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Articles in PresS, published online ahead of print November 1, 2002
J Appl Physiol, 10.1152/jap.00702.2002
Submitted on July 30, 2002
Accepted on October 24, 2002
1 Department of Neurobiology, University of California, Los Angeles, Los Angeles, CA, USA
2 School of Nursing, University of California, Los Angeles, Los Angeles, CA, USA
3 Department of Radiology, University of California, Los Angeles, Los Angeles, CA, USA
4 Department of Neurology, University of California, Los Angeles, Los Angeles, CA, USA
* To whom correspondence should be addressed. E-mail: rharper{at}ucla.edu.
The repetitive upper airway muscle atonic episodes and cardiovascular sequaelae of Obstructive Sleep Apnea (OSA) suggest dysfunction of specific neural sites which integrate afferent airway signals with autonomic and somatic outflow. We determined neural responses to the Valsalva maneuver using functional magnetic resonance imaging. Images were collected during a baseline and three Valsalva maneuvers in eight drug-free OSA patients and 15 controls. Multiple cortical, midbrain, pontine, and medullary regions in both groups showed intensity changes correlated to airway pressure. In OSA subjects, the left inferior parietal cortex, superior temporal gyrus, posterior insular cortex, cerebellar cortex, fastigial nucleus and hippocampus showed attenuated signal changes compared with controls. Enhanced responses emerged in the left lateral precentral gyrus, left anterior cingulate and superior frontal cortex of OSA patients. The anterior cingulate, cerebellar cortex and posterior insular exhibited altered response timing patterns between control and OSA subjects. The response patterns in OSA subjects suggest deficits in particular neural pathways which normally mediate the Valsalva maneuver and compensatory actions in other structures.
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