Network Centrality Alterations In Obstructive Sleep Apnea Patients Before And After Continuous Positive Airway Pressure Treatment

Objectives:This study aimed to explored the characteristics of brain network changes in OSA patients before(pre-CPAP)and after one month of CPAP treatment(post-CPAP)and analyzed the relationship between these changes with clinical characteristics.Methods:21 OSA patients diagnosed by polysomnography(PSG)in the first affiliated Hospital of Nanchang University and 21 age-and sex-matched healthy controls(HC)were recruited in this study.All subjects underwent resting functional magnetic resonance imaging(f MRI)scans and clinical scale assessments,repeat scans and assessments were performed after 1 month of standard CPAP treatment in OSA patients.Voxel-level degree centrality(DC)was used to assess whole-brain network connectivity characteristics,a two-sample t-test was used to compare network differences between pre-CPAP OSA patients and HC,and a paired sample t-test was used to compare the characteristics of brain network changes in OSA patients before and after treatment.The correlations between the DC value and each of the clinical variables were analyzed in the OSA patients.Results:Compared with HC,pre-CPAP OSA patients showed increased DC value in the bilateral cerebellar posterior lobes(CPL)and decreased DC value in the right superior temporal gyrus,left superior frontal gyrus and right middle frontal gyrus.Compared with pre-CPAP OSA patients,post-CPAP OSA patients showed reduced DC value in the bilateral CPL and increased DC values in several brain regions in the frontal,temporal,and insular lobes after CPAP treatment.DC value in the right middle temporal gyrus of pre-CPAP OSA patients were positively correlated with the minimum oxygen saturation(min Sa O2),DC value in the left superior temporal gyrus were negatively correlated with Hamilton Anxiety Inventory(HAMA)scores,DC value in the left precentral and middle frontal gyrus were negatively correlated with Pittsburgh Sleep Quality Index(PSQI)and Hamilton Depression Scale(HAMD)scores,The DC value of the left middle frontal gyrus was negatively correlated with the Epworth Sleepiness Scale(ESS)score.The Montreal Cognitive Assessment(Mo CA)scores were positively correlated with the DC value of the bilateral cerebellum posterior lobe,right middle temporal gyrus,left superior temporal gyrus,left paracentral lobule and left paracentral lobule.Also,Pittsburgh Sleep Quality Index(PSQI)scores were negatively correlated with the DC value of the right middle temporal gyrus in post-CPAP OSA patients.Conclusion:CPAP treatment can effectively reverse the compensatory response of the bilateral CPL and functional network damage brought about by OSA,which may provide potential neuroimaging biomarkers for CPAP treatment evaluation.