打呼噜影响孩子学习成绩？

分享一篇阻塞性睡眠呼吸暂停综合征（OSAS）对儿童认知学习能力影响的文献。

阻塞性睡眠呼吸暂停综合征对儿童齿状回与学习记忆能力的影响

阻塞性睡眠呼吸暂停综合征（OSAS）与间歇性缺氧和睡眠丧失有关。在儿童中，认知功能损害是重要的表现，但其潜在的病理学尚不清楚。

我们假设OSAS会影响齿状回，这是一个对神经发生和认知至关重要的海马亚区，这种影响会进一步影响儿童的认知功能。

在OSAS儿童（n=11）和对照组（n=12；年龄和性别匹配）中，我们进行了弥散张量成像和结构MRI、多导睡眠图和神经心理学评估。

我们发现OSAS与左侧齿状回的平均扩散率降低有关（p=0.002；校正错误发现率；调整性别、年龄和体重指数参数），显示出较大的影响范围（部分为20.491），但与大脑其他任何结构测量值无关。齿状回平均扩散率降低与呼吸暂停低通气指数（Spearman's r=0.50，p=0.008）和觉醒指数（r=0.44，p=0.017）相关。OSAS对神经心理学测量没有显著影响（p=0.5）；但是，较低的语言学习分数与较低的齿状回平均扩散率相关（r=0.54，p=0.004）。通径分析表明齿状回平均扩散率介导了OSAS对言语学习能力的影响。最后，基于齿状回平均扩散率的回归模型诊断准确率达到85.8%（交叉验证）。

本研究证实了OSAS对儿童神经认知功能影响的可能途径，以及齿状回平均扩散率作为OSAS儿童脑病理学早期潜在标志物。

The Effects of Obstructive Sleep Apnea Syndrome on the Dentate Gyrus and Learning and Memory in Children

Obstructive sleep apnea syndrome (OSAS) is associated with intermittent hypoxia and sleep loss. In children, impairments of cognitive function are important manifestations, but the underlying pathology is unknown. We hypothesized that OSAS would affect the dentate gyrus, a hippocampal subdivision essential to neurogenesis and cognition, and that this impact would further affect cognitive function in children. In children with OSAS (n11) and control subjects (n12; age and sex matched), we performed diffusion tensor imaging and structural MRI, polysomnography, and neuropsychological assessments. We found that OSAS was associated with decreased mean diffusivity of the left dentate gyrus (p0.002; false discovery rate corrected; adjusting for sex, age, and body mass index), showing a large effect size (partial 2  0.491), but not with any other structural measures across the brain. Decreased dentate gyrus mean diffusivity correlated with a higher apnea hypopnea index (Spearman’s r0.50, p0.008) and a greater arousal index (r0.44, p0.017). OSAS did not significantly affect neuropsychological measures (p values 0.5); however, a lower verbal learning score correlated with lower dentate gyrus mean diffusivity (r0.54, p0.004). Path analysis demonstrated that dentate gyrus mean diffusivity mediates the impact of OSAS on verbal learning capacity. Finally, the diagnostic accuracy of a regression model based on dentate gyrus mean diffusivity reached 85.8% (cross validated). This study demonstrates a likely pathway of effects of OSAS on neurocognitive function in children, as well as potential utility of the dentate gyrus mean diffusivity as an early marker of brain pathology in children with OSAS.

   
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