Obstructive sleep apnea: Brain structural changes and neurocognitive function before and after treatment

Nicola Canessa, Vincenza Castronovo, Stefano F. Cappa, Mark S. Aloia, Sara Marelli, Andrea Falini, Federica Alemanno, Luigi Ferini-Strambi

Research output: Contribution to journalArticlepeer-review


Rationale: Obstructive sleep apnea (OSA) is commonly associated with neurocognitive impairments that have not been consistently related to specific brain structure abnormalities. Knowledge of the brain structures involved in OSA and the corresponding functional implications could provide clues to the pathogenesis of cognitive impairment and its reversibility in this disorder. Objectives: To investigate the cognitive deficits and the corresponding brain morphology changes in OSA, and the modifications after treatment, using combined neuropsychologic testing and voxel-based morphometry. Methods: A total of 17 patients treatment-naive to sleep apnea and 15 age-matched healthy control subjects underwent a sleep study, cognitive tests, and magnetic resonance imaging. After 3 months of treatment, cognitive and imaging data were collected to assess therapy efficacy. Measurements and Main Results: Neuropsychologic results in pre-treatment OSA showed impairments in most cognitive areas, and in mood and sleepiness. These impairments were associated with focal reductions of gray-matter volume in the left hippocampus (entorhinal cortex), left posterior parietal cortex, and right superior frontal gyrus. After treatment, we observed significant improvements involving memory, attention, and executive-functioning that paralleled gray-matter volume increases in hippocampal and frontal structures. Conclusions: The cognitive and structural deficits in OSA may be secondary to sleep deprivation and repetitive nocturnal intermittent hypoxemia. These negative effects may be recovered by consistent and thorough treatment. Our findings highlight the importance of early diagnosis and successful treatment of this disorder.

Original languageEnglish
Pages (from-to)1419-1426
Number of pages8
JournalAmerican Journal of Respiratory and Critical Care Medicine
Issue number10
Publication statusPublished - May 15 2011


  • Brain structure
  • Neurocognitive function
  • Obstructive sleep apnea
  • Treatment

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine
  • Critical Care and Intensive Care Medicine


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