Intermittent Hypoxia and Effects on Early Learning/Memory: Exploring the Hippocampal Cellular Effects of Pediatric Obstructive Sleep Apnea

Authors

Arvind Chandrakantan
Adam C Adler
Mehmet Tohsun
Farrah Kheradamand
Russell S Ray
Steven Roth

Publication Date

7-1-2021

Journal

Anesthesia & Analgesia

DOI

10.1213/ANE.0000000000005273

PMID

33234943

PMCID

PMC8134503

PubMedCentral® Posted Date

7-1-2022

PubMedCentral® Full Text Version

Author MSS

Published Open-Access

yes

Keywords

Animals, Child, Hippocampus, Humans, Hypoxia, Learning, Sleep Apnea, Obstructive, Hippocampus, Intermittent Hypoxia, Learning and Memory, Neurocognition, Pediatric Obstructive Sleep Apnea, Reactive Oxygen Species

Abstract

This review provides an update on the neurocognitive phenotype of pediatric obstructive sleep apnea (OSA). Pediatric OSA is associated with neurocognitive deficits involving memory, learning, and executive functioning. Adenotonsillectomy (AT) is presently accepted as the first-line surgical treatment for pediatric OSA, but the executive function deficits do not resolve postsurgery, and the timeline for recovery remains unknown. This finding suggests that pediatric OSA potentially causes irreversible damage to multiple areas of the brain. The focus of this review is the hippocampus, 1 of the 2 major sites of postnatal neurogenesis, where new neurons are formed and integrated into existing circuitry and the mammalian center of learning/memory functions. Here, we review the clinical phenotype of pediatric OSA, and then discuss existing studies of OSA on different cell types in the hippocampus during critical periods of development. This will set the stage for future study using preclinical models to understand the pathogenesis of persistent neurocognitive dysfunction in pediatric OSA.