{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,11]],"date-time":"2026-09-11T15:38:37Z","timestamp":1789141117980,"version":"build-2803163510"},"reference-count":49,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2026,2,4]],"date-time":"2026-02-04T00:00:00Z","timestamp":1770163200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,2,4]],"date-time":"2026-02-04T00:00:00Z","timestamp":1770163200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Magnetic Resonance Imaging"],"published-print":{"date-parts":[[2026,6]]},"abstract":"ABSTRACT<\/jats:title>\n \n Background<\/jats:title>\n Excessive daytime sleepiness (EDS) substantially impairs health\u2010related quality of life and cognitive function in obstructive sleep apnea (OSA) patients. However, the underlying neuropathological mechanisms remain poorly understood.<\/jats:p>\n <\/jats:sec>\n \n Purpose<\/jats:title>\n To investigate the associations between EDS, cognitive deficits, and brain alterations in OSA patients.<\/jats:p>\n <\/jats:sec>\n \n Study Type<\/jats:title>\n Prospective.<\/jats:p>\n <\/jats:sec>\n \n Population<\/jats:title>\n One hundred two OSA patients (16 female, median age (IQR) 33.00 [28.00\u201341.00]) and 86 healthy controls (HCs) (16 female, median age (IQR) 33.00 [25.00\u201350.25]) were prospectively recruited.<\/jats:p>\n <\/jats:sec>\n \n Field Strength\/Sequence<\/jats:title>\n 3\u2009T, 3D spoiled gradient\u2010echo, diffusion\u2010weighted spin\u2010echo, blood oxygen level\u2010dependent gradient\u2010echo planar.<\/jats:p>\n <\/jats:sec>\n \n Assessment<\/jats:title>\n The Epworth Sleepiness Scale, multiparameter MRI, and a series of neuropsychological tests (the number connection tests A and B, digit symbol test, line tracing test, serial dotting test, and Stroop Color\/Word test) were performed to evaluate EDS, brain alterations, and cognitive performances.<\/jats:p>\n <\/jats:sec>\n \n Statistical Tests<\/jats:title>\n \n Mann\u2013Whitney\n U<\/jats:italic>\n test, independent samples\n t<\/jats:italic>\n \u2010test, chi\u2010square test, Spearman's correlation, and mediation analyses were used. Significance level:\n p<\/jats:italic>\n \u2009<\u20090.05.\n <\/jats:p>\n <\/jats:sec>\n \n Result<\/jats:title>\n \n OSA patients exhibited statistically poorer cognitive performance (effect size\u2009=\u20090.23\u20130.37), lower diffusion tensor imaging along the perivascular space (DTI\u2010ALPS) index (effect size\u2009=\u20090.25), and abnormal network topology (effect size\u2009=\u2009\u22120.80 to 0.57) compared with HCs. EDS significantly correlated with poorer cognitive performance (\n r<\/jats:italic>\n \u2009=\u2009\u22120.173 to 0.258), lower DTI\u2010ALPS index (\n r<\/jats:italic>\n \u2009=\u2009\u22120.199), and abnormal network topology (\n r<\/jats:italic>\n \u2009=\u2009\u22120.364 to 0.279) in all participants. Furthermore, aberrant degree centrality and nodal efficiency in the bilateral middle frontal gyrus (MFG) and left inferior parietal lobule (IPL) may mediate the relationship between EDS and cognitive deficits (indirect effect\u2009=\u2009\u22120.13 to 0.36).\n <\/jats:p>\n <\/jats:sec>\n \n Data Conclusion<\/jats:title>\n These results demonstrate that cognition, DTI\u2010ALPS index, and network topology were all compromised in OSA. Furthermore, abnormal network topology in the bilateral MFG and left IPL may mediate the relationship between EDS and cognitive deficits.<\/jats:p>\n <\/jats:sec>\n \n Evidence Level<\/jats:title>\n Level 2.<\/jats:p>\n <\/jats:sec>\n \n Technical Efficacy<\/jats:title>\n Stage 2.<\/jats:p>\n <\/jats:sec>","DOI":"10.1002\/jmri.70255","type":"journal-article","created":{"date-parts":[[2026,2,5]],"date-time":"2026-02-05T05:22:24Z","timestamp":1770268944000},"page":"1625-1636","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Associations Between Excessive Daytime Sleepiness, Cognitive Impairment, and Brain Alterations in Patients With Obstructive Sleep Apnea"],"prefix":"10.1002","volume":"63","author":[{"given":"Ying","family":"Li","sequence":"first","affiliation":[{"name":"Department of Radiology Shenzhen University Shenzhen China"},{"name":"Department of Radiology General Hospital of Ningxia Medical University Yinchuan China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shiwei","family":"Lin","sequence":"additional","affiliation":[{"name":"Department of Radiology Shenzhen University Shenzhen China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hongyue","family":"Wei","sequence":"additional","affiliation":[{"name":"Department of Radiology Shenzhen University Shenzhen China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qianyun","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Radiology Shenzhen University Shenzhen China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shengli","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Radiology Shenzhen University Shenzhen China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fajian","family":"Wei","sequence":"additional","affiliation":[{"name":"Department of Radiology Shenzhen University Shenzhen China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shuo","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology Shenzhen Nanshan People's Hospital (NSPH), Shenzhen University Shenzhen China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1298-8506","authenticated-orcid":false,"given":"Yingwei","family":"Qiu","sequence":"additional","affiliation":[{"name":"Department of Radiology Shenzhen University Shenzhen China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,2,4]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1172\/JCI137560"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1513\/AnnalsATS.202006-696FR"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11325-007-0137-7"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00405-024-08756-0"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2869.2008.00660.x"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.2147\/NSS.S327110"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.3389\/fneur.2023.1019457"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.smrv.2021.101572"},{"key":"e_1_2_11_10_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11064-015-1581-6"},{"key":"e_1_2_11_11_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11604-017-0617-z"},{"key":"e_1_2_11_12_1","doi-asserted-by":"publisher","DOI":"10.1126\/science.aax5440"},{"key":"e_1_2_11_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.sleep.2021.12.013"},{"key":"e_1_2_11_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.sleep.2025.03.009"},{"key":"e_1_2_11_15_1","doi-asserted-by":"publisher","DOI":"10.1002\/ana.26516"},{"key":"e_1_2_11_16_1","doi-asserted-by":"publisher","DOI":"10.1002\/mds.28643"},{"key":"e_1_2_11_17_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41386-019-0465-x"},{"issue":"5","key":"e_1_2_11_18_1","doi-asserted-by":"crossref","first-page":"665","DOI":"10.5664\/jcsm.6576","article-title":"AASM Scoring Manual Updates for 2017 (Version 2.4)","volume":"13","author":"Berry R. 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