxygen Oxygen - blood Oxygenation Perfusion Research and Analysis Methods Sex Factors Sexually transmitted diseases Sleep Sleep apnea Sleep Apnea, Obstructive - metabolism Sleep Apnea, Obstructive - physiopathology Sleep disorders Standard error STD Variance analysis
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Summary:	Obstructive sleep apnea (OSA) is accompanied by brain injury, perhaps resulting from apnea-related hypoxia or periods of impaired cerebral perfusion. Perfusion changes can be determined indirectly by evaluation of cerebral blood volume and oxygenation alterations, which can be measured rapidly and non-invasively with the global blood oxygen level dependent (BOLD) signal, a magnetic resonance imaging procedure. We assessed acute BOLD responses in OSA subjects to pressor challenges that elicit cerebral blood flow changes, using a two-group comparative design with healthy subjects as a reference. We separately assessed female and male patterns, since OSA characteristics and brain injury differ between sexes. We studied 94 subjects, 37 with newly-diagnosed, untreated OSA (6 female (age mean ± std: 52.1±8.1 yrs; apnea/hypopnea index [AHI]: 27.7±15.6 events/hr and 31 male 54.3±8.4 yrs; AHI: 37.4±19.6 events/hr), and 20 female (age 50.5±8.1 yrs) and 37 male (age 45.6±9.2 yrs) healthy control subjects. We measured brain BOLD responses every 2 s while subjects underwent cold pressor, hand grip, and Valsalva maneuver challenges. The global BOLD signal rapidly changed after the first 2 s of each challenge, and differed in magnitude between groups to two challenges (cold pressor, hand grip), but not to the Valsalva maneuver (repeated measures ANOVA, p
ISSN:	1932-6203 1932-6203