期刊
PLOS ONE
卷 13, 期 3, 页码 -出版社
PUBLIC LIBRARY SCIENCE
DOI: 10.1371/journal.pone.0194204
关键词
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资金
- Fundacio CELLEX Barcelona
- Ministerio de Economia y Competitividad, Fondo Europeo de Desarrollo Regional, PHOTODEMENTIA [DPI2015-64358-C2-1-R]
- Instituto de Salud Carlos III, Fondo Europeo de Desarrollo Regional, MEDPHOTAGE [DTS16/00087]
- Severo Ochoa Programme for Centres of Excellence in RD [SEV-2015-0522]
- Obra Social la Caixa Foundation
- Institucio CERCA
- Agencia de Gestio dAjuts Universitaris i de Recerca-Generalitat [2017SGR-1380]
- LASERLAB-EUROPE IV [EU-H2020 654148]
- Marie Curie initial training network [OILTEBIA 317526]
- Societat Catalana de Pneumologia, Beca SOCAP
- Sociedad Espanola de Neumologia y Cirugia Toracica, Beca SEPAR
Motivation Obstructive sleep apnea (OSA) can impair cerebral vasoreactivity and is associated with an increased risk of cerebrovascular disease. Unfortunately, an easy-to-use, non-invasive, portable monitor of cerebral vasoreactivity does not exist. Therefore, we have evaluated the use of near-infrared diffuse correlation spectroscopy to measure the microvascular cerebral blood flow (CBF) response to a mild head-of-bed position change as a biomarker for the evaluation of cerebral vasoreactivity alteration due to chronic OSA. Furthermore, we have monitored the effect of two years of continuous positive airway pressure (CPAP) treatment on the cerebral vasoreactivity. Methodology CBF was measured at different head-of-bed position changes (supine to 30 degrees to supine) in sixty-eight patients with OSA grouped according to severity (forty moderate to severe, twenty-eight mild) and in fourteen control subjects without OSA. A subgroup (n = 13) with severe OSA was measured again after two years of CPAP treatment. Results All patients and controls showed a similar CBF response after changing position from supine to 30 degrees (p = 0.819), with a median (confidence interval) change of -17.5 (-10.3, -22.9)%. However, when being tilted back to the supine position, while the control group (p = 0.091) and the mild patients with OSA (p = 0.227) recovered to the initial baseline, patients with moderate and severe OSA did not recover to the baseline (9.8 (0.8, 12.9)%, p < 0.001) suggesting altered cerebral vasoreactivity. This alteration was correlated with OSA severity defined by the apnea-hypopnea index, and with mean nocturnal arterial oxygen saturation. The CBF response was normalized after two years of CPAP treatment upon follow-up measurements. Conclusion In conclusion, microvascular CBF response to a head-of-bed challenge measured by diffuse correlation spectroscopy suggests that moderate and severe patients with OSA have altered cerebral vasoreactivity related to OSA severity. This may normalize after two years of CPAP treatment.
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