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Purpose <p>Obstructive sleep apnea (OSA) is a common sleep disorder linked to cognitive deficits, while the neuroanatomical substrates remain elusive. Diffusion tensor imaging (DTI) enables in vivo evaluation of white matter (WM) integrity, while tract-specific associations with cognition in OSA need further research.</p> Methods <p>A total of 58 participants were enrolled, including healthy controls (HC, <i>n</i> = 14), OSA patients without cognitive impairment (OSA-NC, <i>n</i> = 18), and OSA patients with cognitive impairment (OSA-CI, <i>n</i> = 26). All participants underwent 3.0 T DTI. Fractional anisotropy (FA), mean diffusivity (MD), radial diffusivity (RD), and axial diffusivity (AD) values were extracted from 50 predefined WM tracts. MoCA subtests were converted into seven domain Z-scores. Intergroup differences and tract–cognition correlations were analyzed, adjusting for demographics.</p> Results <p>The OSA-CI group demonstrated widespread FA reductions and MD/RD/AD elevations compared with the HC group, most evident in the corpus callosum, hippocampus, cingulum, fornix, and uncinate fasciculus (<i>p</i> &lt; 0.05). Cognitive impairments were prominent in attention, executive function, and memory domains. Notably, FA in the left uncinate fasciculus was correlated with visuospatial deficits (<i>r</i>=–0.429, <i>p</i> = 0.041), and RD in the right fornix was correlated with delayed recall (<i>r</i> = 0.445, <i>p</i> = 0.033). Additional associations were identified in the genu and external capsule.</p> Conclusions <p>DTI-detected WM alterations are linked to domain-specific cognitive deficits in OSA. The corpus callosum, tapetum, and uncinate fasciculus may serve as early imaging biomarkers of cognitive vulnerability.</p>

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Tract-specific white matter changes and their cognitive correlates in obstructive sleep apnea: a cross-sectional study using 3.0 T diffusion tensor imaging

  • 期刊论文

  • 发表日期：

    2026年2月13日

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  • Bang Luo,
  • Lingling Deng,
  • Biao Wang,
  • Keyang Zhou,
  • Ting Su,
  • Yaxin Yang,
  • Xuanyu Chen,
  • Mei Yuan

摘要

Purpose

Obstructive sleep apnea (OSA) is a common sleep disorder linked to cognitive deficits, while the neuroanatomical substrates remain elusive. Diffusion tensor imaging (DTI) enables in vivo evaluation of white matter (WM) integrity, while tract-specific associations with cognition in OSA need further research.

Methods

A total of 58 participants were enrolled, including healthy controls (HC, n = 14), OSA patients without cognitive impairment (OSA-NC, n = 18), and OSA patients with cognitive impairment (OSA-CI, n = 26). All participants underwent 3.0 T DTI. Fractional anisotropy (FA), mean diffusivity (MD), radial diffusivity (RD), and axial diffusivity (AD) values were extracted from 50 predefined WM tracts. MoCA subtests were converted into seven domain Z-scores. Intergroup differences and tract–cognition correlations were analyzed, adjusting for demographics.

Results

The OSA-CI group demonstrated widespread FA reductions and MD/RD/AD elevations compared with the HC group, most evident in the corpus callosum, hippocampus, cingulum, fornix, and uncinate fasciculus (p < 0.05). Cognitive impairments were prominent in attention, executive function, and memory domains. Notably, FA in the left uncinate fasciculus was correlated with visuospatial deficits (r=–0.429, p = 0.041), and RD in the right fornix was correlated with delayed recall (r = 0.445, p = 0.033). Additional associations were identified in the genu and external capsule.

Conclusions

DTI-detected WM alterations are linked to domain-specific cognitive deficits in OSA. The corpus callosum, tapetum, and uncinate fasciculus may serve as early imaging biomarkers of cognitive vulnerability.