Firdevs Ezgi UÇAN TOKUÇ, Fatma GENÇ, Ömer Tarık SELÇUK, Ruhsen OCAL, Aylin YAMAN

Ağır Derecede Obstrüktif Uyku Apne Sendromu Hastalarında Bilişsel İşlevlerin Değerlendirilmesi

Amaç: Üst solunum yolu obstrüksiyonuna bağlı apne ve oksijen satürasyonunda düşme ile karakterize obstrüktif uyku apne sendromunun (OUAS) bazı nörokognitif bozukluklara sebep olabileceği daha önceki çalışmalarda ileri sürülmüştür. Bu çalışmada sağlıklı kontrol grubuna kıyasla, ağır OUAS hastalarında gelişebilecek ileri kognitif fonksiyonları değerlendirmeyi amaçladık. Gereç ve Yöntemler: Polisomnografik (PSG) inceleme yapılmış olan hastalardan ağır OUAS tanısı alan 18-70 yaş arasındaki 25 hastaya ileri kognitif testler uygulandı. Olgular yaş ve cinsiyet uyumlu 25 sağlıklı kontrol grubu ile kıyaslandı. Hasta ve kontrol gruplarına; epizodik bellek ve öğrenmeyi değerlendirilmek için Rey İşitsel Sözel Öğrenme Testi (Rey ‘Auditory Verbal Learning Test’, AVLT) ile yürütücü fonksiyonlar ve dikkati değerlendirmek için Stroop Testi uygulandı. Bulgular: Gruplar arasında Stroop-1, Stroop-2, Stroop-3, Stroop-4 ve Stroop-Toplam sürelerinde (sırası ile ortalama ± standart sapma: 13,3±5,3 saniye, 13,2±4 saniye, 18,1±7,1 saniye, 24,2±7,4 saniye, 100,8±29,7 saniye ve p değerleri: p=0.031, p=0.044, p=0.013, p=0.027 ve p=0.032) uzama, AVLT testinde ise AVLT B, AVLT Tanıma puanlarında düşüş izlendi (sırası ile ortalama ± standart sapma: 12,7±2,3 puan, 38±10,2 puan ve p değerleri: p=0.042, p<0.001). OUAS grubunda yaş, cinsiyet ve komorbit hastalıklar ile Stroop Testi ve AVLT sonuçları karşılaştırıldığında istatistiksel olarak anlamlı bir farklılık saptanmadı (p>0.05). Sonuç: Çalışmamızda ağır derecede OUAS hastalarında Stroop Testi ve AVLT sonucuna göre dikkat ve epizodik belleğin belirgin şekilde bozulduğunu gösterdik.

Anahtar Kelimeler:

Kognitif disfonksiyon, obstrüktif uyku apne sendromu, rey işitsel sözel öğrenme testi, stroop testi

Evaluation of Cognitive Functions in Patients with Severely Obstructive Sleep Apnea Syndrome

Aim: Obstructive sleep apnea syndrome (OSAS), which is characterized by apnea due to recurrent upper respiratory tract obstruction and a decrease in oxygen saturation, is known to cause many neurocognitive disorders. In this study, we aimed to show the effect on cognitive functions that may develop in severe OSAS patients compared to the healthy control group. Material and Methods: We compared the cognitive status of 25 patients diagnosed with severe OSAS between 18 - 70 years with an all-night Polysomnographic (PSG) examination with 25 healthy voluntary control groups of similar age and gender. In both groups, patients who were previously diagnosed with cognitive dysfunction, who used drugs that would impair cognitive functions and who were diagnosed with a psychiatric disease were exclueded from the study. Rey Auditory Verbal Learning Test (AVLT) and Stroop Test were applied to the patient and control groups. Results: There was slowed responce time in Stroop-1, Stroop-2, Stroop-3, Stroop-4 and Stroop-Total tests (mean ± standard deviation: 13.3±5.3 second, 13.2±4 second, 18.1±7.1 second, 24.2±7.4 second, 100.8±29.7 second and p values: p=0.031, p=0.044, p=0.013, p=0.027, p=0.032, respectively) and also there was worsening in in AVLT B1, AVLT-Recognition tests ( mean ± standard deviation: 12.7±2.3 point, 38±10.2 point and p values: p=0.042, p<0.001 respectively). As compared age, gender, comorbid disease with Stroop Test and AVLT there wasn’t statistically significant in the OSAS group (p>0.05). Conclusion: Our findings confirm that attention and episodic memory can be significantly impaired using the Stroop and AVLT in patients with severe OSAS.

Keywords:

Cognitive dysfunction, obstructive sleep apnea syndrome, Rey auditory verbal learning test, stroop test,

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