Possibilities of predicting the risk of cognitive impairments in patients with sleep apnea and cerebral infarction

Abstract

Objective. To evaluate the effectiveness of superoxide dismutase (SOD) as a marker for predicting cognitive impairment at the end of the acute period of cerebral infarction (CI) in patients with sleep apnea (SA).

Materials and methods. Seventy four patients in the acute period of CI and concomitant SA and 36 patients with СI without AS were examined. All patients underwent respiratory polygraphy, determination of cognitive impairment using the Montreal Cognitive Assessment, and blood SOD analysis.

Results. A threshold value of serum SOD activity ≤47.9 activity units was established, which is a prognostic marker of impairments in visual-constructive/executive skills (AUC ‒ 0.725 (95% CI 0.609–0.823; p=0.003); sensitivity ‒ 70.9% (95% CI 58.1–81.8); specificity ‒ 66.7% (95% CI 34.9–90.1)) and delayed recall (AUC ‒ 0.701 (95% CI 0.584–0.802; p=0.005); sensitivity ‒ 70.5% (95% CI 57.4–81.5); specificity ‒ 61.5% (95% CI 31.6–86.1)) at the end of the acute period of CI in patients with SA.

Conclusion. In patients with SA the threshold value of the blood SOD activity indicator ≤47.9 activity units can be used as a good-quality classifier for identifying risk groups for the development of visual-constructive/executive skills disorders and delayed recall starting from the first days of the CI, and planning their treatment and rehabilitation measures including the appointment of continuous positive airway pressure therapy.