The effect of positive airway pressure therapy on neurocognitive functions, depression and anxiety in obesity hypoventilation syndrome

Abstract

BACKGROUND: The aim of this study is to evaluate the presence of neurocognitive dysfunctions, depression and anxiety and the effect of positive airway pressure (PAP) therapy on these parameters in OHS patients. METHODS: Ten healthy normal and obese controls, 10 OHS and 10 OSAS patients were included in the study. Short form-36, Beck Depression Scale and State-Trade Anxiety Inventory (STAI 1-2) were performed. Wisconsin Card Sorting Test (WCST), Montreal Cognitive Assessment Scale (MOCA), Enhanced Cued Recall (ECR) and Mini Mental Test (MMT) were used for neurocognitive evaluation. All tests were repeated after one night PAP therapy in patient groups. RESULTS: OHS patients had the lowest scores of physical functioning (PF) and social functioning (SF) in SF-36. The total numbers of perseverative errors and incorrect answers were highest in OHS group in WCST. The scores of MOCA, ECR and MMT were lower than controls (p=0,00). Depression and anxiety scores were higher in OHS group than controls (p=0,00) while they were similar in OSAS. There was a significant increase of the number of completed categories in OHS after PAP therapy (p=0,03). Also there were significant increases of MOCA, ECR and MMT and significant decreases of depression and anxiety scores with respect to PAP therapy. CONCLUSIONS: Cognitive dysfunction, depression and anxiety are important underrecognized comorbidities in OHS. It is suggested that short-term PAP therapy had positive effects on neurocognitive functions, depression and anxiety but further multicentre, prospective studies with large number of cases are needed to evaluate the effect of long term PAP therapy on these parameters.