阻塞性睡眠呼吸暂停患儿认知改变与脑白质网络的相关性

目的：探讨阻塞性睡眠呼吸暂停（OSA）患儿的认知功能和脑白质网络改变以及两者之间的相关性。方法：收集2018 年2月至2020 年11月在温州医科大学附属第二医院育英儿童医院接受检查的7～13岁的年龄和性别相匹配的OSA患儿29例、健康对照组21例进行头部高分辨率3D T1WI和DTI扫描。计算每个参与者白质网络的全局属性（同配性）和节点属性（聚类系数、度中心性、局部效率）以及DN：CAS量表分，进行组间比较，并使用分层线性回归分析白质网络属性与认知得分之间的相关性。结果：未经过FDR校正时，OSA组右辅助运动区、右颞横回的度中心性和左中央后回、右颞横回的聚类系数以及左前扣带和旁扣带脑回、右颞横回的局部效率较健康对照组增加（P ＜0.05）；OSA组左眶部额中回、左舌回、左颞中回的度中心性和右颞中回的聚类系数以及右颞中回的局部效率较健康对照组降低（P ＜0.05）。左颞中回的度中心性与DN：CAS中的单词系列（β=0.421，P =0.015）、右颞中回的聚类系数（β=0.507，P =0.023）和局部效率（β=0.504，P =0.010）与同时性加工量表分呈正相关。结论：OSA患儿白质网络具有发生改变的趋势，其中颞中回的节点属性与认知有关，提示脑白质网络异常，特别是颞中回结构的改变，可能是OSA患儿认知损害的神经基础。

Correlation between cognitive changes and brain white matter network in children with obstructive sleep apnea

Objective: To investigate the cognitive function and brain white matter network alterations in children with obstructive sleep apnea (OSA) and the correlation between them. Methods: From February 2018 to November 2020, a total of 29 age - and sex-matched OSA children and 21 healthy controls aged 7-13 years were collected at the Second Affiliated Hospital & Yuying Children’s Hospital of Wenzhou Medical University for high-resolution 3D T1WI and DTI scanning. Global attributes (assortativity) and nodal attributes (clustering coefficient, degree centrality, local efficiency) of the white matter network and DN: CAS scale scores were calculated for each participant, compared between groups, and correlations between white matter network attributes and cognitive scores were analyzed using hierarchical linear regression. Results: Without FDR correction, the degree centrality of the right supplementary motor area, the right heschl gyrus and the clusteringcoefficients of the left postcentral gyrus and the right heschl gyrus, as well as the local efficiency of the left anterior cingulate and paracingulate gyri and the right heschl gyrus increased in the OSA group compared with healthy controls; the degree centrality of the left orbital part of middle frontal gyrus, the left lingual gyrus and the left middle temporal gyrus, the clustering coefficients of the right middle temporal gyrus and the local efficiency of the right middle temporal gyrus decreased in the OSA group compared with healthy controls. Degree centrality in the left middle temporal gyrus was positively correlated with word series in DN: CAS (β=0.421, P=0.015),clustering coefficient in the right middle temporal gyrus (β=0.507, P=0.023) and local efficiency (β=0.504,P=0.010) with simultaneous processing scale scores. Conclusion: The white matter network in children with OSA has a tendency to change, in which the nodal properties of the middle temporal gyrus are associated with cognition, suggesting that abnormalities in the brain white matter network, especially alterations in the structure of the middle temporal gyrus, may be the neural basis of cognitive impairment in children with OSA.