This cross-sectional observational study documented that SCI patients affected by OSA show (i) lower CSF Aβ42 levels which are associated with hypoxia measures and lower scores at memory and intelligence tests; (ii) higher CSF lactate levels which are related to increased WASO and reduced SE; and (iii) higher CSF t-tau and p-tau concentrations which are in a mutual relationship with higher CSF lactate levels and a more significant
sleep fragmentation.
In this report, we documented that the diagnosis of OSA is associated with the CSF biomarker profile of preclinical AD in SCI patients. However, SCI patients well treating OSA by CPAP did not show pathological levels of CSF AD biomarkers and lactate, also displaying both the CSF profile and the neuropsychological evaluation not different from the controls. SCI is actually considered a prodromal stage of AD and may serve as a symptomatic indicator of preclinical AD, representing a pre-MCI condition. Accordingly, SCI is a risk factor for future cognitive decline as well as for MCI and AD. Therefore, SCI condition may identify a target population for interventions at a stage of mild neuronal damage and with still sufficient functional compensation. Furthermore, SCI patients are in a unique position since they are seeking for medical care because of the subjective memory complaints, which make them available for disease-modifying interventions at a time when brain may still be salvageable from AD pathology.
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