Journal of Applied Physiology
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J Appl Physiol (January 3, 2003). doi:10.1152/japplphysiol.00881.2002
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Submitted on September 24, 2002
Accepted on December 30, 2002

FMRI Responses to Cold Pressor Challenges in Control and Obstructive Sleep Apnea Subjects

Ronald M Harper1*, Paul M Macey2, Luke A Henderson2, Mary A Woo3, Katherine E Macey2, Robert C Frysinger2, Jeffry R Alger4, Khanh P Nguyen2, and Frisca L Yan-Go5

1 Neurobiology, University of California at Los Angeles, Los Angeles, CA, USA; Brain Research Institute, University of California at Los Angeles, Los Angeles, CA, USA
2 Neurobiology, University of California at Los Angeles, Los Angeles, CA, USA
3 School of Nursing, University of California at Los Angeles, Los Angeles, CA, USA
4 Radiology, University of California at Los Angeles, Los Angeles, CA, USA; Brain Research Institute, University of California at Los Angeles, Los Angeles, CA, USA
5 Neurology, University of California at Los Angeles, Los Angeles, CA, USA

* To whom correspondence should be addressed. E-mail: rharper{at}ucla.edu.

Obstructive Sleep Apnea (OSA) patients exhibit altered sympathetic outflow, which may reveal mechanisms underlying the syndrome. We used functional magnetic resonance imaging in 16 control and 10 OSA subjects, free of cardiovascular or mood-altering drugs, to examine neural responses to a forehead cold pressor challenge, which elicits respiratory slowing, bradycardia and enhanced sympathetic outflow. The magnitude of cold-induced bradycardia was smaller, and respiratory slowing showed greater inter-subject variability and reached a nadir later in OSA patients. Both groups showed similar signal changes to cold stimulation in multiple brain sites. However, signal increases emerged in OSA over controls in anterior and posterior cingulate, and cerebellar and frontal cortex, while signals markedly declined in the ventral thalamus, hippocampus, and insula rather than rising as in controls; anomalous responses often paralleled changes in breathing and heart rate. Medullary, midbrain areas, lentiform and cerebellar dentate nuclei also showed lower signals in OSA cases. Cold pressor physiologic responses are modified in OSA, and may result from both diminished and exaggerated responses in multiple brain structures.




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