In what is believed to be the first study showing neural changes in the brains of children with serious, untreated sleep apnea, Johns Hopkins researchers conclude that children with the disorder appear to suffer damage in two brain structures tied to learning ability.
Writing in the Aug. 22 issue of the global online journal Public Library of Science Medicine, the Hopkins investigators say they compared 19 children with severe obstructive sleep apnea (OSA) to 12 children without the disorder. Using a special type of MRI, researchers identified changes to the hippocampus and the right frontal cortex. Next, using IQ tests and other standardized performance tests that measure verbal performance, memory and executive function, researchers were able to link the changes in the two brain structures to deficits in neuropsychological performance.
The hippocampus, a structure in the temporal lobe, is vital to learning and memory storage, while the right frontal cortex governs higher-level thinking, such as accessing old memories and using them in new situations.
"This should be a wake-up call to both parents and doctors that undiagnosed or untreated sleep apnea might hurt children's brains," says lead author Ann Halbower, M.D., a lung specialist at the Johns Hopkins Children's Center. "This is truly concerning because we saw changes that suggest brain injury in areas of the brain that house critical cognitive functions, such as attention, learning and working memory."
While researchers have known for years that fragmented sleep, interrupted breathing and oxygen deprivation - all hallmarks of sleep apnea - harm children's learning ability and school performance, this is the first time they have linked changes in the brain's chemistry to the syndrome in children, Halbower believes.
"We cannot say with absolute certainty that sleep apnea caused the injury, but what we found is a very strong association between changes in th
Contact: Katerina Pesheva
Johns Hopkins Medical Institutions