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. 2022:36:103235.
doi: 10.1016/j.nicl.2022.103235. Epub 2022 Oct 17.

Medial temporal lobe and obstructive sleep apnea: Effect of sex, age, cognitive status and free-water

Marie-Ève Martineau-Dussault  1 , Claire André  1 , Véronique Daneault  2 , Andrée-Ann Baril  3 , Katia Gagnon  4 , Hélène Blais  5 , Dominique Petit  6 , Jacques Y Montplaisir  6 , Dominique Lorrain  7 , Célyne Bastien  8 , Carol Hudon  8 , Maxime Descoteaux  9 , Arnaud Boré  10 , Guillaume Theaud  9 , Cynthia Thompson  5 , Julie Legault  1 , Guillermo E Martinez Villar  1 , Alexandre Lafrenière  1 , Chantal Lafond  11 , Danielle Gilbert  12 , Julie Carrier  13 , Nadia Gosselin  14
Affiliations

Medial temporal lobe and obstructive sleep apnea: Effect of sex, age, cognitive status and free-water

Marie-Ève Martineau-Dussault et al. Neuroimage Clin. 2022.

Abstract

Medial temporal structures, namely the hippocampus, the entorhinal cortex and the parahippocampal gyrus, are particularly vulnerable to Alzheimer's disease and hypoxemia. Here, we tested the associations between obstructive sleep apnea (OSA) severity and medial temporal lobe volumes in 114 participants aged 55-86 years (35 % women). We also investigated the impact of sex, age, cognitive status, and free-water fraction correction on these associations. Increased OSA severity was associated with larger hippocampal and entorhinal cortex volumes in women, but not in men. Greater OSA severity also correlated with increased hippocampal volumes in participants with amnestic mild cognitive impairment, but not in cognitively unimpaired participants, regardless of sex. Using free-water corrected volumes eliminated all significant associations with OSA severity. Therefore, the increase in medial temporal subregion volumes may possibly be due to edema. Whether these structural manifestations further progress to neuronal death in non-treated OSA patients should be investigated.

Keywords: Entorhinal cortex; Hippocampus; Mild cognitive impairment; Sex differences; Sleep-disordered breathing.

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Conflict of interest statement

Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Figures

Fig. 1
Fig. 1
Study participants flow chart. PSG = Polysomnography; MRI = Magnetic resonance imaging; RBD = Rapid eye movement sleep behavior disorder; OSA = Obstructive sleep apnea. naMCI: non-amnestic mild cognitive impairment.
Fig. 2
Fig. 2
Associations between hypoxemia severity and entorhinal cortex by age groups. Legend: Panel A presents uncorrected grey matter volumes of the entorhinal cortex in younger (<68 yo) and older participants (≥68 yo) obtained at p < 0.05 corrected for multiple comparisons with a family-wise error correction. Panel B presents the FW-corrected volumes. All volumes were corrected for TIV (volume/TIV*1000). Covariates included in the multiple linear regressions were sex and education. OSA = obstructive sleep apnea; FW = free-water; TIV = total intracranial volume; yo = years old.
Fig. 3
Fig. 3
Associations between OSA severity markers and medial temporal volumes in women and men. Legend: Panel A shows uncorrected grey matter volumes of the hippocampi (upper) and entorhinal cortex (lower) in women and men, obtained at p < 0.05 corrected for multiple comparisons with a family-wise error correction. Panel B presents the FW-corrected volumes. All volumes were corrected for TIV (volume/TIV*1000). Covariates included in the multiple linear regressions were age and education. OSA = obstructive sleep apnea; FW = free-water; TIV = total intracranial volume.
Fig. 4
Fig. 4
Associations between hypoxemia and hippocampal volumes in aMCI participants and controls. Legend: Panel A shows uncorrected volumes of the bilateral hippocampus, obtained at p < 0.05 corrected for multiple comparisons with a family-wise error correction in participants with aMCI only. No association remained significant between any markers of OSA severity and FW-corrected volumes (panel B). All volumes are TIV-normalized (volume/TIV*1000). Covariates included in the multiple linear regressions were age, education and sex. OSA = obstructive sleep apnea; FW = free-water; aMCI = amnestic mild cognitive impairment, TIV = total intracranial volume.
See this image and copyright information in PMC

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