Abstract

Abstract Introduction Obstructive sleep apnea (OSA) has significant effects on quality of life and may lead to cognitive impairments. Continuous positive airway pressure (CPAP) is the standard treatment for OSA, and has been shown to improve sleep disturbances and daytime dysfunction. In this study, we aimed to assess the effects of CPAP on white matter (WM) integrity using longitudinal diffusion tensor imaging (DTI) tests. Methods Twenty-two male patients with moderate to severe OSA were recruited and underwent DTI scanning before and 6-44 months after CPAP treatment. Sixteen male patients with untreated OSA who were not compliant with CPAP were included as a reference group. We compared the functional anisotropy (FA) values between baseline and follow-up MRI in both the CPAP and untreated groups using tract-specific statistical analysis (TSSA) method. Results The TSSA analysis showed that FA values in the middle part of the right CST were increased after treatment in the CPAP group. No significant change in FA value was observed between baseline and post-scan in the untreated group. In the CPAP group, the post-treatment FA value in the anterior part of the right ATR was significantly correlated with durations of CPAP therapy after controlling for age, body mass index, and baseline FA value. Conclusion Our study suggests that long-term CPAP treatment could gradually reverse OSA-induced injury to the WM microstructure, particularly WM associated with the motor and limbic systems. The study findings provide new insights into the mechanisms of cognitive improvement after CPAP treatment in patients with OSA. Support (if any)

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