原发性失眠患者大脑半球间镜像功能连接的静息态功能MRI研究  

Interhemispheric functional connectivity in primary insomnia： a resting-state funtional MRI study

作　　者：李洁[1] 周全[2] 丁建平[1] 梁敏杰[2] 邓雪英[1] 顾基伟[1] 朱慧玲[1] 李跃兴[1] 

机构地区：[1]杭州师范大学附属医院放射科,310015 [2]暨南大学第一附属医院医学影像中心

出　　处：《中华放射学杂志》2014年第8期641-645,共5页Chinese Journal of Radiology

摘　　要：目的 采用静息态fMRI（rs-fMRI）的基于体素镜像同伦连接（VMHC）方法研究原发性失眠（PI）患者两大脑半球间功能连通性.方法 选取21例PI患者（PI组）和20名健康志愿者（对照组）,采用匹兹堡睡眠质量指数量表（PSQI）进行评分,然后行rs-fMRI扫描,采用REST软件来计算PI组和对照组两侧大脑半球间的VMHC值,两组间VMHC值比较采用两样本t检验,最终获得VMHC值有统计差异的统计结果图.VMHC值与PSQI评分间的相关性采用Pearson相关性分析.结果 PI组与对照组分别有3例和1名图像不合格,最终分别纳入18例患者和19名志愿者.与对照组比较,PI组额中回、额上回、眶额回、海马、丘脑、岛叶及枕叶部分脑区（楔叶、舌回）VMHC显著减低（体素大小为1 269～7 425mm^3,t值为-4.47-2.74,P值均＜0.05,Alphasim校正）,其中双侧眶额回之间VMHC（0.324±0.247）与PSQI得分（10.1±1.7）呈显著负相关（r=-0.69,P＜0.01）,其余存在显著改变的VMHC区域相关系数值与PSQI得分均无显著相关（P值均＞0.05）.结论 PI患者在静息态下存在两大脑半球间的功能连接异常.两半球间的VMHC可能作为病理生理学上评估PI患者神经失连接的一种有效的辅助方法.Objective To investigate the resting-state functional connectivity between the two hemispheres in primary insomnia（PI） using voxel-mirrored homotopic connectivity（VMHC） based on restingstate functional MRI（fMRI）.Methods Eighteen PI patients and 19 healthy volunteers matched for age and sex underwent resting-state fMRI scans in a 1.5T scanner.Pittsburgh sleep quality index（PSQI） was performed for all subjects.The data was pre-processed by SPM 8 and then the VMHC values were calculated by REST software.The VMHC values between the two groups were compared by two-sample t-test.The statistical map with significant differences of VMHC value was obtained.Results Compared to the controls,PI patients showed significant VMHC decreases in the middle frontal gyrus（MFG）,superior frontal gyrus（SFG）,orbitofrontal cortex（OFC）,hippocampus,thalamus,insula and a few occipital regions including cuneus and lingual gyrus（voxel size 1 269-7 425 mm^3,t=-4.47-2.74 P〈 0.05,Alphasim corrected）.Negative correlation was observed between VMHC coefficients（0.324±0.247） of OFC and the PSQI score （10.1 ± 1.7） in PI patients（r=-0.69,P〈0.01）.The other regions showing significant VMHC changes had no correlation with the PSQI score（P〉0.05）.Conclusions These findings suggest that the functional coordination between homotopic brain regions is impaired in PI patients.Interhemispheric RSFC may serve as a useful method for evaluating PI where neural connectivity is implicated in the pathophysiology.

关 键 词：入睡和睡眠障碍 磁共振成像 神经网络(计算机) 

分 类 号：R740[医药卫生—神经病学与精神病学]