Altered structural brain network resulting from white matter injury in obstructive sleep apnea

Min Hee Lee, Chang Ho Yun, Areum Min, Yoon Ho Hwang, Seung Ku Lee, Dong Youn Kim, Robert J. Thomas, Bong Soo Han, Chol Shin

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31 Citations (Scopus)


To assess, using fractional anisotropy (FA) analysis, alterations of brain network connectivity in adults with obstructive sleep apnea (OSA). Abnormal networks could mediate clinical functional deficits and reflect brain tissue injury. Methods: Structural brain networks were constructed using diffusion tensor imaging (DTI) from 165 healthy (age 57.99 ± 6.02 years, male 27.9%) and 135 OSA participants (age 59.01 ± 5.91 years, male 28.9%) and global network properties (strength, global efficiency, and local efficiency) and regional efficiency were compared between groups. We examined MRI biomarkers of brain tissue injury using FA analysis and its effect on the network properties. Results: Differences between groups of interest were noted in global network properties (p-value < 0.05, corrected), and regional efficiency (p-value < 0.05, corrected) in the left middle cingulate and paracingulate gyri, right posterior cingulate gyrus, and amygdala. In FA analysis, OSA participants showed lower FA values in white matter (WM) of the right transverse temporal, anterior cingulate and paracingulate gyri, and left postcentral, middle frontal and medial frontal gyri, and the putamen. After culling fiber tracts through WM which showed significant differences in FA, we observed no group difference in network properties. Conclusions: Changes in WM integrity and structural connectivity are present in OSA participants. We found that the integrity of WM affected brain network properties. Brain network analysis may improve understanding of neurocognitive deficits in OSA, enable longitudinal tracking, and provides explanations for specific symptoms and recovery kinetics.

Original languageEnglish
Article numberzsz120
Issue number9
Publication statusPublished - 2019 Sept 6

Bibliographical note

Funding Information:
This research was supported by the Brain Research Program of the National Research Foundation (NRF) funded by the Korean Government (MSIT) (2016M3C7A1905385) and grants from the Korea Centers for Disease Control and Prevention (2011-E71004-00) and the Bio & Medical Technology Development Program of the NRF funded by the Korean Government, MSIP (NRF-2015M3A9B6027142). Conflict of interest statement. R.J.T. is co-inventor and patent holder of the ECG-derived sleep spectrogram, which may be used to phenotype sleep quality, heart rate kinetics during sleep, and central/complex sleep apnea. The technology is licensed by Beth Israel Deaconess Medical Center to MyCardio, LLC; R.J.T. receives Royalties. He is also co-inventor and patent holder of the Positive Airway Pressure Gas Modulator, being developed for treatment of central/complex sleep apnea. He is a consultant in software development and has received grant support from for DeVilbiss Healthcare. R.J.T. consults for Guidepoint Global and GLG Councils in the general area of sleep medicine. He consults for Jazz Pharmaceuticals in the general area of central sleep apnea and excessive daytime sleepiness.The other authors have indicated no financial conflicts of interest.

Publisher Copyright:
© 2019 Sleep Research Society 2019. Published by Oxford University Press on behalf of the Sleep Research Society. All rights reserved. For permissions, please email:


  • diffusion tensor imaging
  • fractional anisotropy
  • obstructive sleep apnea
  • structural brain network

ASJC Scopus subject areas

  • Medicine(all)


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