“OSA is known to be associated with deficits in attention, cognition, and executive function,” said lead author Ann Halbower, MD, associate professor at the Children’s Hospital Sleep Center and University of Colorado-Denver. “Our study is the first to show that treatment of OSA in children can reverse neuronal brain injury, correlated with improvements in attention and verbal memory in these patients.”
In the study, children between the ages of 8 and 11 with moderate to severe OSA were compared to healthy children. Brain imaging with magnetic resonance spectroscopy imaging was performed before treatment in 15 OSA patients and seven healthy children, along with neuropsychological testing.
Treatment included an adenotonsillectomy — surgical removal of the tonsils and adenoids — followed by monitored continuous positive airway pressure (CPAP) or nasal treatments.
Brain imaging and neuropsychological testing was performed again in 11 OSA patients and the seven other children six months after treatment.
Before treatment, children with OSA exhibited significantly decreased N-acetyl aspartate to choline ratios (NAA/Cho) in the left hippocampus and left frontal cortex, along with significant decreases in the executive functions of verbal memory and attention, according to the research. Following treatment, both left and right frontal cortex neuronal metabolites normalized, and hippocampal metabolites improved. Improvements in attention and verbal memory were correlated with normalization of NAA/Cho in the right and left frontal cortex, Halbower said.
“We have demonstrated for the first time that treatment of OSA in children normalizes brain metabolites in portions of the neuronal network responsible for attention and executive function,” she said. “We speculate that if OSA is treated earlier, there may be a more brisk improvement in the hippocampus, a relay station for executive function, learning, and memory. Our results point to the importance of early diagnosis and treatment of OSA in children, as it could potentially have profound effects on their development.”
Source: American Thoracic Society