Objective To investigate the structural network alterations and their correlation with cognitive impairment in patients with obstructive sleep apnea(OSA)syndrome.Methods Twenty patients with OSA and 22 age-and gender-matched healthy controls were collected as study subjects.Apnea-hypopnea index(AHI)and saturation impair time below 90%during total sleep(SIT90)were used to assess the subjects'sleep.Mini mental state examination(MMSE),montreal cognitive assessment(MoCA),and auditory verbal learning test(AVLT)were used to assess the subjects'cognitive status.Pearson's correlation analysis was used to investigate the associations between alterations in brain structural networks and cognition and sleep quality.Logistic regression was used to investigate the efficacy of brain structural network properties in i-dentifying OSA.Results Compared with healthy controls,OSA patients exhibited reduced rich-club connections,global efficiency,local efficiency,and nodal efficiency(all P<0.05).Correlation analysis showed that the rich-club connections of OSA patients was significantly correlated with MMSE score(r =0.589,P =0.006),AVLT latency score(r =0.543,P = 0.013),and AHI score(r =-0.483,P =0.031).Logistic regression showed that rich-club connections had good discrimi-native efficacy(OR =0.031)in OSA(OR =0.59,sensitivity =80%,specificity =86.4%,AUC =0.893,P<0.001).Conclusion OSA patients have characteristic structural network changes before treatment,and the rich-club connection are closely related to their cognitive and sleep status,which is expected to become a new disease marker and a target for early clinical intervention.
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