Risk of Alzheimer’s Disease in Obstructive Sleep Apnea Syndrome: Amyloid-β and Tau Imaging

Article type: Research Article

Authors: Elias, Alby^{a; e; *} | Cummins, Tia^f | Tyrrell, Regan^a | Lamb, Fiona^a | Dore, Vincent^b | Williams, Robert^c | Rosenfeld, J.V.^d | Hopwood, Malcolm^e | Villemagne, Victor L.^a | Rowe, Christopher C.^a

Affiliations: [a] Department of Molecular Imaging and Therapy, Austin Health, The University of Melbourne, Victoria, Australia | [b] CSIRO Brisbane, Queensland, Australia | [c] Melbourne Brain Centre, Parkville, Victoria, Australia | [d] Department of Neurosurgery, Monash University, Victoria, Australia | [e] Department of Psychiatry, The University of Melbourne, Victoria, Australia | [f] The Florey Institute of Neuroscience and Mental Health

Correspondence: [*] Correspondence to: Alby Elias, 343 Burwood Hwy, East Burwood, 3151 Victoria, Australia. Tel.: +61 417325223; Fax: +61 3 98725964; E-mail:[email protected].

Abstract: Background: An association between obstructive sleep apnea (OSA) and Alzheimer’s disease has been suggested but little is known about amyloid-β and tau deposition in this syndrome. Objective: To determine amyloid and tau burden and cognitive function in OSA in comparison with those without a diagnosis of OSA. Methods: The status of OSA was determined by asking participants about history of polysomnographic diagnosis of OSA and the use of Continuous Positive Airway Pressure (CPAP). A comprehensive neuropsychological battery measured cognitive function. Positron emission tomography (PET) was used to measure standardized uptake value ratio (SUVR) of 18F-florbetaben and 18F-AV1451, to quantify amyloid and tau burden. Results: 119 male Vietnam veterans completed assessment. Impairment in visual attention and processing speed and increased body mass index (BMI) were seen in subjects with OSA compared with those without a diagnosis OSA. The cortical uptake of 18F-florbetaben was higher in the OSA group than in the control group (SUVR: 1.35±0.21 versus 1.27±0.16, p = 0.04). There were more apolipoprotein E ɛ4 allele (APOE ɛ4) carriers in the OSA group than in the control group. In multilinear regression analysis, the significance of OSA in predicting 18F-florbetaben uptake remained independent of age and vascular risk factors but not when BMI or APOE ɛ4 was adjusted. The reported use of CPAP (n = 14) had no effect on cognitive or amyloid PET findings. There was no significant difference in 18F-AV1451 uptake between the two groups. Conclusions: Obstructive sleep apnea is associated with Alzheimer’s disease pathology, but this relationship is moderated by APOE ɛ4 and BMI.

Keywords: Alzheimer’s disease, amyloid PET, dementia, obstructive sleep apnea, tau PET

DOI: 10.3233/JAD-180640

Journal: Journal of Alzheimer's Disease, vol. 66, no. 2, pp. 733-741, 2018