The effects of obstructive sleep apnea syndrome on the dentate gyrus and learning and memory in children

Jiook Cha, Johanna A. Zea-Hernandez, Sanghun Sin, Katharina Graw-Panzer, Keivan Shifteh, Carmen R. Isasi, Mark E. Wagshul, Eileen E. Moran, Jonathan Posner, Molly E. Zimmerman, Raanan Arens

Research output: Contribution to journalArticlepeer-review

63 Scopus citations


Obstructive sleep apnea syndrome (OSAS) is associated with intermittent hypoxia and sleep loss. In children, impairments of cognitive function are important manifestations, but the underlying pathology is unknown. We hypothesized that OSAS would affect the dentate gyrus, a hippocampal subdivision essential to neurogenesis and cognition, and that this impact would further affect cognitive function in children. In children with OSAS (n = 11) and control subjects (n = 12; age and sex matched), we performed diffusion tensor imaging and structural MRI, polysomnography, and neuropsychological assessments. We found that OSAS was associated with decreased mean diffusivity of the left dentate gyrus (p = 0.002; false discovery rate corrected; adjusting for sex, age, and body mass index), showing a large effect size (partial n2 = 0.491), but not with any other structural measures across the brain. Decreased dentate gyrus mean diffusivity correlated with a higher apnea hypopnea index (Spearman’s r = -0.50, p = 0.008) and a greater arousal index (r = -0.44, p = 0.017). OSAS did not significantly affect neuropsychological measures (p values >0.5); however, a lower verbal learning score correlated with lower dentate gyrus mean diffusivity (r = 0.54, p = 0.004). Path analysis demonstrated that dentate gyrus mean diffusivity mediates the impact of OSAS on verbal learning capacity. Finally, the diagnostic accuracy of a regression model based on dentate gyrus mean diffusivity reached 85.8% (cross validated). This study demonstrates a likely pathway of effects of OSAS on neurocognitive function in children, as well as potential utility of the dentate gyrus mean diffusivity as an early marker of brain pathology in children with OSAS.

Original languageEnglish (US)
Pages (from-to)4280-4288
Number of pages9
JournalJournal of Neuroscience
Issue number16
StatePublished - Apr 19 2017


  • Diffusion anisotropy
  • Hippocampus
  • Magnetic resonance imaging

ASJC Scopus subject areas

  • Neuroscience(all)


Dive into the research topics of 'The effects of obstructive sleep apnea syndrome on the dentate gyrus and learning and memory in children'. Together they form a unique fingerprint.

Cite this