Decoupling of Global Brain Activity and Cerebrospinal Fluid Dynamics in Obstructive Sleep Apnea: Links to Disease Severity and Hypoxemia

Motivation: Obstructive Sleep Apnea (OSA) can significantly affect brain function, but its impact on brain activity and cerebrospinal fluid (CSF) coupling dynamics remains unexplored. Understanding this interaction could help uncover new neurophysiological mechanisms underlying OSA. Goal(s): This study aims to quantitatively evaluate the global blood-oxygen-level-dependent (gBOLD) and CSF coupling in OSA patients and investigate its relationship with clinical indicators, such as the apnea-hypopnea index (AHI) and oxygen saturation. Approach: 27 OSA patients and 30 controls underwent rs-fMRI and 3D T1 imaging to assess gBOLD-CSF coupling. Results: OSA patients showed reduced gBOLD-CSF coupling, positively correlating with AHI and negatively with oxygen saturation. Impact: This study reveals how OSA disrupts brain-CSF interactions and suggests that gBOLD-CSF coupling may serve as a biomarker for diagnosis and treatment. Future research should explore whether improving oxygenation or sleep quality can restore coupling and enhance cognitive function.