Factors affecting executive functions in obstructive sleep apnea syndrome and volumetric changes in the prefrontal cortex

Purpose Obstructive sleep apnea syndrome (OSAS) is associated with cognitive changes and executive functions are among the cognitive domains most affected. However, it is not completely understood which of the factor(s) among hypoxemia, repeated arousal, and sleepiness affect the executive functions...

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Published in:SpringerPlus 2016-11, Vol.5 (1), p.1934-1934, Article 1934
Main Authors: Yılmaz, Zahide, Voyvoda, Nuray, İnan, Eda, Şirinocak, Pınar Bekdik, Terzi, Rabia
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description Purpose Obstructive sleep apnea syndrome (OSAS) is associated with cognitive changes and executive functions are among the cognitive domains most affected. However, it is not completely understood which of the factor(s) among hypoxemia, repeated arousal, and sleepiness affect the executive functions. This study aims to evaluate the possible relationship between the executive functions and nocturnal parameters, Epworth Sleepiness Scale (ESS) scores, and prefrontal cortex (PFC) volumes. Patients and methods A total of 28 patients aged between 18 and 60 years who were newly diagnosed with OSAS were included in this study. The Wisconsin Card Sorting Test (WCST) and Stroop test which were used in the evaluation of executive functions were applied to all patients. Cranial magnetic resonance imaging (MRI) and volumetric measurements of the PFC were performed. Polysomnography (PSG), WCST, Stroop test, and cranial MRI were also applied to the control group which consisted of age- and education status-matched 15 healthy subjects. The correlation of WCST and Stroop tests and PFC volume, PSG parameters, and ESS scale was examined. Results The WCST-6 test scores were statistically significantly higher in the patient group (p = 0.022; p 
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However, it is not completely understood which of the factor(s) among hypoxemia, repeated arousal, and sleepiness affect the executive functions. This study aims to evaluate the possible relationship between the executive functions and nocturnal parameters, Epworth Sleepiness Scale (ESS) scores, and prefrontal cortex (PFC) volumes. Patients and methods A total of 28 patients aged between 18 and 60 years who were newly diagnosed with OSAS were included in this study. The Wisconsin Card Sorting Test (WCST) and Stroop test which were used in the evaluation of executive functions were applied to all patients. Cranial magnetic resonance imaging (MRI) and volumetric measurements of the PFC were performed. Polysomnography (PSG), WCST, Stroop test, and cranial MRI were also applied to the control group which consisted of age- and education status-matched 15 healthy subjects. The correlation of WCST and Stroop tests and PFC volume, PSG parameters, and ESS scale was examined. Results The WCST-6 test scores were statistically significantly higher in the patient group (p = 0.022; p &lt; 0.05). Additionally, the Stroop test 5 (p = 0.043) and Stroop test-5 correction (p = 0.005) measurements were statistically significantly higher in the patient group (p &lt; 0.05). A negative and statistically significant correlation was found between the WCST-4 and WCST-10 and ESS measurements in the patient group (r −0.452; p 0.016; p &lt; 0.05; r −0.437; p 0.020; p &lt; 0.05). However, there was no correlation between the PSG parameters and WCST and Stroop test scores. No statistically significant differences in the MRI volumetric measurements of the PFC were found between the patient and control groups. Conclusions Impairment in the attentive and executive functions in OSAS is evident. The most influential factor is excessive daytime sleepiness, rather than hypoxemia and severity of the disease.</description><identifier>ISSN: 2193-1801</identifier><identifier>EISSN: 2193-1801</identifier><identifier>DOI: 10.1186/s40064-016-3609-z</identifier><identifier>PMID: 27872798</identifier><language>eng</language><publisher>Cham: Springer International Publishing</publisher><subject>Humanities and Social Sciences ; Medicine ; multidisciplinary ; Science ; Science (multidisciplinary)</subject><ispartof>SpringerPlus, 2016-11, Vol.5 (1), p.1934-1934, Article 1934</ispartof><rights>The Author(s) 2016</rights><rights>SpringerPlus is a copyright of Springer, 2016.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c470t-5e3c91ca216346f2f79175bb963a1d30449f5072c142f940b88c3c9e97fa69603</citedby><cites>FETCH-LOGICAL-c470t-5e3c91ca216346f2f79175bb963a1d30449f5072c142f940b88c3c9e97fa69603</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC5101245/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC5101245/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,723,776,780,881,27901,27902,53766,53768</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/27872798$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Yılmaz, Zahide</creatorcontrib><creatorcontrib>Voyvoda, Nuray</creatorcontrib><creatorcontrib>İnan, Eda</creatorcontrib><creatorcontrib>Şirinocak, Pınar Bekdik</creatorcontrib><creatorcontrib>Terzi, Rabia</creatorcontrib><title>Factors affecting executive functions in obstructive sleep apnea syndrome and volumetric changes in the prefrontal cortex</title><title>SpringerPlus</title><addtitle>SpringerPlus</addtitle><addtitle>Springerplus</addtitle><description>Purpose Obstructive sleep apnea syndrome (OSAS) is associated with cognitive changes and executive functions are among the cognitive domains most affected. However, it is not completely understood which of the factor(s) among hypoxemia, repeated arousal, and sleepiness affect the executive functions. This study aims to evaluate the possible relationship between the executive functions and nocturnal parameters, Epworth Sleepiness Scale (ESS) scores, and prefrontal cortex (PFC) volumes. Patients and methods A total of 28 patients aged between 18 and 60 years who were newly diagnosed with OSAS were included in this study. The Wisconsin Card Sorting Test (WCST) and Stroop test which were used in the evaluation of executive functions were applied to all patients. Cranial magnetic resonance imaging (MRI) and volumetric measurements of the PFC were performed. Polysomnography (PSG), WCST, Stroop test, and cranial MRI were also applied to the control group which consisted of age- and education status-matched 15 healthy subjects. The correlation of WCST and Stroop tests and PFC volume, PSG parameters, and ESS scale was examined. Results The WCST-6 test scores were statistically significantly higher in the patient group (p = 0.022; p &lt; 0.05). Additionally, the Stroop test 5 (p = 0.043) and Stroop test-5 correction (p = 0.005) measurements were statistically significantly higher in the patient group (p &lt; 0.05). A negative and statistically significant correlation was found between the WCST-4 and WCST-10 and ESS measurements in the patient group (r −0.452; p 0.016; p &lt; 0.05; r −0.437; p 0.020; p &lt; 0.05). However, there was no correlation between the PSG parameters and WCST and Stroop test scores. No statistically significant differences in the MRI volumetric measurements of the PFC were found between the patient and control groups. Conclusions Impairment in the attentive and executive functions in OSAS is evident. 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However, it is not completely understood which of the factor(s) among hypoxemia, repeated arousal, and sleepiness affect the executive functions. This study aims to evaluate the possible relationship between the executive functions and nocturnal parameters, Epworth Sleepiness Scale (ESS) scores, and prefrontal cortex (PFC) volumes. Patients and methods A total of 28 patients aged between 18 and 60 years who were newly diagnosed with OSAS were included in this study. The Wisconsin Card Sorting Test (WCST) and Stroop test which were used in the evaluation of executive functions were applied to all patients. Cranial magnetic resonance imaging (MRI) and volumetric measurements of the PFC were performed. Polysomnography (PSG), WCST, Stroop test, and cranial MRI were also applied to the control group which consisted of age- and education status-matched 15 healthy subjects. The correlation of WCST and Stroop tests and PFC volume, PSG parameters, and ESS scale was examined. Results The WCST-6 test scores were statistically significantly higher in the patient group (p = 0.022; p &lt; 0.05). Additionally, the Stroop test 5 (p = 0.043) and Stroop test-5 correction (p = 0.005) measurements were statistically significantly higher in the patient group (p &lt; 0.05). A negative and statistically significant correlation was found between the WCST-4 and WCST-10 and ESS measurements in the patient group (r −0.452; p 0.016; p &lt; 0.05; r −0.437; p 0.020; p &lt; 0.05). However, there was no correlation between the PSG parameters and WCST and Stroop test scores. No statistically significant differences in the MRI volumetric measurements of the PFC were found between the patient and control groups. Conclusions Impairment in the attentive and executive functions in OSAS is evident. 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Medicine
multidisciplinary
Science
Science (multidisciplinary)
title Factors affecting executive functions in obstructive sleep apnea syndrome and volumetric changes in the prefrontal cortex
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