The Relevant Research Of Cognition Impairment Of Obstructive Sleep Apnea Hypopnea Syndrome With Cerebral Small Vascular Disease Patients

Background: Obstructive sleep apnea hypopnea syndrome(OSAHS)is an important risk factor for cognitive dysfunction,which is also one of the main clinical manifestations of cerebral small vessel disease(CSVD).However,little is known about the cognitive influence of CSVD patients with OSAHS.Thus,we focused on the CSVD patients with OSAHS,aimed to explore the effects of cognitive influence and neuroimaging mechanism in patients of OSAHS with CSVD and providing new ideas for improving the cognitive prognosis.Methods:From October 2021 to February 2023,totally 20 CSVD patients with mild OSAHS(CSVD-m OSAHS group)and 20 CSVD patients with moderate and severe OSAHS(CSVDms OSAHS group)were enrolled in this study at Nanjing Drum Tower Hospital.We explored the differences between the two groups in demographic data,sleep monitoring indicators,neuropsychological scale scores,CSVD neuroimaging features,and fractional amplitude of lowfrequency fluctuation(f ALFF),and also explore the correlation between sleep monitoring indicators,neuroimaging parameters,and neuropsychological scale scores.Results: The cognitive performance of CSVD patients with moderate and severe OSAHS was generally worse than that of CSVD patients with mild OSAHS,especially in terms of orientation.Compared with patients with CSVD and mild OSAHS,patients with CSVD and moderate and severe OSAHS had a significant decrease in f ALFF in the right orbital superior frontal gyrus.Correlation analysis showed that both CSVD neuroimaging features and the degree of nocturnal sleep hypopnea and hypoxia were significantly correlated with general cognitive function and multiple cognitive domain functions.In the CSVD-ms OSAHS group,(1)the max duration of hypopnea was significantly negatively correlated with the orientation score in the MMSE(r =-0.487,P = 0.034);(2)the f ALFF of the right orbital superior frontal gyrus was significantly positively correlated with the minimal oxygen saturation(r = 0.514,P = 0.020),negatively correlated with the max apnea duration(r =-0.659,P = 0.002),and positively correlated with location orientation(r = 0.462,P = 0.040),as well as visuospatial and executive function(r = 0.554,P = 0.011).Conclusion: OSAHS aggravated cognitive impairment in patients with CSVD,and the right orbital superior frontal gyrus cortex might be the key brain region for it.