# Brain Changes in Pediatric Obstructive Sleep Apnea

> **NIH NIH R21** · UNIVERSITY OF CALIFORNIA LOS ANGELES · 2022 · $195,000

## Abstract

PROJECT SUMMARY/ ABSTRACT
 Pediatric obstructive sleep apnea (OSA) is a common and progressive syndrome accompanied by severe
cognition, mood, and daytime behavioral issues, as well as poor school performance, presumably stemming
from compromised neural tissue, induced by intermittent hypoxia and perfusion changes. However, it is unclear
whether the brain tissue injury is in acute or chronic condition, and whether myelin is preferentially affected than
axons, an essential step to understand, since interventions for neural repair/recovery differ for acute vs chronic
and myelin vs axonal injury. Also, it is unclear whether accompanying brain changes in pediatric OSA have
functional consequences, resulting to cognitive or mood deficits. In addition, intermittent hypoxia triggers a
cascade of injurious processes affecting endothelial cells, but unclear whether regional cerebral blood flow (CBF)
is reduced in pediatric OSA. Treatment methods for pediatric OSA include tonsillectomy and/or adenoidectomy,
and it is unclear whether brain tissue changes, regional CBF, and neural responses to cognitive challenge
improve post-treatment. Using diffusion tensor imaging (DTI) and diffusion kurtosis imaging (DKI)-based
procedures, acute and chronic tissue changes and axonal status and myelin integrity can be assessed. Regional
brain CBF can be assessed by validated arterial spin labeling (ASL) imaging, and regional neural activity to
cognitive challenge can be examined with blood-oxygen-level-dependent (BOLD) functional magnetic resonance
imaging (MRI). Thus, using 28 treatment-naïve, pediatric OSA and 28 control children, the specific aims are to;
determine the nature and types of brain tissue injury, using DTI and DKI measures, in untreated pediatric OSA
over healthy controls; identify regional brain CBF, using ASL imaging, and neural responses to cognitive
challenge, using BOLD functional MRI in pediatric OSA over healthy children; assess cognitive (by the differential
ability scale II and NEPSY II) and emotion functions (by the child behavior checklist) in pediatric OSA compared
to control children, and examine relationships between brain injury and cognitive and emotion dysfunctions in
pediatric OSA; and examine whether brain tissue changes, reduced CBF, and altered neural responses to
cognitive challenge reverse, and cognition and mood signs improve after adenotonsillectomy at 6 months in
pediatric OSA. In summary, the nature and types of brain injury, regional CBF changes, and neural responses
to cognitive challenge, and whether brain tissue changes, altered CBF, and diminished neural responses, as
well as mood and cognitive functions recover after adenotonsillectomy in pediatric OSA will be examined.
Evaluation of pathological characteristics is essential to assess the mechanisms of damage, and to suggest
intervention strategies before and after surgery. The findings will also help guide potential treatments to
rescue/restore brain tissue (e.g., nonstero...

## Key facts

- **NIH application ID:** 10468277
- **Project number:** 5R21HD102544-02
- **Recipient organization:** UNIVERSITY OF CALIFORNIA LOS ANGELES
- **Principal Investigator:** Rajesh Kumar
- **Activity code:** R21 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2022
- **Award amount:** $195,000
- **Award type:** 5
- **Project period:** 2021-08-11 → 2024-07-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10468277

## Citation

> US National Institutes of Health, RePORTER application 10468277, Brain Changes in Pediatric Obstructive Sleep Apnea (5R21HD102544-02). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/10468277. Licensed CC0.

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