How does obstructive sleep apnea alter cerebral hemodynamics?
Por:
Gregori-Pla, C, Zirak, P, Cotta, G, Bramon, P, Blanco, I, Serra, I, Mola, A, Fortuna, A, Sola-Soler, J, Giraldo, BFG, Durduran, T, Mayos, M
Publicada:
19 jun 2023
Ahead of Print:
1 jun 2023
Resumen:
Study Objectives We aimed to characterize the cerebral hemodynamic response to obstructive sleep apnea/hypopnea events, and evaluate their association to polysomnographic parameters. The characterization of the cerebral hemodynamics in obstructive sleep apnea (OSA) may add complementary information to further the understanding of the severity of the syndrome beyond the conventional polysomnography. Methods Severe OSA patients were studied during night sleep while monitored by polysomnography. Transcranial, bed-side diffuse correlation spectroscopy (DCS) and frequency-domain near-infrared diffuse correlation spectroscopy (NIRS-DOS) were used to follow microvascular cerebral hemodynamics in the frontal lobes of the cerebral cortex. Changes in cerebral blood flow (CBF), total hemoglobin concentration (THC), and cerebral blood oxygen saturation (StO(2)) were analyzed. Results We considered 3283 obstructive apnea/hypopnea events from sixteen OSA patients (Age (median, interquartile range) 57 (52-64.5); females 25%; AHI (apnea-hypopnea index) 84.4 (76.1-93.7)). A biphasic response (maximum/minimum followed by a minimum/maximum) was observed for each cerebral hemodynamic variable (CBF, THC, StO(2)), heart rate and peripheral arterial oxygen saturation (SpO(2)). Changes of the StO(2) followed the dynamics of the SpO(2), and were out of phase from the THC and CBF. Longer events were associated with larger CBF changes, faster responses and slower recoveries. Moreover, the extrema of the response to obstructive hypopneas were lower compared to apneas (p < .001). Conclusions Obstructive apneas/hypopneas cause profound, periodic changes in cerebral hemodynamics, including periods of hyper- and hypo-perfusion and intermittent cerebral hypoxia. The duration of the events is a strong determinant of the cerebral hemodynamic response, which is more pronounced in apnea than hypopnea events.
Filiaciones:
Gregori-Pla, C:
Barcelona Inst Sci & Technol, ICFO Inst Ciencies Foton, Ave Carl Friedrich Gauss 3, Castelldefels 08860, Barcelona, Spain
Zirak, P:
Barcelona Inst Sci & Technol, ICFO Inst Ciencies Foton, Ave Carl Friedrich Gauss 3, Castelldefels 08860, Barcelona, Spain
Cotta, G:
Barcelona Inst Sci & Technol, ICFO Inst Ciencies Foton, Ave Carl Friedrich Gauss 3, Castelldefels 08860, Barcelona, Spain
Bramon, P:
Barcelona Inst Sci & Technol, ICFO Inst Ciencies Foton, Ave Carl Friedrich Gauss 3, Castelldefels 08860, Barcelona, Spain
Blanco, I:
Barcelona Inst Sci & Technol, ICFO Inst Ciencies Foton, Ave Carl Friedrich Gauss 3, Castelldefels 08860, Barcelona, Spain
Serra, I:
Univ Autonoma Barcelona, Dept Matemat, Fac Ciencies, Cerdanyola Del Valles 08193, Barcelona, Spain
Barcelona Supercomp Ctr, Comp Architecture & Operating Syst, Placa Eusebi Guell 1-3, Barcelona 08034, Spain
Mola, A:
Hosp Santa Creu & Sant Pau, Dept Resp Med, Sleep Unit, C Sant Quinti 89, Barcelona 08041, Spain
Fortuna, A:
Hosp Santa Creu & Sant Pau, Dept Resp Med, Sleep Unit, C Sant Quinti 89, Barcelona 08041, Spain
Sola-Soler, J:
Univ Politecn Catalunya UPC, Barcelona Tech, Automat Control Dept ESAII, Barcelona 08028, Spain
Barcelona Inst Sci & Technol, Inst Bioengn Catalonia IBEC, Barcelona 08019, Spain
Ctr Invest Biomed Red Bioingn Biomat & Nanomed CI, Zaragoza 50018, Spain
Giraldo, BFG:
Univ Politecn Catalunya UPC, Barcelona Tech, Automat Control Dept ESAII, Barcelona 08028, Spain
Barcelona Inst Sci & Technol, Inst Bioengn Catalonia IBEC, Barcelona 08019, Spain
Ctr Invest Biomed Red Bioingn Biomat & Nanomed CI, Zaragoza 50018, Spain
Durduran, T:
Barcelona Inst Sci & Technol, ICFO Inst Ciencies Foton, Ave Carl Friedrich Gauss 3, Castelldefels 08860, Barcelona, Spain
Inst Catalana Recerca & Estudis Avancats ICREA, Passeig De Lluis Companys 23, Barcelona 08010, Spain
Mayos, M:
Hosp Santa Creu & Sant Pau, Dept Resp Med, Sleep Unit, C Sant Quinti 89, Barcelona 08041, Spain
CIBER Enfermedades Resps CibeRes, CB06-06,C Montforte Lemos 3-5, Madrid 28029, Spain
hybrid, All Open Access; Hybrid Gold
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