Display options
Cite
Daulatzai MA. Pathogenesis of cognitive dysfunction in patients with obstructive sleep apnea: a hypothesis with emphasis on the nucleus tractus solitarius. Sleep Disord. 2012;2012:251096doi: 10.1155/2012/251096.
Daulatzai, M. A. (2012). Pathogenesis of cognitive dysfunction in patients with obstructive sleep apnea: a hypothesis with emphasis on the nucleus tractus solitarius. Sleep disorders, 2012251096. https://doi.org/10.1155/2012/251096
Daulatzai, Mak Adam. "Pathogenesis of cognitive dysfunction in patients with obstructive sleep apnea: a hypothesis with emphasis on the nucleus tractus solitarius." Sleep disorders vol. 2012 (2012): 251096. doi: https://doi.org/10.1155/2012/251096
Daulatzai MA. Pathogenesis of cognitive dysfunction in patients with obstructive sleep apnea: a hypothesis with emphasis on the nucleus tractus solitarius. Sleep Disord. 2012;2012:251096. doi: 10.1155/2012/251096. Epub 2012 Jan 16. PMID: 23470865; PMCID: PMC3581091.
Copy Download .nbib Format: NLM
Share it on

Sleep Disord. 2012;2012:251096. doi: 10.1155/2012/251096. Epub 2012 Jan 16.

Pathogenesis of cognitive dysfunction in patients with obstructive sleep apnea: a hypothesis with emphasis on the nucleus tractus solitarius.

Sleep disorders

Mak Adam Daulatzai

Affiliations

  1. Sleep Disorders Group, EEE Department, MSE, The University of Melbourne, Parkville, VIC 3010, Australia.

PMID: 23470865 PMCID: PMC3581091 DOI: 10.1155/2012/251096

Abstract

OSA is characterized by the quintessential triad of intermittent apnea, hypoxia, and hypoxemia due to pharyngeal collapse. This paper highlights the upstream mechanisms that may trigger cognitive decline in OSA. Three interrelated steps underpin cognitive dysfunction in OSA patients. First, several risk factors upregulate peripheral inflammation; these crucial factors promote neuroinflammation, cerebrovascular endothelial dysfunction, and oxidative stress in OSA. Secondly, the neuroinflammation exerts negative impact globally on the CNS, and thirdly, important foci in the neocortex and brainstem are rendered inflamed and dysfunctional. A strong link is known to exist between neuroinflammation and neurodegeneration. A unique perspective delineated here underscores the importance of dysfunctional brainstem nuclei in etiopathogenesis of cognitive decline in OSA patients. Nucleus tractus solitarius (NTS) is the central integration hub for afferents from upper airway (somatosensory/gustatory), respiratory, gastrointestinal, cardiovascular (baroreceptor and chemoreceptor) and other systems. The NTS has an essential role in sympathetic and parasympathetic systems also; it projects to most key brain regions and modulates numerous physiological functions. Inflamed and dysfunctional NTS and other key brainstem nuclei may play a pivotal role in triggering memory and cognitive dysfunction in OSA. Attenuation of upstream factors and amelioration of the NTS dysfunction remain important challenges.

References

  1. Arch Surg. 1996 Nov;131(11):1148-53; discussion 1153-4 - PubMed
  2. J Neuroimmunol. 2006 May;174(1-2):63-73 - PubMed
  3. Neuroradiology. 2010 Aug;52(8):711-21 - PubMed
  4. Circulation. 2008 Apr 29;117(17):2270-8 - PubMed
  5. Nat Rev Cardiol. 2010 Dec;7(12):686-98 - PubMed
  6. Proc Natl Acad Sci U S A. 1994 Nov 22;91(24):11393-7 - PubMed
  7. Am J Respir Crit Care Med. 2010 Dec 15;182(12):1540-5 - PubMed
  8. Circ Res. 1973 May;32(5):584-93 - PubMed
  9. Chest. 2008 Jan;133(1):86-91 - PubMed
  10. Brain Behav Immun. 2009 Mar;23(3):309-17 - PubMed
  11. Respiration. 2010;79(5):370-6 - PubMed
  12. Am J Respir Crit Care Med. 2001 Mar;163(3 Pt 1):685-9 - PubMed
  13. FASEB J. 2005 Aug;19(10):1329-31 - PubMed
  14. Am J Physiol. 1999 Sep;277(3):H1207-14 - PubMed
  15. Sleep. 2004 Feb 1;27(1):123-8 - PubMed
  16. J Clin Invest. 1995 Dec;96(6):2661-6 - PubMed
  17. Clin Exp Immunol. 2002 Nov;130(2):256-62 - PubMed
  18. Brain. 2008 Jul;131(Pt 7):1880-94 - PubMed
  19. Neuroscience. 2009 Feb 6;158(3):1062-73 - PubMed
  20. J Neurosci Res. 2006 Mar;83(4):557-66 - PubMed
  21. Brain Behav Immun. 2011 Aug;25(6):1113-22 - PubMed
  22. J Int Neuropsychol Soc. 2004 Jan;10(1):60-71 - PubMed
  23. Diabetes. 1996 Nov;45(11):1455-62 - PubMed
  24. Sleep Med. 2009 Sep;10(8):875-81 - PubMed
  25. Sleep. 2009 Mar;32(3):373-81 - PubMed
  26. Respir Physiol Neurobiol. 2011 Sep 30;178(3):422-8 - PubMed
  27. Sleep. 2007 May;30(5):648-53 - PubMed
  28. Best Pract Res Clin Endocrinol Metab. 2010 Oct;24(5):843-51 - PubMed
  29. Diabetes. 2008 Jun;57(6):1470-81 - PubMed
  30. Neurobiol Aging. 2010 Sep;31(9):1649-53 - PubMed
  31. Sleep Med Rev. 2002 Dec;6(6):443-55 - PubMed
  32. Chest. 2005 May;127(5):1674-9 - PubMed
  33. Sleep Med Rev. 2003 Feb;7(1):35-51 - PubMed
  34. Am J Physiol Heart Circ Physiol. 2001 Jun;280(6):H2598-606 - PubMed
  35. Brain Behav Immun. 2008 Mar;22(3):301-11 - PubMed
  36. Neurology. 2009 Jan 6;72(1):56-62 - PubMed
  37. Am J Physiol. 1998 Oct;275(4):H1236-46 - PubMed
  38. Circulation. 1999 Mar 9;99(9):1183-9 - PubMed
  39. Nat Rev Neurosci. 2010 Feb;11(2):114-26 - PubMed
  40. Sleep. 2010 Mar;33(3):371-7 - PubMed
  41. JAMA. 2003 Oct 8;290(14):1906-14 - PubMed
  42. Auton Neurosci. 2008 Nov 3;142(1-2):40-4 - PubMed
  43. J Immunol. 2006 Nov 15;177(10):7211-24 - PubMed
  44. Respir Physiol Neurobiol. 2003 Jul 16;136(2-3):167-78 - PubMed
  45. Acta Physiol Scand. 2003 Mar;177(3):385-90 - PubMed
  46. J Hypertens. 1999 Jan;17(1):61-6 - PubMed
  47. Am J Respir Crit Care Med. 2007 Jun 1;175(11):1186-91 - PubMed
  48. Physiol Rev. 1979 Oct;59(4):919-57 - PubMed
  49. J Neurosci. 1997 Dec 15;17(24):9473-80 - PubMed
  50. Am J Emerg Med. 1996 Nov;14(7):649-53 - PubMed
  51. Brain Behav Immun. 2007 Jan;21(1):47-59 - PubMed
  52. J Neuroinflammation. 2008 Mar 18;5:10 - PubMed
  53. J Appl Physiol (1985). 1996 Dec;81(6):2618-26 - PubMed
  54. Am J Respir Crit Care Med. 2002 Nov 15;166(10):1382-7 - PubMed
  55. Neurobiol Aging. 2010 Mar;31(3):368-77 - PubMed
  56. Respir Physiol Neurobiol. 2005 Jul 28;147(2-3):263-72 - PubMed
  57. J Anat. 2008 Feb;212(2):106-13 - PubMed
  58. Neuroscience. 2005;134(2):657-69 - PubMed
  59. Clin Cardiol. 1998 Apr;21(4):271-6 - PubMed
  60. Cerebrovasc Brain Metab Rev. 1991 Winter;3(4):281-96 - PubMed
  61. J Neurol Neurosurg Psychiatry. 1992 Oct;55(10):916-20 - PubMed
  62. Proc Natl Acad Sci U S A. 1998 Jul 7;95(14):7987-92 - PubMed
  63. N Engl J Med. 1993 Feb 4;328(5):303-7 - PubMed
  64. N Engl J Med. 1993 Apr 29;328(17):1230-5 - PubMed
  65. Am J Med. 1999 Jul;107(1):85-97 - PubMed
  66. Am J Physiol. 1997 Dec;273(6):H2926-30 - PubMed
  67. Cell Death Differ. 2011 Nov;18(11):1679-91 - PubMed
  68. Free Radic Biol Med. 2005 May 15;38(10):1311-22 - PubMed
  69. Sleep Breath. 2012 Jun;16(2):283-94 - PubMed
  70. Brain Res. 1978 Sep 15;153(1):1-26 - PubMed
  71. Alzheimers Res Ther. 2010 Jan 22;2(1):1 - PubMed
  72. J Neurosci. 2003 Aug 27;23(21):7922-30 - PubMed
  73. Neuroimmunomodulation. 2001;9(4):183-92 - PubMed
  74. Clin Cardiol. 2004 Apr;27(4):223-7 - PubMed
  75. Neurochem Res. 2011 Mar;36(3):487-93 - PubMed
  76. Curr Drug Targets. 2010 May;11(5):586-98 - PubMed
  77. Am Rev Respir Dis. 1991 Oct;144(4):939-44 - PubMed
  78. J Neuroinflammation. 2006 Sep 27;3:27 - PubMed
  79. J Appl Physiol Respir Environ Exerc Physiol. 1978 Jun;44(6):931-8 - PubMed
  80. PLoS One. 2011;6(5):e19847 - PubMed
  81. Am J Respir Crit Care Med. 2004 Oct 1;170(7):799-803 - PubMed
  82. Lancet. 1999 Oct 23;354(9188):1435-9 - PubMed
  83. Am J Respir Crit Care Med. 2011 May 15;183(10):1419-26 - PubMed
  84. Neuroimage. 2011 Jan 15;54(2):787-93 - PubMed
  85. J Clin Endocrinol Metab. 2000 Mar;85(3):1151-8 - PubMed
  86. Am J Pathol. 2010 Aug;177(2):974-83 - PubMed
  87. Biol Psychiatry. 2010 Nov 15;68(10):930-41 - PubMed
  88. Curr Cardiovasc Risk Rep. 2011 Oct;5(5):407-412 - PubMed
  89. Neuroimage. 2008 Oct 1;42(4):1537-43 - PubMed
  90. Am J Respir Crit Care Med. 2000 Aug;162(2 Pt 1):566-70 - PubMed
  91. J Neuroimmunol. 1999 Nov 15;101(2):148-60 - PubMed
  92. J Neurosci Res. 1997 May 15;48(4):287-98 - PubMed
  93. J Neuropathol Exp Neurol. 2011 Mar;70(3):201-17 - PubMed
  94. J Biol Chem. 2001 Aug 3;276(31):29307-12 - PubMed
  95. Sleep Med. 2004 Nov;5(6):593-6 - PubMed
  96. Circulation. 2000 Nov 21;102(21):2607-10 - PubMed
  97. Hell J Nucl Med. 2010 May-Aug;13(2):138-43 - PubMed
  98. Neurology. 2006 Oct 10;67(7):1221-4 - PubMed
  99. Sleep. 2007 Dec;30(12):1667-73 - PubMed
  100. Neurosci Biobehav Rev. 2009 Feb;33(2):89-94 - PubMed
  101. Sleep. 2008 Aug;31(8):1103-9 - PubMed
  102. Angiology. 1999 Nov;50(11):959-61 - PubMed
  103. Ann N Y Acad Sci. 2005 Jun;1051:340-50 - PubMed
  104. Sleep. 2005 Oct;28(10):1312-6 - PubMed
  105. Neurology. 2006 Sep 12;67(5):834-42 - PubMed
  106. Inflamm Res. 2006 Jun;55(6):221-7 - PubMed
  107. Stroke. 1994 Jul;25(7):1481-8 - PubMed
  108. Am J Hypertens. 2007 Jan;20(1):44-52 - PubMed
  109. Endocrinol Metab Clin North Am. 2003 Dec;32(4):869-94 - PubMed
  110. Brain Behav Immun. 2010 Mar;24(3):486-92 - PubMed
  111. Am J Respir Crit Care Med. 2008 Mar 1;177(5):544-54 - PubMed
  112. Clin Hemorheol Microcirc. 2000;22(1):21-7 - PubMed
  113. Sleep Breath. 2012 Sep;16(3):813-9 - PubMed
  114. J Appl Physiol (1985). 2008 Dec;105(6):1852-7 - PubMed
  115. Adv Cardiol. 2011;46:139-170 - PubMed
  116. Sleep Breath. 2011 Jan;15(1):63-9 - PubMed
  117. Chest. 2008 Nov;134(5):911-918 - PubMed
  118. Neuroscience. 2002;112(1):7-11 - PubMed
  119. Neuroimmunomodulation. 1998 May-Aug;5(3-4):143-59 - PubMed
  120. Sleep Breath. 2011 Jan;15(1):3-11 - PubMed
  121. Clin Sci (Lond). 2002 May;102(5):547-52 - PubMed
  122. QJM. 1998 Sep;91(9):627-33 - PubMed
  123. Expert Rev Mol Med. 2011 Jun 10;13:e19 - PubMed
  124. J Sleep Res. 2012 Apr;21(2):147-54 - PubMed
  125. Eur J Appl Physiol. 2010 May;109(2):201-11 - PubMed
  126. Obesity (Silver Spring). 2011 Jul;19(7):1382-7 - PubMed
  127. Circulation. 1999 Aug 17;100(7):706-12 - PubMed
  128. Neurobiol Aging. 2006 May;27(5):723-32 - PubMed
  129. J Appl Physiol (1985). 1988 Apr;64(4):1346-53 - PubMed
  130. Obesity (Silver Spring). 2011 Mar;19(3):500-4 - PubMed
  131. Circ Res. 1981 Feb;48(2):292-8 - PubMed
  132. Neuron. 2009 Oct 15;64(1):28-32 - PubMed
  133. Adv Cardiol. 2011;46:43-66 - PubMed
  134. Nat Rev Immunol. 2007 Feb;7(2):161-7 - PubMed
  135. Circ Res. 2001 Feb 2;88(2):E14-22 - PubMed
  136. Circulation. 2005 Oct 25;112(17):2660-7 - PubMed
  137. Circulation. 2002 May 28;105(21):2462-4 - PubMed
  138. Neurobiol Aging. 2011 Jan;32(1):85-102 - PubMed
  139. Sleep Breath. 2003 Sep;7(3):105-10 - PubMed
  140. Acta Neuropathol. 2010 Sep;120(3):277-86 - PubMed
  141. Nature. 2011 Apr 21;472(7343):319-24 - PubMed
  142. J Appl Physiol (1985). 2008 Oct;105(4):1333-41 - PubMed
  143. J Neuroimmunol. 2001 Oct 1;119(2):365-76 - PubMed
  144. J Clin Invest. 2007 Feb;117(2):289-96 - PubMed
  145. J Appl Physiol (1985). 1989 Nov;67(5):2095-100 - PubMed
  146. Brain Res. 2009 Oct 19;1294:128-37 - PubMed
  147. Hypertension. 2001 Feb;37(2 Pt 2):511-5 - PubMed
  148. J Clin Endocrinol Metab. 2004 May;89(5):2119-26 - PubMed
  149. Am J Physiol Regul Integr Comp Physiol. 2001 Jan;280(1):R289-99 - PubMed
  150. Am J Physiol Regul Integr Comp Physiol. 2001 Nov;281(5):R1394-400 - PubMed
  151. J Neurosci. 1982 Oct;2(10):1424-38 - PubMed
  152. Am J Respir Crit Care Med. 2002 Mar 1;165(5):670-6 - PubMed
  153. Am J Respir Crit Care Med. 2002 Apr 1;165(7):934-9 - PubMed
  154. Exp Physiol. 2006 Sep;91(5):935-41 - PubMed
  155. Eur J Cardiothorac Surg. 2008 Aug;34(2):344-9 - PubMed
  156. Hum Brain Mapp. 2009 Jul;30(7):2090-7 - PubMed
  157. Circulation. 2001 Dec 18;104(25):3052-6 - PubMed
  158. Sleep Med Rev. 2006 Apr;10(2):83-96 - PubMed
  159. J Clin Invest. 1991 Jun;87(6):1953-7 - PubMed
  160. Ital J Anat Embryol. 2005 Oct-Dec;110(4):255-60 - PubMed
  161. Psychiatry Res. 2011 Mar 31;191(3):153-9 - PubMed
  162. J Psychosom Res. 2004 May;56(5):549-53 - PubMed
  163. Neurobiol Aging. 2010 Feb;31(2):290-300 - PubMed
  164. Pediatr Clin North Am. 2011 Jun;58(3):621-35 - PubMed
  165. Neurobiol Dis. 2004 Oct;17(1):44-53 - PubMed
  166. Vasc Health Risk Manag. 2008;4(6):1327-35 - PubMed
  167. Biogerontology. 2010 Oct;11(5):627-33 - PubMed
  168. Chest. 1988 Apr;93(4):678-83 - PubMed
  169. J Alzheimers Dis. 2010;20(2):355-67 - PubMed
  170. Nat Cell Biol. 2008 Nov;10(11):1241-7 - PubMed
  171. Sleep Med. 2006 Aug;7(5):424-30 - PubMed
  172. Future Cardiol. 2011 Mar;7(2):241-9 - PubMed
  173. Neuroscience. 2004;126(2):313-23 - PubMed
  174. N Engl J Med. 2011 Feb 17;364(7):656-65 - PubMed
  175. Am J Respir Crit Care Med. 2003 Aug 15;168(4):469-75 - PubMed
  176. Chest. 1997 Feb;111(2):387-93 - PubMed
  177. Eur J Neurol. 2009 Mar;16(3):386-91 - PubMed
  178. Sleep. 2007 Feb;30(2):225-7 - PubMed
  179. J Alzheimers Dis. 2010;21(4):1039-63 - PubMed
  180. Am J Respir Crit Care Med. 1996 Jun;153(6 Pt 1):1972-6 - PubMed
  181. Respir Physiol Neurobiol. 2006 Mar 28;151(1):44-60 - PubMed
  182. Sleep. 2007 Sep;30(9):1145-52 - PubMed
  183. J Am Coll Cardiol. 1999 Nov 15;34(6):1744-9 - PubMed
  184. Nat Neurosci. 2011 Mar;14(3):381-6 - PubMed
  185. J Appl Physiol (1985). 2003 Oct;95(4):1394-404 - PubMed
  186. Brain Pathol. 2000 Jan;10(1):113-26 - PubMed
  187. Am J Respir Crit Care Med. 1994 Mar;149(3 Pt 1):707-14 - PubMed
  188. Respir Physiol Neurobiol. 2003 Nov 14;138(2-3):275-90 - PubMed
  189. J Hypertens. 1996 May;14(5):577-84 - PubMed
  190. Mol Neurobiol. 2010 Jun;41(2-3):115-28 - PubMed
  191. Arch Intern Med. 1994 Oct 10;154(19):2219-24 - PubMed
  192. Am J Respir Crit Care Med. 2004 Sep 1;170(5):541-6 - PubMed
  193. BMJ Open. 2011 Jan 1;1(2):e000175 - PubMed
  194. Toxicology. 2004 Sep 1;201(1-3):197-207 - PubMed
  195. Mol Psychiatry. 2011 Jul;16(7):751-62 - PubMed
  196. Int J Immunopathol Pharmacol. 2011 Apr-Jun;24(2):529-34 - PubMed
  197. J Appl Physiol (1985). 2001 Sep;91(3):1245-50 - PubMed
  198. Hypertension. 2006 May;47(5):833-9 - PubMed
  199. Ageing Res Rev. 2009 Jan;8(1):18-30 - PubMed
  200. J Cereb Blood Flow Metab. 2000 Jun;20(6):967-78 - PubMed
  201. Auton Neurosci. 2008 Nov 3;142(1-2):25-31 - PubMed
  202. Exp Physiol. 2010 May;95(5):595-600 - PubMed
  203. Am J Physiol Cell Physiol. 2010 Jun;298(6):C1594-602 - PubMed
  204. J Sleep Res. 1995 Jun;4(S1):135-144 - PubMed
  205. Neuroepidemiology. 2010;34(4):222-9 - PubMed
  206. Circulation. 2005 Aug 2;112(5):759-70 - PubMed
  207. Am Rev Respir Dis. 1987 Jun;135(6):1316-9 - PubMed
  208. Biochemistry. 2011 Nov 15;50(45):9911-22 - PubMed
  209. Adv Exp Med Biol. 2006;588:65-73 - PubMed
  210. Arch Neurol. 2003 Jul;60(7):989-94 - PubMed
  211. Int J Clin Pract Suppl. 2002 Jul;(129):59-64 - PubMed
  212. Eur J Pharmacol. 2004 Oct 1;500(1-3):399-411 - PubMed
  213. Trends Neurosci. 1998 Apr;21(4):154-9 - PubMed
  214. Hypertens Res. 2010 Sep;33(9):867-71 - PubMed
  215. Behav Brain Res. 2000 Jul;112(1-2):151-8 - PubMed
  216. J Neurol Neurosurg Psychiatry. 2003 Jun;74(6):788-9 - PubMed
  217. Am J Physiol Heart Circ Physiol. 2000 Jul;279(1):H234-7 - PubMed
  218. PLoS One. 2011 Jan 19;6(1):e16277 - PubMed
  219. Circulation. 2002 Sep 17;106(12):1439-41 - PubMed
  220. J Clin Invest. 1995 Oct;96(4):1897-904 - PubMed
  221. Brain Res. 2008 Oct 21;1236:1-7 - PubMed
  222. Chest. 1995 Sep;108(3):625-30 - PubMed
  223. Annu Rev Physiol. 1994;56:93-116 - PubMed
  224. J Neurochem. 2010 Feb;112(4):854-69 - PubMed
  225. Laryngoscope. 1991 Dec;101(12 Pt 1):1318-22 - PubMed
  226. J Gerontol A Biol Sci Med Sci. 2006 Apr;61(4):405-10 - PubMed
  227. Neuron. 2010 Jun 10;66(5):695-709 - PubMed
  228. Antioxid Redox Signal. 2009 Jan;11(1):59-98 - PubMed
  229. J Appl Physiol (1985). 2004 Oct;97(4):1343-8 - PubMed
  230. Sleep. 2010 Feb;33(2):235-41 - PubMed
  231. Sleep Disord. 2011;2011:596879 - PubMed
  232. N Engl J Med. 1996 Feb 1;334(5):292-5 - PubMed
  233. J Neurosci Res. 2011 Apr;89(4):506-14 - PubMed
  234. Lancet. 1994 Jul 2;344(8914):14-8 - PubMed
  235. Arch Int Physiol Biochim Biophys. 1991 Sep;99(5):A3-52 - PubMed
  236. J Neurol. 2003 Aug;250(8):907-12 - PubMed
  237. Exp Gerontol. 1998 Aug;33(5):371-8 - PubMed
  238. J Appl Physiol (1985). 2003 Apr;94(4):1583-95 - PubMed
  239. Scand J Work Environ Health. 1986 Aug;12(4 Spec No):280-3 - PubMed
  240. J Neuroinflammation. 2007 May 02;4:12 - PubMed
  241. Mediators Inflamm. 2010;2010:675320 - PubMed
  242. Am J Respir Crit Care Med. 2011 Dec 1;184(11):1305-12 - PubMed
  243. Neuroimage. 2008 Jan 1;39(1):500-14 - PubMed
  244. J Auton Nerv Syst. 1996 Jan 5;56(3):184-90 - PubMed

Publication Types