Cerebral vasoreactivity in response to a head-of-bed position change is altered in patients with moderate and severe obstructive sleep apnea
Gregori-Pla, Clara (Institut de Ciències Fotòniques)
Cotta, Gianluca (Institut de Ciències Fotòniques)
Blanco, Igor (Institut de Ciències Fotòniques)
Zirak, Peyman (Institut de Ciències Fotòniques)
Giovannella, Martina (Institut de Ciències Fotòniques)
Mola, Anna (Institut d'Investigació Biomèdica Sant Pau)
Fortuna Gutiérrez, Ana Mª (Institut d'Investigació Biomèdica Sant Pau)
Durduran, Turgut (Institució Catalana de Recerca i Estudis Avançats)
Mayos, Mercè (Institut d'Investigació Biomèdica Sant Pau)
Universitat Autònoma de Barcelona

Date:	2018
Abstract:	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. CBF was measured at different head-of-bed position changes (supine to 30° 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. All patients and controls showed a similar CBF response after changing position from supine to 30° (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. 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.
Grants:	Ministerio de Economía y Competitividad DPI2015-64358-C2-1-R Ministerio de Economía y Competitividad DTS16/00087 Ministerio de Economía y Competitividad SEV-2015-0522
Rights:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, fins i tot amb finalitats comercials, sempre i quan es reconegui l'autoria de l'obra original.
Language:	Anglès
Document:	Article ; recerca ; Versió publicada
Published in:	PloS one, Vol. 13 Núm. 3 (march 2018) , p. e0194204, ISSN 1932-6203

DOI: 10.1371/journal.pone.0194204
PMID: 29538409

16 p, 1.1 MB

The record appears in these collections:
Research literature > UAB research groups literature > Research Centres and Groups (research output) > Health sciences and biosciences > Institut de Recerca Sant Pau
Articles > Research articles
Articles > Published articles