Evaluation Of Brain Functional Changes In Patients With Obstructive Sleep Apnea-hypopnea Syndrome After Uvulopalatopharyngoplasty Based On Amplitude Of Low-frequency Fluctuation

Objective : To investigate the changes of low-frequency fluctuation after uvulopalatopharyngoplasty(UPPP)in patients with moderate-to-severe obstructive sleep apnea-hypopnea syndrome(OSAHS)using rs-fMRI.Methods:Thirteen untreated moderate-to-severe OSAHS and twenty age-matched and years-of education-matched healthy controls underwent resting-state functional magnetic resonance imaging(rs-fMRI).As well as,these thirteen untreated moderate-to-severe OSAHS would accept the UPPP operations and follow-up six months after surgery with rs-fMRI.The ALFF method was used to assess the local features of spontaneous brain activity.Partial correlation analysis was used to explore the relationship between the observed mean ALFF values of the different areas and sleep apnea hypopnea index(AHI),oxygen saturation index(ODI),body mass index(BMI),the cognitive scale score as sample mental scale(MMSE)and sleepiness scale(ESS),complex figure test scale(CFT),CFT-delay,logical memory test scale(LMT),LMT-delay.Results:Compared with healthy controls,moderate-to-severe OSAHS of preoperative group had significantly higher scores for BMI,AHI,ODI and had lower scores for CFT-immediate recall;The preoperative group showed significant higher ALFF areas in the right parahippocampal gyrus,temporal lobe,right fusiform gyrus and lower ALFF areas in the bilateral precuneus and posterior cingulate cortex.Futhermore,there were positive correlations between BMI and ALFF in bilateral precuneus(r=-0.604,p =0.029).Compared with the preoperative group,postoperative group had significantly lower scores for AHI,ODI and had higher scores for ESS and CFT-delay recall score;It showed significant higher ALFF areas in the right angular gyrus,supramarginal gyrus,superior temporal gyrus,left posterior cingulate cortex and left precuneus.Conclusion: The changes of ALFF in moderate-to-severe OSAHS showed compensatory and damaging changes in the corresponding brain regions,suggesting that neurosensory dysfunction.UPPP surgery improves the hypoxia of OSAHS,reflecting the therapeutic effect of the surgery from the function of brain.