Brainstem Involvement as a Cause of Central Sleep Apnea: Pattern of Microstructural Cerebral Damage in Patients with Cerebral Microangiopathy
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{"title"=>"Brainstem Involvement as a Cause of Central Sleep Apnea: Pattern of Microstructural Cerebral Damage in Patients with Cerebral Microangiopathy", "type"=>"journal", "authors"=>[{"first_name"=>"Thomas", "last_name"=>"Duning", "scopus_author_id"=>"9040983700"}, {"first_name"=>"Michael", "last_name"=>"Deppe", "scopus_author_id"=>"54880134400"}, {"first_name"=>"Eva", "last_name"=>"Brand", "scopus_author_id"=>"57201213800"}, {"first_name"=>"Jörg", "last_name"=>"Stypmann", "scopus_author_id"=>"6701491473"}, {"first_name"=>"Charlotte", "last_name"=>"Becht", "scopus_author_id"=>"55658144800"}, {"first_name"=>"Anna", "last_name"=>"Heidbreder", "scopus_author_id"=>"16042294500"}, {"first_name"=>"Peter", "last_name"=>"Young", "scopus_author_id"=>"56693679900"}], "year"=>2013, "source"=>"PLoS ONE", "identifiers"=>{"issn"=>"19326203", "scopus"=>"2-s2.0-84876589194", "sgr"=>"84876589194", "pui"=>"368792906", "pmid"=>"23637744", "doi"=>"10.1371/journal.pone.0060304"}, "id"=>"53eaff23-8d6d-35ab-9188-8fb0dd303f52", "abstract"=>"BACKGROUND: The exact underlying pathomechanism of central sleep apnea with Cheyne-Stokes respiration (CSA-CSR) is still unclear. Recent studies have demonstrated an association between cerebral white matter changes and CSA. A dysfunction of central respiratory control centers in the brainstem was suggested by some authors. Novel MR-imaging analysis tools now allow far more subtle assessment of microstructural cerebral changes. The aim of this study was to investigate whether and what severity of subtle structural cerebral changes could lead to CSA-CSR, and whether there is a specific pattern of neurodegenerative changes that cause CSR. Therefore, we examined patients with Fabry disease (FD), an inherited, lysosomal storage disease. White matter lesions are early and frequent findings in FD. Thus, FD can serve as a \"model disease\" of cerebral microangiopathy to study in more detail the impact of cerebral lesions on central sleep apnea.\\n\\nPATIENTS AND METHODS: Genetically proven FD patients (n = 23) and age-matched healthy controls (n = 44) underwent a cardio-respiratory polysomnography and brain MRI at 3.0 Tesla. We applied different MR-imaging techniques, ranging from semiquantitative measurement of white matter lesion (WML) volumes and automated calculation of brain tissue volumes to VBM of gray matter and voxel-based diffusion tensor imaging (DTI) analysis.\\n\\nRESULTS: In 5 of 23 Fabry patients (22%) CSA-CSR was detected. Voxel-based DTI analysis revealed widespread structural changes in FD patients when compared to the healthy controls. When calculated as a separate group, DTI changes of CSA-CSR patients were most prominent in the brainstem. Voxel-based regression analysis revealed a significant association between CSR severity and microstructural DTI changes within the brainstem.\\n\\nCONCLUSION: Subtle microstructural changes in the brainstem might be a neuroanatomical correlate of CSA-CSR in patients at risk of WML. DTI is more sensitive and specific than conventional structural MRI and other advanced MR analyses tools in demonstrating these abnormalities.", "link"=>"http://www.mendeley.com/research/brainstem-involvement-cause-central-sleep-apnea-pattern-microstructural-cerebral-damage-patients-cer", "reader_count"=>33, "reader_count_by_academic_status"=>{"Unspecified"=>4, "Professor > Associate Professor"=>2, "Researcher"=>5, "Student > Doctoral Student"=>3, "Student > Ph. D. Student"=>8, "Student > Postgraduate"=>1, "Other"=>5, "Student > Master"=>3, "Student > Bachelor"=>1, "Lecturer > Senior Lecturer"=>1}, "reader_count_by_user_role"=>{"Unspecified"=>4, "Professor > Associate Professor"=>2, "Researcher"=>5, "Student > Doctoral Student"=>3, "Student > Ph. D. Student"=>8, "Student > Postgraduate"=>1, "Other"=>5, "Student > Master"=>3, "Student > Bachelor"=>1, "Lecturer > Senior Lecturer"=>1}, "reader_count_by_subject_area"=>{"Engineering"=>4, "Unspecified"=>5, "Biochemistry, Genetics and Molecular Biology"=>1, "Medicine and Dentistry"=>13, "Agricultural and Biological Sciences"=>4, "Neuroscience"=>2, "Pharmacology, Toxicology and Pharmaceutical Science"=>1, "Psychology"=>3}, "reader_count_by_subdiscipline"=>{"Engineering"=>{"Engineering"=>4}, "Medicine and Dentistry"=>{"Medicine and Dentistry"=>13}, "Neuroscience"=>{"Neuroscience"=>2}, "Psychology"=>{"Psychology"=>3}, "Agricultural and Biological Sciences"=>{"Agricultural and Biological Sciences"=>4}, "Biochemistry, Genetics and Molecular Biology"=>{"Biochemistry, Genetics and Molecular Biology"=>1}, "Unspecified"=>{"Unspecified"=>5}, "Pharmacology, Toxicology and Pharmaceutical Science"=>{"Pharmacology, Toxicology and Pharmaceutical Science"=>1}}, "reader_count_by_country"=>{"Austria"=>1, "France"=>1}, "group_count"=>0}

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Figshare

  • {"files"=>["https://ndownloader.figshare.com/files/1033039"], "description"=>"<p>Coloured bars represent t-values; display threshold is set at t value >3.16. A: FA values of the complete FD patients group (n = 23) were significantly reduced in WM areas covering widespread parts of the brain, indicating structural WM changes extending beyond the WM lesions that showed up on conventional MRI. B and C: Subgroup analyses of both patient groups (without (1B; n = 18) and with (1C; n = 5) CSA-CSR), relative to the healthy controls (n = 44). Clusters of FA changes in patients with CSA-CSR were most pronounced in the brainstem. By contrast, FD patients without CSA-CSR revealed more widespread FA decreases in supratentorial areas, but only subtle brainstem involvement. SPM  =  Statistical Parametric Mapping; FD = Fabry Disease; FA = Fractional Anisotropy; WM = White Matter; MRI = Magnetic Resonance Imaging; CSA-CSR = Central sleep apnea with Cheyne-Stokes respiration.</p>", "links"=>[], "tags"=>["Anatomy and physiology", "Neurological system", "Motor systems", "Respiratory system", "Clinical research design", "Case-control studies", "Diagnostic medicine", "pathology", "anatomical pathology", "neuropathology", "neurology", "Neurodegenerative diseases", "neuroimaging", "Sleep disorders", "representations", "fa", "maps", "superimposed", "normalized", "t1-weighted", "template", "clusters", "microstructural", "fd", "compared", "controls", "corrected", "50", "contiguous"], "article_id"=>689173, "categories"=>["Medicine", "Biological Sciences"], "users"=>["Thomas Duning", "Michael Deppe", "Eva Brand", "Jörg Stypmann", "Charlotte Becht", "Anna Heidbreder", "Peter Young"], "doi"=>["https://dx.doi.org/10.1371/journal.pone.0060304.g001"], "stats"=>{"downloads"=>0, "page_views"=>0, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_SPM_glass_brain_representations_upper_row_and_statistical_FA_maps_that_were_superimposed_on_a_normalized_T1_weighted_template_lower_row_showing_clusters_of_microstructural_damage_of_the_FD_patient_group_compared_to_healthy_controls_ANCOVA_modelling_age_a/689173", "title"=>"SPM \"glass brain\" representations (upper row) and statistical FA maps that were superimposed on a normalized T1-weighted template (lower row) showing clusters of microstructural damage of the FD patient group compared to healthy controls (ANCOVA, modelling age as a co-variate; p<0.001, corrected for multiple comparison; minimum of 50 contiguous voxels).", "pos_in_sequence"=>0, "defined_type"=>1, "published_date"=>"2013-04-23 02:32:53"}
  • {"files"=>["https://ndownloader.figshare.com/files/1033040"], "description"=>"<p>SPM “glass brain” presentation (left) and statistical FA maps that were superimposed on a normalized T1-weigthed template (middle and right) showing symmetric clusters of correlation between relative CSR length and decreased FA values in the upper brainstem and in frontal WM as well as in connecting fibres between both areas (p<0.001, minimum of 50 continuous voxels; corrected for multiple comparisons). Coloured bars represent t-values; display threshold is set at t-value >3.71. CSR = Cheyne-Stokes Respiration; CSA = Central Sleep Apnea; SPM = Statistical Parametric Mapping; FA = Fractional Anisotropy.</p>", "links"=>[], "tags"=>["Anatomy and physiology", "Neurological system", "Motor systems", "Respiratory system", "Clinical research design", "Case-control studies", "Diagnostic medicine", "pathology", "anatomical pathology", "neuropathology", "neurology", "Neurodegenerative diseases", "neuroimaging", "Sleep disorders", "regions", "microstructural", "lesions", "severity", "csr", "patients"], "article_id"=>689174, "categories"=>["Medicine", "Biological Sciences"], "users"=>["Thomas Duning", "Michael Deppe", "Eva Brand", "Jörg Stypmann", "Charlotte Becht", "Anna Heidbreder", "Peter Young"], "doi"=>["https://dx.doi.org/10.1371/journal.pone.0060304.g002"], "stats"=>{"downloads"=>0, "page_views"=>0, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Brain_regions_in_which_microstructural_lesions_were_associated_with_the_severity_of_CSR_in_patients_with_CSA_/689174", "title"=>"Brain regions in which microstructural lesions were associated with the severity of CSR in patients with CSA.", "pos_in_sequence"=>0, "defined_type"=>1, "published_date"=>"2013-04-23 02:32:54"}
  • {"files"=>["https://ndownloader.figshare.com/files/1033042"], "description"=>"<p>There were no differences of brain tissue volumes between both patient groups or between FD patients and healthy controls. Values of lesion load did also not differ between both patient groups (two-sample t-tests).</p><p>Patients with CSA-CSR showed significantly decreased sleep efficiency, a higher AHI and cAHI, and a more severe oxygen desaturation compared to patients without CSA-CSR. Four patients with OSAS were found, two in both patient groups.</p><p>P-values in bold indicate significant differences between both patient groups.</p><p>Sleep Efficiency = total sleep time/total recording time ×100; Sleep stages: 1 = alpha rhythm is attenuated and replaced by low amplitude, mixed frequency for more than 50% of the epoch; 2 = presence of sleep spindles and K complexes on a background of low-amplitude, mixed frequency activity; 3 = slow wave activity in greater than 20% <a href=\"http://www.plosone.org/article/info:doi/10.1371/journal.pone.0060304#pone.0060304-Iber1\" target=\"_blank\">[2]</a>. FD = Fabry Disease; CSA = Central Sleep Apnea; WM = White Matter; GM = Gray Matter; WML = White Matter Lesion; REM = Rapid Eye Movements; NREM = Non-REM; AHI = Apnea/Hypopnea Index; cAHI = central AHI; oAHI = obstructive AHI; SpO<sub>2</sub> = Saturation of peripheral Oxygen; PLMS = Periodic Limb Movement; CRS = Cheyne-Stokes Respiration; CSR rel. = duration of CSR episodes/total duration of sleep.</p>", "links"=>[], "tags"=>["Anatomy and physiology", "Neurological system", "Motor systems", "Respiratory system", "Clinical research design", "Case-control studies", "Diagnostic medicine", "pathology", "anatomical pathology", "neuropathology", "neurology", "Neurodegenerative diseases", "neuroimaging", "Sleep disorders", "deviations", "mr", "imaging", "polysomnographic"], "article_id"=>689176, "categories"=>["Medicine", "Biological Sciences"], "users"=>["Thomas Duning", "Michael Deppe", "Eva Brand", "Jörg Stypmann", "Charlotte Becht", "Anna Heidbreder", "Peter Young"], "doi"=>["https://dx.doi.org/10.1371/journal.pone.0060304.t002"], "stats"=>{"downloads"=>0, "page_views"=>0, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Means_and_Standard_Deviations_of_the_MR_imaging_analyses_and_polysomnographic_parameter_/689176", "title"=>"Means and Standard Deviations of the MR imaging analyses and polysomnographic parameter.", "pos_in_sequence"=>0, "defined_type"=>3, "published_date"=>"2013-04-23 02:32:56"}
  • {"files"=>["https://ndownloader.figshare.com/files/1033043"], "description"=>"<p>Patients with CSA-CSR had a higher ESS score (P = 0.02). All other clinical and demographic data did not differ among both patient groups (P>0.05, two-sample t-tests).</p><p>CSA = Central Sleep Apnea; MSSI = Mainz Severity Score Index; WML = White Matter Lesions; LVEF = Left Ventricular Ejection Fraction; NYHA = New York Heart Association functional class; eGFR = estimated Glomerular Filtration Rate; ESS = Epworth Sleepiness Scale; ERT = Enzyme Replacement Therapy; LVEDD = Left Ventricular End-Diastolic Diameter; IVSD = Interventricular Septal Wall Thickness; EF = Ejection Fraction; BMI = Body Mass Index; *Mean±Standard Deviation.</p>", "links"=>[], "tags"=>["Anatomy and physiology", "Neurological system", "Motor systems", "Respiratory system", "Clinical research design", "Case-control studies", "Diagnostic medicine", "pathology", "anatomical pathology", "neuropathology", "neurology", "Neurodegenerative diseases", "neuroimaging", "Sleep disorders", "patients"], "article_id"=>689177, "categories"=>["Medicine", "Biological Sciences"], "users"=>["Thomas Duning", "Michael Deppe", "Eva Brand", "Jörg Stypmann", "Charlotte Becht", "Anna Heidbreder", "Peter Young"], "doi"=>["https://dx.doi.org/10.1371/journal.pone.0060304.t001"], "stats"=>{"downloads"=>0, "page_views"=>0, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Demographic_and_clinical_characteristics_of_patients_and_controls_/689177", "title"=>"Demographic and clinical characteristics of patients and controls.", "pos_in_sequence"=>0, "defined_type"=>3, "published_date"=>"2013-04-23 02:32:57"}

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  • {"unique-ip"=>"174", "full-text"=>"436", "pdf"=>"6", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"1", "year"=>"2018", "month"=>"10"}
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  • {"unique-ip"=>"137", "full-text"=>"340", "pdf"=>"1", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2019", "month"=>"9"}
  • {"unique-ip"=>"149", "full-text"=>"317", "pdf"=>"5", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"1", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2019", "month"=>"10"}
  • {"unique-ip"=>"170", "full-text"=>"354", "pdf"=>"10", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2019", "month"=>"12"}
  • {"unique-ip"=>"173", "full-text"=>"299", "pdf"=>"6", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2020", "month"=>"2"}
  • {"unique-ip"=>"166", "full-text"=>"310", "pdf"=>"5", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2020", "month"=>"3"}
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  • {"unique-ip"=>"130", "full-text"=>"269", "pdf"=>"4", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2020", "month"=>"5"}
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  • {"unique-ip"=>"158", "full-text"=>"351", "pdf"=>"3", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2020", "month"=>"7"}
  • {"unique-ip"=>"135", "full-text"=>"283", "pdf"=>"2", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"2", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2020", "month"=>"8"}
  • {"unique-ip"=>"135", "full-text"=>"316", "pdf"=>"5", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"4", "supp-data"=>"0", "cited-by"=>"1", "year"=>"2020", "month"=>"9"}
  • {"unique-ip"=>"141", "full-text"=>"274", "pdf"=>"2", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2020", "month"=>"10"}
  • {"unique-ip"=>"127", "full-text"=>"195", "pdf"=>"1", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"1", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2020", "month"=>"11"}
  • {"unique-ip"=>"98", "full-text"=>"179", "pdf"=>"4", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2020", "month"=>"12"}
  • {"unique-ip"=>"121", "full-text"=>"187", "pdf"=>"4", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2021", "month"=>"1"}
  • {"unique-ip"=>"86", "full-text"=>"144", "pdf"=>"2", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2021", "month"=>"2"}

Relative Metric

{"start_date"=>"2013-01-01T00:00:00Z", "end_date"=>"2013-12-31T00:00:00Z", "subject_areas"=>[{"subject_area"=>"/Biology and life sciences", "average_usage"=>[269, 466, 588, 697, 800, 896, 988, 1076, 1165, 1254, 1340, 1417]}, {"subject_area"=>"/Biology and life sciences/Neuroscience", "average_usage"=>[261, 444, 554, 655, 748, 834, 923, 1004, 1089, 1170, 1244, 1315, 1380]}, {"subject_area"=>"/Biology and life sciences/Physiology", "average_usage"=>[256, 449, 572, 676, 775, 866, 955, 1041, 1127, 1213, 1290, 1370, 1437]}, {"subject_area"=>"/Medicine and health sciences", "average_usage"=>[264, 460, 584, 692, 794, 887, 978, 1067, 1154, 1241, 1328, 1408, 1474]}, {"subject_area"=>"/Medicine and health sciences/Diagnostic medicine", "average_usage"=>[244, 425, 535, 636, 728, 814, 900, 982, 1063, 1139, 1221, 1296, 1361]}, {"subject_area"=>"/Medicine and health sciences/Radiology and imaging", "average_usage"=>[230, 403, 513, 618, 711, 806, 896, 985, 1065, 1141, 1225, 1296, 1360]}]}
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Net::HTTPBadRequest

Source
CrossRef
Time
2020-07-24 16:18:55 UTC
Target URL
http://doi.crossref.org/servlet/getForwardLinks?usr=plos&pwd=Sp5BS5-wNH6_jJ&doi=10.1371%2Fjournal.pone.0060304
Trace

/app/models/concerns/networkable.rb:21:in `get_result'
/app/models/source.rb:165:in `get_data'
/app/models/retrieval_status.rb:47:in `perform_get_data'
/app/jobs/source_job.rb:52:in `block (2 levels) in perform'
/app/jobs/source_job.rb:51:in `block in perform'
/app/jobs/source_job.rb:35:in `each'
/app/jobs/source_job.rb:35:in `perform'