背景:阻塞性睡眠呼吸暂停综合征(OSAS)患者在许多方面都有认知功能障碍,然而,这些患者的决策功能尚不清楚.在这项研究中,采用骰子任务游戏(GDT)研究OSAS患者的决策功能。
方法:从2021年6月至2022年3月,选择了30名中度至重度OSAS的参与者和27名经睡眠呼吸监测仪诊断为无OSAS或轻度OSAS的参与者。通过已知风险概率的GDT测试了风险决策。一般人口统计信息和背景认知功能,例如整体认知功能和执行功能,进行测试以建立基线数据。
结果:性别差异无统计学意义,年龄,以及两组之间的教育年限。在GDT期间,与无OSAS组或轻度OSAS组相比,中度至重度OSAS组选择的安全性选项在统计学上显着降低(7.53±4.43vs.10.26±4.26,p=0.022)。中度至重度OSAS组使用的风险高于无OSAS或轻度OSAS组(10.47±4.43vs.7.74±4.26,p=0.022)。中、重度OSAS组的负反馈使用率低于无或轻度OSAS组(7.50、52.50vs.28.57,1020,p=0.001)。在GDT结束时,与无OSAS或轻度OSAS的患者相比,中度和重度OSAS组的总资产为负的可能性更大(-1846.67±2587.20vs.300.00±1509.97,p<0.001)。多元线性回归分析表明,GDT中风险方案的选择与负反馈利用率呈负相关。
结论:中度和重度OSAS患者在整个研究过程中显示决策受损。决策障碍与执行过程有关,可能是由于前额叶皮层功能减弱所致。然而,记忆的功能,注意,语言,抽象,和方向相对保留。
BACKGROUND: Patients with obstructive sleep apnea syndrome (OSAS) have cognitive dysfunction in many aspects, however, these patients\' decision-making function remains unclear. In this study, the Game of Dice Task (GDT) was used to investigate the function of decision making in patients with OSAS.
METHODS: 30 participants with moderate to severe OSAS and 27 participants with no or mild OSAS diagnosed by sleep breathing monitor were selected from June 2021 to March 2022. Risky decision making was tested through the GDT with known risk probability. General demographic information and background cognitive functions, such as the overall cognitive functioning and executive functioning, were tested to establish baseline data.
RESULTS: There were no significant differences in gender, age, and years of education between the two groups. During the GDT, the moderate to severe OSAS group opted for the safety option at a statistically significant lower rate when compared to the no or mild OSAS group (7.53 ± 4.43 vs. 10.26 ± 4.26, p = 0.022). The moderate to severe OSAS group utilized the higher risk option than the group with no or mild OSAS (10.47 ± 4.43 vs. 7.74 ± 4.26, p = 0.022). The utilization rate of negative feedback in the moderate and severe OSAS group was lower than that in the no or mild OSAS group (7.50, 52.50 vs. 28.57, 100.00, p = 0.001). At the end of the GDT, the moderate and severe OSAS group was more likely to have negative total assets than the patients with no or mild OSAS (-1846.67 ± 2587.20 vs. 300.00 ± 1509.97, p < 0.001). Multiple linear regression analysis shows that there is a negative correlation between the selection of risk options and negative feedback utilization in the GDT.
CONCLUSIONS: Patients with moderate and severe OSAS displayed impaired decision-making throughout the study. Impaired decision-making is related to executive processes and may be caused by diminished prefrontal cortex functioning. However, the functions of memory, attention, language, abstraction, and orientation are relatively retained.