Early Signs of Cognitive Impairment in Patients with Obstructive Sleep Apnea Hypopnea Syndrome: An Event-Related Potential Study_Journal of Biomedical Engineering

Authors：

ZOUKe ¹ , SUNYuanfeng ¹ , TANGXiangdong ¹ , LEIFei ¹ , DULina ¹ , CHENZhesi ² , YANTingting ³ ,  ZHENGZhong ¹

1. Sleep Medicine Center, West China Hospital, Sichuan University, Chengdu 610041, China;
2. Acupuncture and Moxibustion College, Chengdu University of Traditional Chinese Medicine, Chengdu 610072, China;
3. Institute for Disaster Management and Reconstruction, Sichuan University-Hong Kong Polytechnic University, Chengdu 610065, China;

Corresponding author：

ZHENGZhong, Email: zhengzhong1963@163.com

Keywords：

obstructive sleep apnea hypopnea syndrome; cognitive impairment; event related potential

DOI：

10.7507/1001-5515.20140164

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This study seeks to explore the early signs of cognitive impairment in patients with obstructive sleep apnea hypopnea syndrome (OSAHS). According to polysomnography, twenty patients diagnosed with OSAHS and twenty normal controls underwent event-related potential (ERP) examination including mismatch negativity (MMN) and P₃₀₀. Compared with normal controls, OSAHS patients showed significantly prolonged latency of MMN and P₃₀₀ at Cz. After controlling age and body mass index (BMI), MMN latency positively correlated with apnea hypopnea index (AHI), oxygen reduction index, stage N1 sleep and arousal index, while MMN latency negatively correlated with stage N3 sleep and mean blood oxygen saturation; and P₃₀₀ latency positively related to AHI and oxygen reduction index; no relationships were found among MMN latency, MMN amplitude, P₃₀₀ latency and P₃₀₀ amplitude. These results suggest that the brain function of automatic processing and controlled processing aere impaired in OSAHS patients, and these dysfunction are correlated with nocturnal repeatedly hypoxemia and sleep structure disturbance.

Citation： ZOUKe, SUNYuanfeng, TANGXiangdong, LEIFei, DULina, CHENZhesi, YANTingting, ZHENGZhong. Early Signs of Cognitive Impairment in Patients with Obstructive Sleep Apnea Hypopnea Syndrome: An Event-Related Potential Study. Journal of Biomedical Engineering, 2014, 31(4): 870-874. doi: 10.7507/1001-5515.20140164 Copy

1.	PUNJABI N M. The epidemiology of adult obstructive sleep apnea[J]. Proc Am Thorac Soc, 2008, 5(2):136-143.
2.	JORDAN A S, MCEVOY R D, EDWARDS J K, et al. The influence of gender and upper airway resistance on the ventilatory response to arousal in obstructive sleep apnoea in humans[J]. J Physiol, 2004, 558(Pt 3): 993-1004.
3.	ALOIA M S, ARNEDT J T, DAVIS J D, et al. Neuropsychological sequelae of obstructive sleep apnea-hypopnea syndrome: a critical review[J]. J Int Neuropsychol Soc, 2004, 10(5): 772-785.
4.	BEEBE D W, GROESZ L, WELLS C, et al. The neuropsychological effects of obstructive sleep apnea: a meta-analysis of norm-referenced and case-controlled data[J]. Sleep, 2003, 26(3): 298-307.
5.	辛忠海,王宁宇,李金兰,等.中青年OSAHS患者缺氧程度与认知功能损害的相关性研究[J]. 听力学及言语疾病杂志,2009,17(3):231-234.
6.	刘萍,邓丽影,刘昊,等.阻塞性睡眠呼吸暂停低通气综合征患者的认知功能评估[J]. 江西医学院学报,2009,49(3):115-117.
7.	INOUE Y, NANBA K, KOJIMA K, et al. P₃₀₀ abnormalities in patients with severe sleep apnea syndrome[J]. Psychiat Clin Neurosci, 2001, 55(3): 247-248.
8.	MARTINS C H, CASTRO JÚNIOR N D, COSTA FILHO O A, et al. Obstructive sleep apnea and P₃₀₀ evoked auditory potential[J]. Braz J Otorhinolaryngol, 2011, 77(6): 700-705.
9.	WEN X H, WANG N Y, LIU J F, et al. Detection of cognitive impairment in patients with obstructive sleep apnea hypopnea syndrome using mismatch negativity[J]. Neural Regen Res, 2012, 7(20): 1591-1598.
10.	GOSSELIN N, MATHIEU A, MAZZA S, et al. Attentional deficits in patients with obstructive sleep apnea syndrome: an event-related potential study[J]. Clin Neurophysiol, 2006, 117(10): 2228-2235.
11.	NÄÄTÄNEN R, WINKLER I. The concept of auditory stimulus representation in cognitive neuroscience[J]. Psychol Bull, 1999, 125(6): 826-859.
12.	SATEIA M J. Neuropsychological impairment and quality of life in obstructive sleep apnea[J]. Clin Chest Med, 2003, 24(2): 249-259.
13.	MOLHOLM S, MARTINEZ A, RITTER W, et al. The neural circuitry of pre-attentive auditory change-detection: an fMRI study of pitch and duration mismatch negativity generators[J]. Cereb Cortex, 2005, 15(5): 545-551.
14.	YAOUHI K, BERTRAN F, CLOCHON P, et al. A combined neuropsychological and brain imaging study of obstructive sleep apnea[J]. J Sleep Res, 2009, 18(1): 36-48.
15.	潘志杰,刘微波,张玲菊,等.阻塞性睡眠呼吸暂停综合征事件相关电位和记忆功能的相关性[J].中华结核和呼吸杂志,2011,34(10):749-752.
16.	NAEGELE B, PEPIN J L, LEVY P, et al. Cognitive executive dysfunction in patients with obstructive sleep apnea syndrome (OSAS) after CPAP treatment[J]. Sleep, 1998, 21(4): 392-397.

1. PUNJABI N M. The epidemiology of adult obstructive sleep apnea[J]. Proc Am Thorac Soc, 2008, 5(2):136-143.
2. JORDAN A S, MCEVOY R D, EDWARDS J K, et al. The influence of gender and upper airway resistance on the ventilatory response to arousal in obstructive sleep apnoea in humans[J]. J Physiol, 2004, 558(Pt 3): 993-1004.
3. ALOIA M S, ARNEDT J T, DAVIS J D, et al. Neuropsychological sequelae of obstructive sleep apnea-hypopnea syndrome: a critical review[J]. J Int Neuropsychol Soc, 2004, 10(5): 772-785.
4. BEEBE D W, GROESZ L, WELLS C, et al. The neuropsychological effects of obstructive sleep apnea: a meta-analysis of norm-referenced and case-controlled data[J]. Sleep, 2003, 26(3): 298-307.
5. 辛忠海,王宁宇,李金兰,等.中青年OSAHS患者缺氧程度与认知功能损害的相关性研究[J]. 听力学及言语疾病杂志,2009,17(3):231-234.
6. 刘萍,邓丽影,刘昊,等.阻塞性睡眠呼吸暂停低通气综合征患者的认知功能评估[J]. 江西医学院学报,2009,49(3):115-117.
7. INOUE Y, NANBA K, KOJIMA K, et al. P₃₀₀ abnormalities in patients with severe sleep apnea syndrome[J]. Psychiat Clin Neurosci, 2001, 55(3): 247-248.
8. MARTINS C H, CASTRO JÚNIOR N D, COSTA FILHO O A, et al. Obstructive sleep apnea and P₃₀₀ evoked auditory potential[J]. Braz J Otorhinolaryngol, 2011, 77(6): 700-705.
9. WEN X H, WANG N Y, LIU J F, et al. Detection of cognitive impairment in patients with obstructive sleep apnea hypopnea syndrome using mismatch negativity[J]. Neural Regen Res, 2012, 7(20): 1591-1598.
10. GOSSELIN N, MATHIEU A, MAZZA S, et al. Attentional deficits in patients with obstructive sleep apnea syndrome: an event-related potential study[J]. Clin Neurophysiol, 2006, 117(10): 2228-2235.
11. NÄÄTÄNEN R, WINKLER I. The concept of auditory stimulus representation in cognitive neuroscience[J]. Psychol Bull, 1999, 125(6): 826-859.
12. SATEIA M J. Neuropsychological impairment and quality of life in obstructive sleep apnea[J]. Clin Chest Med, 2003, 24(2): 249-259.
13. MOLHOLM S, MARTINEZ A, RITTER W, et al. The neural circuitry of pre-attentive auditory change-detection: an fMRI study of pitch and duration mismatch negativity generators[J]. Cereb Cortex, 2005, 15(5): 545-551.
14. YAOUHI K, BERTRAN F, CLOCHON P, et al. A combined neuropsychological and brain imaging study of obstructive sleep apnea[J]. J Sleep Res, 2009, 18(1): 36-48.
15. 潘志杰,刘微波,张玲菊,等.阻塞性睡眠呼吸暂停综合征事件相关电位和记忆功能的相关性[J].中华结核和呼吸杂志,2011,34(10):749-752.
16. NAEGELE B, PEPIN J L, LEVY P, et al. Cognitive executive dysfunction in patients with obstructive sleep apnea syndrome (OSAS) after CPAP treatment[J]. Sleep, 1998, 21(4): 392-397.

Journal of Biomedical Engineering

Early Signs of Cognitive Impairment in Patients with Obstructive Sleep Apnea Hypopnea Syndrome: An Event-Related Potential Study

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