阻塞性睡眠呼吸暂停的脑影像研究：来自静息态脑电和功能磁共振的证据

The brain imaging studies of obstructive sleep apnea: evidence from resting-state EEG and fMRI

阻塞性睡眠呼吸暂停(obstructive sleep apnea, OSA)是一种常见的临床睡眠障碍,表现为上呼吸道在睡眠时反复阻塞,并导致睡眠片段化、间歇性低血氧等症状。本文回顾了针对OSA患者的静息态脑成像研究,包括静息态脑电(electroencephalography, EEG)和静息态功能磁共振成像(functional magnetic resonance imaging, fMRI)。在静息态EEG中,OSA主要表现为前额叶和中央区域δ波和θ波增加;而在静息态fMRI研究中,OSA患者在默认网络(default-mode network, DMN)、中央执行网络(central executive network, CEN)和突显网络(salience network, SN)等大尺度脑网络水平上存在改变。综合来自静息态EEG和静息态fMRI的研究,大量证据都共同指出OSA患者前额叶区域的活动异常,并且其异常活动强度与OSA严重程度相关,表明前额叶是OSA患者大脑功能受损的一个关键脑区。最后,本文从治疗效果、多模态数据采集、以及相关共病等方面对OSA未来研究方向进行了展望。

Obstructive sleep apnea(OSA) is a common clinic sleep disorder, and characterized by obstruction of upper airway during sleep, resulting in sleep fragmentation and intermittent hypoxemia. We reviewed the brain imaging studies in OSA patients compared with healthy subjects, including studies of functional magnetic resonance imaging(fMRI) and electroencephalography(EEG). The resting-state EEG studies showed increased power of δ and θ in the front and central regions of the cerebral cortex in OSA patients. While resting-state fMRI studies demonstrated altered large-scale networks in default-mode network(DMN), central executive network(CEN) and salience network(SN). Evidence from resting-state studies of both fMRI and EEG focused on the abnormal activity in prefrontal cortex(PFC), which is correlated with OSA severity. These findings suggested that the PFC may play a key role in the abnormal function of OSA patients. Finally, based on the perspectives of treatment effect, multimodal data acquisition, and comorbidities, we discussed the future research direction of the neuroimaging study of OSA.