Whole Brain Amide Proton Transfer Weighted Imaging in Children With Obstructive Sleep Apnea

Purpose To investigate alteration of brain amide proton transfer weighted (APTw) signals in children with obstructive sleep apnea (OSA) and to assess the association of APTw signals in different brain regions with cognitive impairment. Methods This prospective study was conducted from September 2021 to December 2023. Forty‐six children with mild to severe OSA and 20 non‐OSA volunteers with matched age and gender underwent a whole brain APTw imaging scan. The APTw signals of 29 regions of the brain were compared between the OSA group and volunteers with Fisher's least significant differences post‐hoc analysis or the Kruskal–Wallis test with the Steel‐Dwass test. The correlation of the APTw signals of different brain regions and cognitive assessment scores was analyzed with Pearson's correlation analysis or Spearman's correlation analysis. Results The APTw signals in the white matter of the inferior frontal gyrus, the white matter of the angular gyrus, and the thalamus of children with mild OSA and volunteers were significantly lower than that of children with moderate‐severe OSA. The APTw signals of the gray matter of the supramarginal gyrus, the gray matter of the lingual gyrus, the corona radiata, and the genu of corpus callosum in children with moderate‐severe OSA were significantly lower than that of volunteers. The APTw signals of the frontal‐parietal‐temporal regions, hippocampus, and corona radiata were significantly associated with cognitive assessment scores. Conclusions APTw imaging could be used for detecting frontal‐parietal‐temporal regions and hippocampus damage in children with OSA, which possibly explain cognitive impairments associated with OSA.