Preliminary study of MK parametric map based on DKI technique in evaluating brain microstructural damage and cognitive impairment in patients with moderate and severe OSA
Objective:The mean kurtosis (MK) of diffusion kurtosis imaging (DKI) was used to investigate the changes of brain microstructural integrity and its relationship with neurocognitive impairment in adult patients with moderate and severe obstructive sleep apnea (OSA),and to explore the potential neuropathological mechanism of cognitive impairment in OSA patients. Materials and Methods:A total of 40 patients with moderate and severe OSA (OSA group) and 40 healthy controls (control group) were collected. Age,sex and years of education were matched between the two groups. Cognitive function evaluation and MRI examination were performed. The gray and white matter regions of the whole brain on the MK parameter map were extracted quantitatively by post-processing program. The differences of MK values in different brain regions between the two groups were compared. Partial correlation analysis was used to analyze the correlation between MK values and respiratory sleep parameters and cognitive scores in OSA group. Results:Compared with the control group,the MK values of 20 brain regions in the OSA patient group were decreased,including the bilateral precentral and postcentral cortex,the left cingulate,and the hippocampus,etc,and the difference was statistically significant (P<0.05,FDR correction). The total score of Montreal Cognitive Assessment (MoCA),the scores of visual space and executive function,abstract and delayed recall in the OSA group were significantly lower,the difference was statistically significant (P<0.05). The results of partial correlation analysis showed that the lowest oxygen saturation (LSaO2) was positively correlated with the MK of the right precentral gyrus,postcentral gyrus and bilateral parietal cortex (r=0.446,0.350,0.456,0.442,P<0.05) in OSA group. The delayed recall score was positively correlated with the MK of the left hippocampus (r=0.353,P<0.05). Conclusions:DKI imaging can sensitively detect the microstructural damage of brain tissue in patients with moderate and severe OSA,and the abnormal microstructural changes in some brain regions are related to cognitive dysfunction,which provides imaging basis for exploring the neuropathological mechanism of cognitive impairment in patients with OSA.
obstructive sleep apneadiffusion kurtosis imagingmean kurtosismagnetic resonance imagingcognitive function
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