| Title |
Association of sleep apnea with clinically silent microvascular brain tissue changes in acute cerebral ischemia
|
|---|---|
| Published in |
Journal of Neurology, November 2013
|
| DOI | 10.1007/s00415-013-7200-z |
| Pubmed ID | |
| Authors |
Jessica Kepplinger, Kristian Barlinn, Amelia K. Boehme, Johannes Gerber, Volker Puetz, Lars-Peder Pallesen, Wiebke Schrempf, Imanuel Dzialowski, Karen C. Albright, Andrei V. Alexandrov, Heinz Reichmann, Ruediger von Kummer, Ulf Bodechtel |
| Abstract |
The aim of this study was to determine the importance of sleep apnea in relation to clinically silent microvascular brain tissue changes in patients with acute cerebral ischemia. Patients with acute cerebral ischemia prospectively underwent nocturnal respiratory polygraphy within 5 days from symptom-onset. Sleep apnea was defined as apnea-hypopnea-index (AHI) ≥5/h. Experienced readers blinded to clinical and sleep-related data reviewed brain computed tomography and magnetic resonance imaging scans for leukoaraiosis and chronic lacunar infarctions. Ischemic lesions were considered clinically silent when patients did not recall associated stroke-like symptoms. Functional outcome was assessed with modified Rankin Scale at discharge, 6 and 12 months. Fifty-one of 56 (91 %) patients had sleep apnea of any degree. Patients with moderate-to-severe leukoaraiosis (Wahlund score ≥5) were found to have higher mean AHI than those with none or mild leukoaraiosis (34.4 vs. 12.8/h, p < 0.001). Moderate-to-severe sleep apnea (AHI ≥15/h) was found to be an independent predictor of moderate-to-severe leukoaraiosis (adjusted OR 6.03, 95 % CI 1.76-20.6, p = 0.0042) and of moderate-to-severe leukoaraiosis associated with clinically silent chronic lacunar infarctions (adjusted OR 10.5, 95 % CI 2.19-50.6, p = 0.003). The higher the Wahlund score and the AHI, the more likely unfavorable functional outcome resulted over time (p = 0.0373). In acute cerebral ischemia, sleep apnea is associated with clinically silent microvascular brain tissue changes and may negatively influence functional outcome. Routine sleep apnea screening and further investigation of possible long-term effects of non-invasive ventilatory treatment of sleep apnea appear warranted in this at-risk population. |
X Demographics
The data shown below were collected from the profile of 1 X user who shared this research output. Click here to find out more about how the information was compiled.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Norway | 1 | 100% |
Demographic breakdown
| Type | Count | As % |
|---|---|---|
| Practitioners (doctors, other healthcare professionals) | 1 | 100% |
Mendeley readers
The data shown below were compiled from readership statistics for 64 Mendeley readers of this research output. Click here to see the associated Mendeley record.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Unknown | 64 | 100% |
Demographic breakdown
| Readers by professional status | Count | As % |
|---|---|---|
| Researcher | 9 | 14% |
| Student > Bachelor | 9 | 14% |
| Student > Ph. D. Student | 8 | 13% |
| Student > Master | 8 | 13% |
| Other | 4 | 6% |
| Other | 15 | 23% |
| Unknown | 11 | 17% |
| Readers by discipline | Count | As % |
|---|---|---|
| Medicine and Dentistry | 29 | 45% |
| Nursing and Health Professions | 7 | 11% |
| Neuroscience | 5 | 8% |
| Unspecified | 2 | 3% |
| Agricultural and Biological Sciences | 1 | 2% |
| Other | 4 | 6% |
| Unknown | 16 | 25% |
Attention Score in Context
This research output has an Altmetric Attention Score of 1. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 27 February 2014.
All research outputs
#15,298,293
of 22,751,628 outputs
Outputs from Journal of Neurology
#3,217
of 4,461 outputs
Outputs of similar age
#192,386
of 306,527 outputs
Outputs of similar age from Journal of Neurology
#25
of 45 outputs
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