Sustained Attention Neuroimaging in Sleep Apnea

Project Summary/Abstract: The proposed training grant is designed to advance the academic career of Dr. Ankit Parekh, PhD, by building on his strong background in applied mathematics (signal and image processing) and providing multidisciplinary training which will allow him to become an independent quantitative investigator. Dr. Parekh’s career goals are to enter full-time academic research in sleep medicine with specialization in developing quantitative biomarkers for daytime sleepiness in obstructive sleep apnea (OSA). Career development and training: Dr. Parekh’s training plan features an outstanding research and education environment at the Icahn School of Medicine at Mount Sinai (ISMMS) along with internationally renowned mentors having complimentary expertise. His primary mentoring team comprises Drs. Indu Ayappa, PhD, (expert in sleep physiology and daytime consequences of OSA), David M. Rapoport, MD, (expert in pathophysiology of OSA and its treatment), Andrew Varga, MD, PhD, (expert in sleep neurobiology, learning and memory) and Trey Hedden, PhD (expert in neuroimaging). His training plan features a combination of carefully designed coursework and practical training experiences in 1) experimental design and methodology, 2) pathophysiology of OSA and sleepiness, and 3) neuroimaging. Research plan: The proposed research builds on Dr. Parekh’s prior work and pilot feasibility studies funded by the AASM and ISMMS. The aims of the proposed research are to understand the underlying causes of inter-individual variability in lapses in vigilance in OSA patients and develop novel quantitative sleep EEG biomarkers for sleepiness that capture this variability. Using a multimodal approach involving sleep EEG and daytime fMRI, the proposed research utilizes the CPAP withdrawal model to show that: 1) Prefrontal and thalamic activity during vigilance testing mediates the relationship between sleep EEG and next-day lapses in vigilance. 2) OSA is associated with decreased prefrontal and thalamic activity. 3) Changes in sleep EEG as a result of OSA will predict the changes in prefrontal and thalamic activity. Successful completion of the training and research plan will allow Dr. Parekh to contribute independently to research in development of quantitative biomarkers for daytime sleepiness.