Altered cortical excitability in patients with untreated obstructive sleep apnea syndrome

Abstract Objective To investigate cortical excitability in patients with obstructive sleep apnea syndrome (OSAS) during wakefulness. Methods The authors recruited 45 untreated severe OSAS (all males, mean age 47.2 years, mean apnea–hypopnea index = 44.6 h−1 ) patients and 44 age-matched healthy male...

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Bibliographic Details
Published in:Sleep medicine 2010-10, Vol.11 (9), p.857-861
Main Authors: Joo, Eun Yeon, Kim, Hye-Jung, Lim, Yang-Hee, Koo, Dae-Lim, Hong, Seung Bong
Format: Article
Language:English
Subjects:
Case-Control Studies
Cerebral Cortex - physiopathology
Cortical excitability
Cortical silent period
Electromyography
Evoked Potentials, Motor - physiology
Humans
Male
Middle Aged
Motor Cortex - physiopathology
Motor evoked potential
Neurology
Obstructive sleep apnea syndrome
Polysomnography
Resting motor threshold
Sleep - physiology
Sleep Apnea, Obstructive - complications
Sleep Apnea, Obstructive - physiopathology
Sleep Medicine
Transcranial Magnetic Stimulation
Wakefulness - physiology
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Summary:Abstract Objective To investigate cortical excitability in patients with obstructive sleep apnea syndrome (OSAS) during wakefulness. Methods The authors recruited 45 untreated severe OSAS (all males, mean age 47.2 years, mean apnea–hypopnea index = 44.6 h−1 ) patients and 44 age-matched healthy male volunteers (mean apnea–hypopnea index = 3.4 h−1 ). The TMS parameters measured were resting motor threshold (RMT), motor evoked potential (MEP) amplitude, cortical silent period (CSP), and short-interval intracortical inhibition (SICI) and intracortical facilitation (ICF). These parameters were measured in the morning (9–10 am) more than 2 h after arising and the parameters of patients and controls were compared. The Epworth Sleepiness Scale (ESS) and the Stanford Sleepiness Scale (SSS) were also measured before the TMS study. Results OSAS patients had a significantly higher RMT and a longer CSP duration ( t -test, p < 0.001) compared to healthy volunteers. No significant difference was observed between MEP amplitudes at any stimulus intensity or between the SICI (2, 3, 5 ms) and ICF (10, 15, 20 ms) values of OSAS patients and healthy volunteers ( p > 0.05). Conclusions This TMS-based study suggests that untreated severe OSAS patients have imbalanced cortical excitabilities that enhanced inhibition or decreased brain excitability when awake during the day.
ISSN:1389-9457
1878-5506
DOI:10.1016/j.sleep.2010.02.015