ArticleChest2013
Urinary neurotransmitters are selectively altered in children with obstructive sleep apnea and predict cognitive morbidity.
Article in Chest, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 22 papers, 1 of them a synthesis that pooled it.
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Who cites it
22 citing papers in PubMed, 1 synthesis or guideline pooled it, 57 citations in OpenAlex.
- Diagnostic capability of biological markers in assessment of obstructive sleep apnea: a systematic review and meta-analysis.Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine · 2015Pooled it
- Trial
- Article
- Sympathetic nervous system activity is associated with choroidal thickness and axial length in school-aged children.The British journal of ophthalmology · 2024Article
- Diagnosis of Paediatric Obstructive Sleep-Disordered Breathing beyond Polysomnography.Children (Basel, Switzerland) · 2023Review
- Investigating the Relationship between Obstructive Sleep Apnoea, Inflammation and Cardio-Metabolic Diseases.International journal of molecular sciences · 2023Review
- Article
- Screening of plasma exosomal lncRNAs to identify potential biomarkers for obstructive sleep apnea.Annals of translational medicine · 2022Article
- Intermittent Hypoxia Interferes with Autocrine Effects of GABA on Insulin Secretion in Postnatal Rodents-Implications for Pediatric Obstructive Sleep Apnea.Children (Basel, Switzerland) · 2022Article
- Neurocognitive Consequences in Children with Sleep Disordered Breathing: Who Is at Risk?Children (Basel, Switzerland) · 2022Review
- Urinary Aromatic Amino Acid Metabolites Associated With Postoperative Emergence Agitation in Paediatric Patients After General Anaesthesia: Urine Metabolomics Study.Frontiers in pharmacology · 2022Article
- DNA Methylation in Pediatric Obstructive Sleep Apnea: An Overview of Preliminary Findings.Frontiers in pediatrics · 2018Review
- Machines Learning to Detect Obstructive Sleep Apnea in Children. Are We There Yet?American journal of respiratory and critical care medicine · 2017Article
- Urinary biomarkers and obstructive sleep apnea in patients with Down syndrome.Sleep medicine · 2017Article
- A predictive model for obstructive sleep apnea and Down syndrome.American journal of medical genetics. Part A · 2017Observational
- Review
- Article
- Review
- Sleep Disordered Breathing in Children.Indian journal of pediatrics · 2015Review
- Biomarkers associated with obstructive sleep apnea: A scoping review.Sleep medicine reviews · 2015Article
Corrections and comments
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Authors and funding
5 authors at 1 institution in 1 country.
Funding
Abstract
backgroundPediatric obstructive sleep apnea (OSA) is associated with cognitive dysfunction, suggesting altered neurotransmitter function. We explored overnight changes in neurotransmitters in the urine of children with and without OSA.
methodsUrine samples were collected from children with OSA and from control subjects before and after sleep studies. A neurocognitive battery assessing general cognitive ability (GCA) was administered to a subset of children with OSA. Samples were subjected to multiple enzyme-linked immunosorbent assays for 12 neurotransmitters, and adjusted for creatinine concentrations.
resultsThe study comprised 50 children with OSA and 20 control subjects. Of the children with OSA, 20 had normal GCA score (mean ± SD) (101.2 ± 14.5) and 16 had a reduced GCA score (87.3 ± 13.9; P < .001). Overnight increases in epinephrine, norepinephrine, and γ-aminobutyric acid (GABA) levels emerged in children with OSA; taurine levels decreased. Using combinatorial approaches and cutoff values for overnight changes of these four neurotransmitters enabled prediction of OSA (area under the curve [AUC]: 0.923; P < .0001). Furthermore, GABA and taurine alterations, as well as overnight reductions in phenylethylamine, were more prominent in children with OSA and low GCA than in children with OSA and normal GCA (P < .001), and they reliably discriminated GCA status (AUC: 0.977; P < .0001).
conclusionsPediatric OSA is associated with overnight increases in urinary concentrations of catecholamines indicative of heightened sympathetic outflow. Increases in GABA levels and decreases in taurine levels could underlie mechanisms of neuronal excitotoxicity and dysfunction. Combinatorial approaches using defined cutoffs in overnight changes in concentrations of selected neurotransmitters in urine may not only predict OSA but also the presence of cognitive deficits. Larger cohort studies appear warranted to confirm these findings.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.