Compensatory Neural Recruitment for Error-Related Cerebral Activity in Patients with Moderate-To-Severe Obstructive Sleep Apnea

• Main Authors: Ping-Song Chou, Sharon Chia-Ju Chen, Chung-Yao Hsu, Li-Min Liou, Meng-Ni Wu, Ching-Kuan Liu, Chiou-Lian Lai
• Format: Article
• Language: English
• Published: MDPI AG 2019-07-01
• Series: Journal of Clinical Medicine
• Subjects: action monitoring; error positivity; error-related negativity; functional magnetic resonance imaging; modified Flanker task; obstructive sleep apnea
• Online Access: https://www.mdpi.com/2077-0383/8/7/1077

(1) Background: Although it is known that obstructive sleep apnea (OSA) impairs action-monitoring function, there is only limited information regarding the associated cerebral substrate underlying this phenomenon. (2) Methods: The modified Flanker task, error-related event-related potentials (ERPs), namely, error-related negativity (ERN) and error positivity (Pe), and functional magnetic resonance imaging (fMRI) were used to evaluate neural activities and the functional connectivity underlying action-monitoring dysfunction in patients with different severities of OSA. (3) Results: A total of 14 control (<i>Cont</i>) subjects, 17 patients with moderate OSA (<i>m</i>OSA), and 10 patients with severe OSA (<i>s</i>OSA) were enrolled. A significant decline in posterror correction rate was observed in the modified Flanker task when patients with <i>m</i>OSA were compared with <i>Cont</i> subjects. Comparison between patients with <i>m</i>OSA and <i>s</i>OSA did not reveal any significant difference. In the analysis of ERPs, ERN and Pe exhibited declined amplitudes in patients with <i>m</i>OSA compared with <i>Cont</i> subjects, which were found to increase in patients with <i>s</i>OSA. Results of fMRI revealed a decreased correlation in multiple anterior cingulate cortex functional-connected areas in patients with <i>m</i>OSA compared with <i>Cont</i> subjects. However, these areas appeared to be reconnected in patients with <i>s</i>OSA. (4) Conclusions: The behavioral, neurophysiological, and functional image findings obtained in this study suggest that <i>m</i>OSA leads to action-monitoring dysfunction; however, compensatory neural recruitment might have contributed to the maintenance of the action-monitoring function in patients with <i>s</i>OSA.