The evaluation on mild cognitive dysfunction and behavior change in patients with obstructive sleep apnea hypopnea syndrome based on event related potential

Abstract

Objective To investigate the mild cognitive impairment and behavior changes measured by neuropsychological test scale evaluation and the P300 of ERP in the patients with obstructive sleep apnea hypopnea syndrome (OSAHS).Methods A prospective study with 10 moderate to 26 severe OSAHS patients and 17 controls were carried out to determine whether the participants have mild cognitive impairment (MCI) by Montreal cognitive assessment scale (MoCA).Parallel Epworth sleepiness scale (ESS),Hamilton Anxiety Scale (HAMA),Hamilton Depression Scale (HAMD),symptom checklist 90 and P300,respectively,in patients with moderate,severe OSAHS group and normal control group to compare their cognitive function and behavior change.Correlation and multiple linear regression analysis between MoCA score,P300 parameters and the correlation with ESS score.Results In moderate to severe OSAHS patients in Cz,C3,C4,P300 latency was significantly prolonged compared with normal control group (F =4.164,4.018,3.960,P ＜0.05) ;MoCA score of severe OSAHS group (25.42±2.76) was significantly prolonged (F =3.954,P ＜0.01) than that of the normal control group (27.41±1.80).The MoCA analysis showed that memory/delayed recall score of the severe group (2.81 ± 0.98) was significantly decreased than the normal control group (4.06 ± 0.97,Z =13.075,P ＜0.01).The HAMA scores of the moderate and severe group were significantly higher than the normal group (F =3.576,P ＜0.05).The HAMD scores of the severe group were also significantly higher than the normal group (F =3.487,P ＜0.05).Correlation analysis showed that Fz,Cz,Pz,C3,C4,P300 latency and MoCA score was negatively correlated (r =-0.422,-0.410,-0.374,-0.424,-0.442,P ＜0.01) ;Fz P300 amplitude was negatively related to MoCA score (r =-0.346,P =0.013),ESS score and sleep apnea hypopnea index (AHI),the longest apnea time were positively correlated (r =0.409,0.342,P ＜ 0.05),and the average finger pulse oximetry (MSPO2) were negatively correlated (r =-0.342,P =0.041),memory/delayed recall and the minimum SPO2 (LSPO2) were positively correlated (r =0.355,P =0.041).Pz P300 latency and Fz P300 amplitude had significant influence on the MoCA.Conclusions ①Moderate to severe OSAHS patients existing MCI;②There was anxiety in moderate to severe OSAHS patients,depression in severe ones;③P300 detection can be used as electric physiological indicator of the evaluation of cognitive dysfunction in OSAHS patients,early detection of OSAHS in patients with cognitive dysfunction,combined with the MoCA score may provide the basis for early clinical intervention. Key words: Obstructive sleep apnea hypopnea syndrom; Cognitive function; Event related potential P300 ;  The Montreal cognitive assessment scale;  Anxiety;  Depression