Effects of Continuous Positive Airway Pressure on Neuroimaging Biomarkers and Cognition in Adult Obstructive Sleep Apnea: A Randomized Controlled Trial

作者：Huajun Xu, Yupu Liu, Chenyang Li, Xinyi Li, Li Shen, Hui Wang, Feng Liu, Juanjuan Zou, Yunyan Xia, Weijun Huang, Yuenan Liu, Zhenfei Gao, Yiqun Fu, Fan Wang, Shujian Huang, Zhiyuan Song, Fan Song, Yiqing Gao, Yu Peng, Jianyin Zou, Huaming Zhu, Suru Liu, Linpeng Li, Xiaoyue Zhu, Yuanping Xiong, Yuli Hu, Jiaxin Yang, Yuehua Li, Feng Gao, Qihao Guo, Hengye Huang, Weituo Zhang, Jiping Li, Yanqing Chen, Pin Dong, Jun Yang, Jingrong Lv, Peihua Wang, Yiyuan Sun, Biyun Qian, Kristine Yaffe, Jian Guan, Hongliang Yi, Yue Leng, Shankai Yin · 发表于：American Journal of Respiratory and Critical Care Medicine · 年份：2025 · DOI：10.1164/rccm.202406-1170oc · 被引用次数：13 · 研究领域：Obstructive Sleep Apnea Research、Cardiovascular and Diving-Related Complications

Abstract Rationale Obstructive sleep apnea (OSA) is associated with cognitive impairment. The effects of continuous positive airway pressure (CPAP) on neuroimaging biomarkers and cognitive performance among middle-aged patients with OSA and normal cognition remain unclear. Objectives To investigate the effects of CPAP therapy over 12 months on neuroimaging biomarkers and cognitive performance. Methods In this multicenter, randomized clinical trial, we randomly assigned 148 participants with normal cognition and an apnea–hypopnea index ⩾15/h into two groups: patients receiving CPAP with best supportive care (BSC); and patients receiving BSC alone. The primary endpoint was Montreal Cognitive Assessment (MoCA) score at 6 months after enrollment. The secondary endpoints were intranetwork functional connectivity (FC) of default mode network (DMN) and cortical thickness assessed by functional and structural magnetic resonance imaging, other neuroimaging biomarkers, and neurobehavioral tests. Measurements and Main Results Between 2017 and 2021, 148 patients were recruited from five hospitals. Linear mixed models showed that there was no significant difference in MoCA scores at 6 months between the CPAP and BSC groups (difference, −0.04; 95% confidence interval [CI], −0.72 to 0.65; P = 0.91). However, there were significant differences in the FC of DMN (difference, −13.73; 95% CI, −23.40 to −4.06; P = 0.01) and cortical thickness (difference, −0.06 mm; 95% CI, −0.10 to −0.01 mm; P = ...