Abstract #4920

Altered blood pulsatility & small vessel disease marker associations in obstructive sleep apnoea post-continuous positive airway pressure

Michael S Stringer¹, Lizzie Hill², Alasdair Morgan¹, Dany Jaime Garcia¹, Lucia Ballerini³, Will Hewins⁴, Rosalind Brown¹, Roberto Duarte Coello¹, Bradley Macintosh^5,6, Jose Bernal⁷, Andrew Lim^6,8, Rosa Sommer^6,8, Maria Valdes Hernandez¹, Francesca Chappell¹, Sandra Black⁶, Ian Marshall¹, Fergus Doubal¹, Renata Riha⁹, Michael J Thrippleton¹, and Joanna M Wardlaw¹

¹Centre for Clinical Brain Sciences and UK Dementia Research Institute, University of Edinburgh, Edinburgh, United Kingdom, ²School of Applied Sciences, University of the West of England, Bristol, United Kingdom, ³University for Foreigners of Perugia, Perugia, Italy, ⁴School of Health in Social Science, University of Edinburgh, Edinburgh, United Kingdom, ⁵Department of Medical Biophysics, University of Toronto, Toronto, ON, Canada, ⁶Hurvitz Brain Sciences Program, Sunnybrook Research Institute, Toronto, ON, Canada, ⁷Institute of Cognitive Neurology and Dementia Research, Otto-Von-Guericke University and DZNE Magdeburg, Madgeburg, Germany, ⁸Institute of Medical Sciences, University of Toronto, Toronto, ON, Canada, ⁹Department of Sleep Medicine, Royal Infirmary of Edinburgh, NHS Lothian, Edinburgh, United Kingdom

Synopsis

Keywords: Neurofluids, Blood vessels, Phase contrast MRI

Motivation: Sleep affects vascular health and brain waste clearance. Sleep disorders, including obstructive sleep apnoea (OSA), are associated with higher small vessel disease (SVD) burden increasing stroke/dementia risk. OSA treatment relies on continuous positive airway pressure (CPAP).

Goal(s): We aimed to assess the effect of CPAP on MRI-based blood pulsatility index (PI) measures and associations with SVD burden.

Approach: We assessed arterial/venous PI using phase-contrast MRI in patients with moderate/severe OSA before and after 4 months CPAP.

Results: Arterial PI tended lower post-CPAP, consistent with better vascular health. Post-CPAP patients with higher venous PI had less severe basal ganglia perivascular space burden.

Impact: Few studies have investigated MRI-based blood pulsatility index (PI) in obstructive sleep apnoea (OSA). We found effective treatment may improve brain vascular health, altering blood PI. Higher venous PI post-treatment may link to brain waste clearance, but requires further study.

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