Volumetric brain magnetic resonance imaging analysis in children with obstructive sleep apnea

Mary Frances Musso; Hannah M Lindsey; Elisabeth A Wilde; Jill V Hunter; Daniel G Glaze; Naomi J Goodrich-Hunsaker; Trevor C Wu; Garrett Black; Brian Biekman; Wei Zhang; Huirong Zhu; Grace Shebha Anand; Ellen M Friedman

doi:10.1016/j.ijporl.2020.110369

Volumetric brain magnetic resonance imaging analysis in children with obstructive sleep apnea

Int J Pediatr Otorhinolaryngol. 2020 Nov:138:110369. doi: 10.1016/j.ijporl.2020.110369. Epub 2020 Sep 7.

Authors

Affiliations

¹ Department of Otolaryngology and Head and Neck Surgery, Baylor College of Medicine, Houston, TX, USA; Department of Pediatric Otolaryngology and Head and Neck Surgery, Texas Children's Hospital, Houston, TX, USA. Electronic address: mxmusso@texaschildrens.org.
² Department of Neurology, University of Utah, Salt Lake City, UT, USA; Department of Psychology, Brigham Young University, Provo, UT, USA.
³ Department of Neurology, University of Utah, Salt Lake City, UT, USA; H. Ben Taub Department of Physical Medicine & Rehabilitation, Baylor College of Medicine, Houston, TX, USA; Department of Radiology, Baylor College of Medicine, Houston, TX, USA; Department of Neurology, Baylor College of Medicine, Houston, TX, USA.
⁴ H. Ben Taub Department of Physical Medicine & Rehabilitation, Baylor College of Medicine, Houston, TX, USA; Department of Radiology, Baylor College of Medicine, Houston, TX, USA; Department of Pediatric Radiology, Texas Children's Hospital, Houston, TX, USA.
⁵ Department of Pediatrics, Texas Children's Hospital, Houston, TX, USA; Department of Neurology, Texas Children's Hospital, Houston, TX, USA; Department of Pediatrics, Baylor College of Medicine, Houston, TX, USA; Department of Neurology, Baylor College of Medicine, Houston, TX, USA.
⁶ H. Ben Taub Department of Physical Medicine & Rehabilitation, Baylor College of Medicine, Houston, TX, USA; Hauenstein Neurosciences, Mercy Health St. Mary's, Grand Rapids, MI, USA; Department of Translational Science and Molecular Medicine, Michigan State University, MI, USA.
⁷ H. Ben Taub Department of Physical Medicine & Rehabilitation, Baylor College of Medicine, Houston, TX, USA.
⁸ Department of Pediatric Otolaryngology and Head and Neck Surgery, Texas Children's Hospital, Houston, TX, USA.
⁹ Department of Otolaryngology and Head and Neck Surgery, Baylor College of Medicine, Houston, TX, USA; Department of Pediatric Otolaryngology and Head and Neck Surgery, Texas Children's Hospital, Houston, TX, USA.

PMID: 32927352
DOI: 10.1016/j.ijporl.2020.110369

Abstract

Objectives: Pediatric Obstructive Sleep Apnea (OSA) is associated with neurocognitive deficits. Cerebral structural alterations in the frontal cortex, cerebellum, and hippocampus have been reported in adult OSA patients. These brain areas are important for executive functioning, motor regulation of breathing, and memory function, respectively. Corresponding evidence comparing cerebral structures in pediatric OSA patients is limited. The objective of this study is to investigate MRI differences in cortical thickness and cortical volume in children with and without OSA.

Study design: Prospective, single institutional case-control study.

Methods: Forty-five children were recruited at a pediatric tertiary care center (27 with OSA; mean age 9.9 ± 1.9 years, and 18 controls; mean age 10.5 ± 1.0 years). The OSA group underwent magnetic resonance imaging (MRI), polysomnography (PSG) and completed the Pediatric Daytime Sleepiness Scale (PDSS) and the Child's Sleep Habits Questionnaire (CSHQ). High-resolution T1-weighted MRI was utilized to examine cortical thickness and gray and white matter volume in children with OSA compared to a healthy group of demographically-comparable children without OSA selected from a pre-existing MRI dataset.

Results: Children with OSA showed multiple regions of cortical thinning primarily in the left hemisphere. Reduced gray matter (GM) volume was noted in the OSA group in multiple frontal regions of the left hemisphere (superior frontal, rostral medial frontal, and caudal medial frontal regions). Reduced white matter (WM) volume in both the left and right hemisphere was observed in regions of the frontal, parietal, and occipital lobes in children with OSA.

Conclusion: This study noted differences in cortical thickness and GM and WM regional brain volumes in children with OSA. These findings are consistent with other pediatric studies, which also report differences between healthy children and those with OSA. We found that the severity of OSA does not correlate with the extent of MRI alterations.

Keywords: Brain volume; MRI; Obstructive sleep apnea; Pediatric.

MeSH terms

Brain Cortical Thickness*
Case-Control Studies
Child
Female
Gray Matter / diagnostic imaging
Gray Matter / pathology*
Humans
Magnetic Resonance Imaging
Male
Organ Size
Polysomnography
Prospective Studies
Sleep Apnea, Obstructive / diagnostic imaging
Sleep Apnea, Obstructive / pathology*
White Matter / diagnostic imaging
White Matter / pathology*