阻塞性睡眠呼吸暂停病人嗜睡的脑功能默认网络与认知功能损害机制

项目名称： 阻塞性睡眠呼吸暂停病人嗜睡的脑功能默认网络与认知功能损害机制

项目编号： No.81500072

项目类型： 青年科学基金项目

立项/批准年度： 2016

项目学科： 医药、卫生

项目作者： 李哲

作者单位： 电子科技大学

项目金额： 18万元

中文摘要： 嗜睡与认知功能损害是阻塞性睡眠呼吸暂停（OSA）病人常见的脑功能受损症状，但中枢机制不甚清楚。功能磁共振采集的人体在静息态下的默认模式网络（DMN）反映的是大脑处于无任务基线状态时，一些脑区存在的有规律和较强烈自发活动现象。DMN采集时对人体状态的要求与反映客观嗜睡水平的多次小睡测试（MSLT）的方法学非常类似。脑影像学技术发现OSA病人白天静息态下的异常脑区与睡眠剥夺后1和2期，甚至3期睡眠发生的脑区有较多重叠。因此推测，DMN可能敏感的探测到基于MSLT判断的OSA嗜睡相关的异常脑区和脑网络连接。本研究中，我们将采用MSLT判断的OSA嗜睡与不嗜睡病人的比较及CPAP治疗后前后的比较，用DMN探测同嗜睡可能相关的异常脑区和连接及同认知功能测量结果的关系，探讨OSA嗜睡发生的脑网络机制及对认知功能的影响。研究结果将增加我们对OSA嗜睡和认知功能损害机制的了解，为进一步的诊疗策略提供资料。

中文关键词： 阻塞性睡眠呼吸暂停；日间嗜睡；默认网络；认知功能；日间多次睡眠潜伏期测量

英文摘要： Excessive daytime sleepiness (EDS) and impairment of cognitive function are among the often seen symptoms in the patients with obstructive sleep apnea (OSA), but the mechanisms of central nerve system remain unclear. Default mode network (DMN) obtained by functional magnetic resonance imaging in resting state reflects regular functioning connections and intensively spontaneous activity across different brain regions under the condition that the brain without task processing in baseline state. The methods for DMN data obtaining are very similar to the protocols of multiple daytime sleepiness test (MSLT) in the requirement of the subjects’ conditions. It has been demonstrated that patients with OSA had similar abnormal brain regions to those related to inducing sleep stages 1, 2 and even 3 after sleep deprivation. Therefore, we speculate that DMN may sensitively detect the abnormal brain regions and connections which are related to EDS determined by MSLT in patients with OSA. In the current proposal, we plan to compare OSA patients between with and without EDS based on MSLT and between before and after therapy of continuous positive airway pressure (CPAP), utilizing DMN to determine the possible abnormal brain regions and connections, and their relationship to outcomes of cognitive function tasks, in order to explore the mechanisms of brain networks inducing EDS and their impact on the cognitive function. The outcomes of the research will increase our understanding to the mechanisms of EDS and impairment of cognitive function in patients with OSA and will be valuable in further development of diagnosis and treatment strategy.

英文关键词： Obstructive Sleep Apnea;Excessive Daytime Sleepiness;Default Mode Network;Cognitive Function;Multiple Daytime Sleepiness Test