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Article ; Online: Predicting the impact of CPAP on brain health: A study using the sleep EEG-derived brain age index.

Yook, Soonhyun / Park, Hea Ree / Joo, Eun Yeon / Kim, Hosung

Annals of clinical and translational neurology

2024 Volume 11, Issue 5, Page(s) 1172–1183

Abstract: Objective: This longitudinal study investigated potential positive impact of CPAP treatment on brain health in individuals with obstructive sleep Apnea (OSA). To allow this, we aimed to employ sleep electroencephalogram (EEG)-derived brain age index ( ... ...

Abstract	Objective: This longitudinal study investigated potential positive impact of CPAP treatment on brain health in individuals with obstructive sleep Apnea (OSA). To allow this, we aimed to employ sleep electroencephalogram (EEG)-derived brain age index (BAI) to quantify CPAP's impact on brain health and identify individually varying CPAP effects on brain aging using machine learning approaches. Methods: We retrospectively analyzed CPAP-treated (n = 98) and untreated OSA patients (n = 88) with a minimum 12-month follow-up of polysomnography. BAI was calculated by subtracting chronological age from the predicted brain age. To investigate BAI changes before and after CPAP treatment, we compared annual ΔBAI between CPAP-treated and untreated OSA patients. To identify individually varying CPAP effectiveness and factors influencing CPAP effectiveness, machine learning approaches were employed to predict which patient displayed positive outcomes (negative annual ΔBAI) based on their baseline clinical features. Results: CPAP-treated group showed lower annual ΔBAI than untreated (-0.6 ± 2.7 vs. 0.3 ± 2.6 years, p < 0.05). This BAI reduction with CPAP was reproduced independently in the Apnea, Bariatric surgery, and CPAP study cohort. Patients with more severe OSA at baseline displayed more positive annual ΔBAI (=accelerated brain aging) when untreated and displayed more negative annual ΔBAI (=decelerated brain aging) when CPAP-treated. Machine learning models achieved high accuracy (up to 86%) in predicting CPAP outcomes. Interpretation: CPAP treatment can alleviate brain aging in OSA, especially in severe cases. Sleep EEG-derived BAI has potential to assess CPAP's impact on brain health. The study provides insights into CPAP's effects and underscores BAI-based predictive modeling's utility in OSA management.
MeSH term(s)	Humans ; Continuous Positive Airway Pressure ; Male ; Electroencephalography ; Female ; Sleep Apnea, Obstructive/therapy ; Sleep Apnea, Obstructive/physiopathology ; Middle Aged ; Adult ; Brain/physiopathology ; Retrospective Studies ; Machine Learning ; Longitudinal Studies ; Polysomnography ; Aged ; Aging/physiology
Language	English
Publishing date	2024-02-23
Publishing country	United States
Document type	Journal Article
ZDB-ID	2740696-9
ISSN	2328-9503 ; 2328-9503
ISSN (online)	2328-9503
ISSN	2328-9503
DOI	10.1002/acn3.52032
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Article ; Online: Does the adoption of emerging technologies improve technical efficiency? Evidence from Korean manufacturing SMEs.

Hwang, Won-Sik / Kim, Ho-Sung

Small business economics

2021 Volume 59, Issue 2, Page(s) 627–643

Abstract: Despite the proliferation of innovative technologies during the Fourth Industrial Revolution (4IR), there is a severe lack of quantitative and empirical studies that deal with the effectiveness of recently emerging technologies. This study examines the ... ...

Abstract	Despite the proliferation of innovative technologies during the Fourth Industrial Revolution (4IR), there is a severe lack of quantitative and empirical studies that deal with the effectiveness of recently emerging technologies. This study examines the impact of employing core technologies of the 4IR on small and medium enterprises (SMEs). We used the firm-level cross-sectional data on Korean manufacturing SMEs, including the information on technology utilization. The stochastic production frontier estimation with selectivity correction is employed, besides matching technique to obtain unbiased estimates on technology efficiency. The empirical analysis finds that adopting emerging technologies enhances the productivity of SMEs. After observed and unobserved factors are controlled, the technical efficiency of adopters is higher by more than 26% on average, compared to non-adopters. Moreover, if the gap among production frontiers is considered, the difference in productivity would rise further. Additionally, a strategic alliance is a crucial route for SMEs to accept new technologies.
Language	English
Publishing date	2021-10-07
Publishing country	United States
Document type	Journal Article
ZDB-ID	1478919-X
ISSN	1573-0913 ; 0921-898X
ISSN (online)	1573-0913
ISSN	0921-898X
DOI	10.1007/s11187-021-00554-w
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Article: Are there effects of light exposure on daytime sleep for rotating shift nurses after night shift?: an EEG power analysis.

Yook, Soonhyun / Choi, Su Jung / Zang, Cong / Joo, Eun Yeon / Kim, Hosung

Frontiers in neuroscience

2024 Volume 18, Page(s) 1306070

Abstract: Introduction: Night-shift workers often face various health issues stemming from circadian rhythm shift and the consequent poor sleep quality. We aimed to study nurses working night shifts, evaluate the electroencephalogram (EEG) pattern of daytime ... ...

Abstract	Introduction: Night-shift workers often face various health issues stemming from circadian rhythm shift and the consequent poor sleep quality. We aimed to study nurses working night shifts, evaluate the electroencephalogram (EEG) pattern of daytime sleep, and explore possible pattern changes due to ambient light exposure (30 lux) compared to dim conditions (<5 lux) during daytime sleep. Moethods: The study involved 31 participants who worked night shifts and 24 healthy adults who had never worked night shifts. The sleep macro and microstructures were analyzed, and electrophysiological activity was compared (1) between nighttime sleep and daytime sleep with dim light and (2) between daytime sleep with dim and 30 lux light conditions. Results: The daytime sleep group showed lower slow or delta wave power during non-rapid eye movement (NREM) sleep than the nighttime sleep group. During daytime sleep, lower sigma wave power in N2 sleep was observed under light exposure compared to no light exposure. Moreover, during daytime sleep, lower slow wave power in N3 sleep in the last cycle was observed under light exposure compared to no light exposure. Discussion: Our study demonstrated that night shift work and subsequent circadian misalignment strongly affect sleep quality and decrease slow and delta wave activities in NREM sleep. We also observed that light exposure during daytime sleep could additionally decrease N2 sleep spindle activity and N3 waves in the last sleep cycle.
Language	English
Publishing date	2024-03-27
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2411902-7
ISSN	1662-453X ; 1662-4548
ISSN (online)	1662-453X
ISSN	1662-4548
DOI	10.3389/fnins.2024.1306070
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Article ; Online: Deep learning of sleep apnea-hypopnea events for accurate classification of obstructive sleep apnea and determination of clinical severity.

Yook, Soonhyun / Kim, Dongyeop / Gupte, Chaitanya / Joo, Eun Yeon / Kim, Hosung

Sleep medicine

2024 Volume 114, Page(s) 211–219

Abstract: Background: /Objective: Automatic apnea/hypopnea events classification, crucial for clinical applications, often faces challenges, particularly in hypopnea detection. This study aimed to evaluate the efficiency of a combined approach using nasal ... ...

Abstract	Background: /Objective: Automatic apnea/hypopnea events classification, crucial for clinical applications, often faces challenges, particularly in hypopnea detection. This study aimed to evaluate the efficiency of a combined approach using nasal respiration flow (RF), peripheral oxygen saturation (SpO2), and ECG signals during polysomnography (PSG) for improved sleep apnea/hypopnea detection and obstructive sleep apnea (OSA) severity screening. Methods: An Xception network was trained using main features from RF, SpO2, and ECG signals obtained during PSG. In addition, we incorporated demographic data for enhanced performance. The detection of apnea/hypopnea events was based on RF and SpO2 feature sets, while the screening and severity categorization of OSA utilized predicted apnea/hypopnea events in conjunction with demographic data. Results: Using RF and SpO2 feature sets, our model achieved an accuracy of 94 % in detecting apnea/hypopnea events. For OSA screening, an exceptional accuracy of 99 % and an AUC of 0.99 were achieved. OSA severity categorization yielded an accuracy of 93 % and an AUC of 0.91, with no misclassification between normal and mild OSA versus moderate and severe OSA. However, classification errors predominantly arose in cases with hypopnea-prevalent participants. Conclusions: The proposed method offers a robust automatic detection system for apnea/hypopnea events, requiring fewer sensors than traditional PSG, and demonstrates exceptional performance. Additionally, the classification algorithms for OSA screening and severity categorization exhibit significant discriminatory capacity.
MeSH term(s)	Humans ; Deep Learning ; Sleep Apnea, Obstructive ; Sleep Apnea Syndromes/diagnosis ; Sleep ; Polysomnography
Language	English
Publishing date	2024-01-11
Publishing country	Netherlands
Document type	Journal Article
ZDB-ID	2012041-2
ISSN	1878-5506 ; 1389-9457
ISSN (online)	1878-5506
ISSN	1389-9457
DOI	10.1016/j.sleep.2024.01.015
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Zs.A 5315: Show issues			Location: Je nach Verfügbarkeit (siehe Angabe bei Bestand) bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular Jg. 1995 - 2021: Lesesall (2.OG) ab Jg. 2022: Lesesaal (EG)
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Article ; Online: Obstructive Sleep Apnea and Striatal Dopamine Availability in Parkinson's Disease.

Oh, Yoon-Sang / Kim, Joong-Seok / Lyoo, Chul Hyoung / Kim, Hosung

Movement disorders : official journal of the Movement Disorder Society

2023 Volume 38, Issue 6, Page(s) 1068–1076

Abstract: Background: Sleep disorders are frequently associated with Parkinson's disease. Obstructive sleep apnea syndrome is one of these sleep disorders and is associated with the severity of motor symptoms in Parkinson's disease. Obstructive sleep apnea can ... ...

Abstract	Background: Sleep disorders are frequently associated with Parkinson's disease. Obstructive sleep apnea syndrome is one of these sleep disorders and is associated with the severity of motor symptoms in Parkinson's disease. Obstructive sleep apnea can lead to dopaminergic neuronal cell degeneration and may impair the clearance of α-synuclein in Parkinson's disease. Striatal dopamine uptake is a surrogate marker of nigral dopaminergic cell damage. Objective: We aimed to investigate the differences in striatal dopamine availability between Parkinson's disease patients with or without obstructive sleep apnea. Methods: A total of 85 de novo and nonmedicated Parkinson's disease patients were enrolled. Full-night polysomnography was performed for all patients, and obstructive sleep apnea was diagnosed as apnea/hypopnea index ≥5. Positron emission tomography was performed with Results: Dopamine availability in the caudate nucleus of the obstructive sleep apnea group was significantly lower than that of the nonobstructive sleep apnea group. On subgroup analysis, such association was found in female but not in male patients. In other structures (putamen, globus pallidus, and thalamus), dopamine availability did not differ between the two groups. Conclusion: This study supports the proposition that obstructive sleep apnea can contribute to reduced striatal dopamine transporter availability in Parkinson's disease. Additional studies are needed to assess the causal association between obstructive sleep apnea and the neurodegenerative process in Parkinson's disease. © 2023 International Parkinson and Movement Disorder Society.
MeSH term(s)	Humans ; Male ; Female ; Parkinson Disease/complications ; Parkinson Disease/diagnostic imaging ; Dopamine ; Corpus Striatum/diagnostic imaging ; Corpus Striatum/metabolism ; Dopamine Plasma Membrane Transport Proteins/metabolism ; Sleep Apnea Syndromes ; Sleep Apnea, Obstructive/complications ; Sleep Apnea, Obstructive/diagnostic imaging
Chemical Substances	Dopamine (VTD58H1Z2X) ; Dopamine Plasma Membrane Transport Proteins
Language	English
Publishing date	2023-04-12
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	607633-6
ISSN	1531-8257 ; 0885-3185
ISSN (online)	1531-8257
ISSN	0885-3185
DOI	10.1002/mds.29402
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Zs.A 2555: Show issues			Location: Je nach Verfügbarkeit (siehe Angabe bei Bestand) bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular Jg. 1995 - 2021: Lesesall (2.OG) ab Jg. 2022: Lesesaal (EG)
Zs.MO 238: Show issues

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Article: Static and dynamic brain morphological changes in isolated REM sleep behavior disorder compared to normal aging.

Park, Gilsoon / Jo, Hyunjin / Chai, Yaqiong / Park, Hea Ree / Lee, Hanul / Joo, Eun Yeon / Kim, Hosung

Frontiers in neuroscience

2024 Volume 18, Page(s) 1365307

Abstract: Objective/background: To assess whether cerebral structural alterations in isolated rapid eye movement sleep behavior disorder (iRBD) are progressive and differ from those of normal aging and whether they are related to clinical symptoms.: Patients/ ... ...

Abstract	Objective/background: To assess whether cerebral structural alterations in isolated rapid eye movement sleep behavior disorder (iRBD) are progressive and differ from those of normal aging and whether they are related to clinical symptoms. Patients/methods: In a longitudinal study of 18 patients with iRBD (age, 66.1 ± 5.7 years; 13 males; follow-up, 1.6 ± 0.6 years) and 24 age-matched healthy controls (age, 67.0 ± 4.9 years; 12 males; follow-up, 2.0 ± 0.9 years), all participants underwent multiple extensive clinical examinations, neuropsychological tests, and magnetic resonance imaging at baseline and follow-up. Surface-based cortical reconstruction and automated subcortical structural segmentation were performed on T1-weighted images. We used mixed-effects models to examine the differences between the groups and the differences in anatomical changes over time. Results: None of the patients with iRBD demonstrated phenoconversion during the follow-up. Patients with iRBD had thinner cortices in the frontal, occipital, and temporal regions, and more caudate atrophy, compared to that in controls. In similar regions, group-by-age interaction analysis revealed that patients with iRBD demonstrated significantly slower decreases in cortical thickness and caudate volume with aging than that observed in controls. Patients with iRBD had lower scores on the Korean version of the Mini-Mental Status Examination ( Conclusion: Patients with iRBD show brain atrophy in the regions that are overlapped with the areas that have been documented to be affected in early stages of Parkinson's disease. Such atrophy in iRBD may not be progressive but may be slower than that in normal aging. Cognitive impairment in iRBD is not progressive.
Language	English
Publishing date	2024-05-01
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2411902-7
ISSN	1662-453X ; 1662-4548
ISSN (online)	1662-453X
ISSN	1662-4548
DOI	10.3389/fnins.2024.1365307
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Article: LEARNING TO SYNTHESIZE CORTICAL MORPHOLOGICAL CHANGES USING GRAPH CONDITIONAL VARIATIONAL AUTOENCODER.

Chai, Yaqiong / Liu, Mengting / Duffy, Ben A / Kim, Hosung

Proceedings. IEEE International Symposium on Biomedical Imaging

2021 Volume 2021, Page(s) 1495–1499

Abstract: Changes in brain morphology, such as cortical thinning are of great value for understanding the trajectory of brain aging and various neurodegenerative diseases. In this work, we employed a generative neural network variational autoencoder (VAE) that is ... ...

Abstract	Changes in brain morphology, such as cortical thinning are of great value for understanding the trajectory of brain aging and various neurodegenerative diseases. In this work, we employed a generative neural network variational autoencoder (VAE) that is conditional on age and is able to generate cortical thickness maps at various ages given an input cortical thickness map. To take into account the mesh topology in the model, we proposed a loss function based on weighted adjacency to integrate the surface topography defined as edge connections with the cortical thickness mapped as vertices. Compared to traditional conditional VAE that did not use the surface topological information, our method better predicted "future" cortical thickness maps, especially when the age gap became wider. Our model has the potential to predict the distinctive temporospatial pattern of individual cortical morphology in relation to aging and neurodegenerative diseases.
Language	English
Publishing date	2021-05-25
Publishing country	United States
Document type	Journal Article
ISSN	1945-7928
ISSN	1945-7928
DOI	10.1109/isbi48211.2021.9433837
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Article ; Online: Altered cerebrocerebellar functional connectivity in patients with obstructive sleep apnea and its association with cognitive function.

Park, Hea Ree / Cha, Jungho / Joo, Eun Yeon / Kim, Hosung

Sleep

2021 Volume 45, Issue 1

Abstract: Study objectives: Previous functional MRI studies have reported altered brain networks in patients with obstructive sleep apnea (OSA). However, the extent and pattern of abnormal connectivity were inconsistent across studies, and cerebrocerebellar ... ...

Abstract	Study objectives: Previous functional MRI studies have reported altered brain networks in patients with obstructive sleep apnea (OSA). However, the extent and pattern of abnormal connectivity were inconsistent across studies, and cerebrocerebellar connections have been rarely assessed. We investigated functional network changes in cerebral and cerebellar cortices of OSA patients. Methods: Resting-state functional MRI, polysomnography, and neuropsychological (NP) test data were acquired from 74 OSA patients (age: 45.8 ± 10.7 years) and 33 healthy subjects (39.6 ± 9.3 years). Connectivity matrices were extracted by computing correlation coefficients from various regions of interest, and Fisher r-to-z transformations. In the functional connections that showed significant group differences, linear regression was conducted to examine the association between connectivity and clinical characteristics. Results: Patients with OSA showed reduced functional connectivity (FC) in cerebrocerebellar connections linking different functional networks, and greater FC in cortical between-network connections in prefrontal regions involving the default mode network (DMN) and the control network. For OSA group, we found no correlation between FC and sleep parameters including lowest SaO2 and arousal index in the connections where significant associations were observed in healthy subjects. FC changes in DMN areas were related to reduced verbal fluency in OSA. Lower local efficiency and lower clustering coefficient of the salience network in the left cerebellum were also observed in OSA. Conclusions: OSA affects mainly the cerebrocerebellar pathway. The disruption of function in these connections are related to sleep fragmentation and hypoxia during sleep. These abnormal network functions, especially DMN, are suggested to participate in cognitive decline of OSA.
MeSH term(s)	Adult ; Brain ; Brain Mapping ; Cognition ; Humans ; Magnetic Resonance Imaging ; Middle Aged ; Polysomnography ; Sleep Apnea, Obstructive/complications ; Sleep Apnea, Obstructive/diagnostic imaging
Language	English
Publishing date	2021-08-25
Publishing country	United States
Document type	Journal Article ; Research Support, N.I.H., Extramural ; Research Support, Non-U.S. Gov't
ZDB-ID	424441-2
ISSN	1550-9109 ; 0161-8105
ISSN (online)	1550-9109
ISSN	0161-8105
DOI	10.1093/sleep/zsab209
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Article: White matter microstructure and connectivity changes after surgery in male adults with obstructive sleep apnea: recovery or reorganization?

Chai, Yaqiong / Park, Hea Ree / Jo, Hyunjin / Seo, Min Young / Kim, Hyo Yeol / Joo, Eun Yeon / Kim, Hosung

Frontiers in neuroscience

2023 Volume 17, Page(s) 1221290

Abstract: Study objectives: Obstructive sleep apnea (OSA) is a prevalent clinical problem significantly affecting cognitive functions. Surgical treatment is recommended for those unable to use continuous positive airway pressure. We aimed to investigate the ... ...

Abstract	Study objectives: Obstructive sleep apnea (OSA) is a prevalent clinical problem significantly affecting cognitive functions. Surgical treatment is recommended for those unable to use continuous positive airway pressure. We aimed to investigate the therapeutic effect of upper airway surgery on the white matter (WM) microstructure and brain connectivity in patients with OSA. Methods: Twenty-one male patients with moderate-to-severe OSA were recruited for multi-level upper airway surgery. Overnight polysomnography (PSG), neuropsychiatric tests, and brain MRI scans were acquired before and 6.1 ± 0.8 months after surgery. Nineteen male patients with untreated OSA were also included as a reference group. We calculated the longitudinal changes of diffusion tensor imaging (DTI) parameters, including fractional anisotropy (ΔFA) and mean/axial/radial diffusivity (ΔMD/AD/RD). We also assessed changes in network properties based on graph theory. Results: Surgically treated patients showed improvement in PSG parameters and verbal memory after surgery. Globally, ΔFA was significantly higher and ΔRD was lower in the surgery group than in the untreated group. Especially ΔFA of the tracts involved in the limbic system was higher after surgery. In network analysis, higher Δbetweenness and lower Δclustering coefficients were observed in the surgical group than in the untreated group. Finally, the improvement of verbal memory after surgery positively correlated with ΔFA in superior thalamic radiation ( Conclusion: Surgical treatment of OSA can alleviate alterations in WM integrity and disruptions in local networks, particularly for the tracts involved in the limbic system. These findings may further explain the cognitive improvement observed after the treatment of OSA.
Language	English
Publishing date	2023-09-28
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2411902-7
ISSN	1662-453X ; 1662-4548
ISSN (online)	1662-453X
ISSN	1662-4548
DOI	10.3389/fnins.2023.1221290
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Article ; Online: More extensive white matter disruptions present in untreated obstructive sleep apnea than we thought: A large sample diffusion imaging study.

Koo, Dae Lim / Cabeen, Ryan P / Yook, Soon Hyun / Cen, Steven Yong / Joo, Eun Yeon / Kim, Hosung

Human brain mapping

2023 Volume 44, Issue 8, Page(s) 3045–3056

Abstract: Obstructive sleep apnea (OSA) may lead to white mater (WM) disruptions and cognitive deficits. However, no studies have investigated the full extent of the brain WM, and its associations with cognitive deficits in OSA remain unclear. We thus applied ... ...

Abstract	Obstructive sleep apnea (OSA) may lead to white mater (WM) disruptions and cognitive deficits. However, no studies have investigated the full extent of the brain WM, and its associations with cognitive deficits in OSA remain unclear. We thus applied diffusion tensor imaging (DTI) tractography with multi-fiber models and used atlas-based bundle-specific approach to investigate the WM abnormalities for various tracts of the cerebral cortex, thalamus, brainstem, and cerebellum in patients with untreated OSA. We enrolled 100 OSA patients and 63 healthy controls. Fractional anisotropy (FA) and mean diffusivity (MD) values mapped on 33 regions of interest including WM tracts of cortex, thalamus, brainstem, and cerebellum were obtained from tractography-based reconstructions. We compared FA/MD values between groups and correlated FA/MD with clinical data in the OSA group after controlling for age and body mass index. OSA patients showed significantly lower FA values in multiple WM fibers including corpus callosum, inferior fronto-occipital fasciculus, middle/superior longitudinal fasciculi, thalamic radiations, and uncinate (FDR <0.05). Higher FA values were found in medial lemniscus of patients compared to controls (FDR <0.05). Lower FA values of rostrum of corpus callosum correlated with lower visual memory performance in OSA group (p < .005). Our quantitative DTI analysis demonstrated that untreated OSA could negatively impact the integrity of pathways more broadly, including brainstem structures such as medial lemniscus, in comparison to previous findings. Fiber tract abnormalities of the rostral corpus callosum were associated with impaired visual memory in untreated OSA may provide insights into the related pathomechanism.
MeSH term(s)	Humans ; White Matter/diagnostic imaging ; Diffusion Tensor Imaging/methods ; Brain/diagnostic imaging ; Sleep Apnea, Obstructive/diagnostic imaging ; Diffusion Magnetic Resonance Imaging ; Anisotropy
Language	English
Publishing date	2023-03-10
Publishing country	United States
Document type	Journal Article ; Research Support, N.I.H., Extramural ; Research Support, Non-U.S. Gov't
ZDB-ID	1197207-5
ISSN	1097-0193 ; 1065-9471
ISSN (online)	1097-0193
ISSN	1065-9471
DOI	10.1002/hbm.26261
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