失眠障碍患者静息态局部脑区功能一致性研究  

Functional consistency of resting brain regions in patients with insomnia

作　　者：李敏[1,2] 张爱霞 徐勇[1] 张克让[1] 高强[3] 徐成[3] 王彦芳[1] LI Min;ZHANG Aixia;XU Yong;ZHANG Kerang;GAO Qiang;XU Cheng;WANG Yanfang(Department of Psychiatry,the First Hospital of Shanxi Medical University,Taiyuan 030001,China)

机构地区：[1]山西医科大学第一医院精神卫生科,太原030001 [2]山西医科大学第一临床医学院 [3]山西省人民医院磁共振室

出　　处：《中国神经精神疾病杂志》2018年第10期577-582,共6页Chinese Journal of Nervous and Mental Diseases

基　　金：国家重点研发项目(编号:2016YFC1307103);四川省西部精神医学协会公益科研项目(编号:Wcpafund-201507);吴阶平医学基金会临床科研专项资助基金(编号:320.6750.15062).

摘　　要：目的探究失眠障碍患者特异性脑区功能异常及其与睡眠指标的关系。方法纳入23例失眠障碍患者及22名正常对照,采用静息态功能磁共振(resting-state functional MRI, rs-fMRI)扫描被试脑部并进行局部一致性(regional homogeneity, ReHo)分析,匹兹堡睡眠质量指数评定量表(Pittsburgh sleep quality index,PSQI)评定睡眠质量,研究组进行多导睡眠图监测(polysomnography,PSG)采集睡眠指标。结果与对照组相比,失眠障碍患者的左侧中央前回(t=4.27,P<0.01)、右侧中央后回(t=4.74,P<0.01)、左侧枕中回(t=4.39,P<0.01)、右侧枕中回(t=4.32,P<0.01)及左侧舌回(t=4.99,P<0.01)存在ReHo值增高,左侧脑岛(t=-5.29,P<0.01)及右侧梭状回(t=-4.05,P<0.01)存在ReHo值减低。失眠障碍患者左侧中央前回的ReHo值与REM潜伏期呈负相关(r=-0.47,P=0.03),右侧梭状回ReHo值与N2睡眠持续时间呈负相关(r=-0.44,P=0.04),与PSQI量表相关性无统计学意义(P>0.05)。结论失眠障碍患者存在功能异常脑区,涉及运动感觉皮层、情感加工脑区及视觉皮质区,其异常脑区可能参与介导睡眠结构的维持。Objective To explore the specific brain function abnormalities of patients with insomnia and its relationship with sleep indicators.Methods Twenty-three patients with insomnia and 22 controls were included.The resting-state functional magnetic resonance imaging(rs-fMRI)of brain and the regional homogeneity(ReHo)analysis method were applied.Pittsburgh sleep quality index(PSQI)was used to assess sleep quality.The patient group conducted polysomnography(PSG)to collect sleep indicators.Results Compared with the control group,patients with insomnia showed higher ReHo in the left precentral gyrus(t=4.27,P<0.01),the right postcentral gyrus(t=4.74,P<0.01),the left middle occipital gyrus(t=4.39,P<0.01),the right middle occipital gyrus(t=4.32,P<0.01)and the left lingual gyrus(t=4.99,P<0.01),and lower ReHo in the left lnsula(t=-5.29,P<0.01)and the right fusiform gyrus(t=-4.05,P<0.01).There was a negative correlation between ReHo values in the left precentral gyrus and REM latency(r=-0.47袁P=0.03),and the ReHo value of the right fusiform gyrus was negatively correlated with the duration of N2 sleep(r=-0.44,P=0.04)in patients.There was no significant correlation with the PSQI scale(P>0.05).Conclusion Patients with insomnia have abnormal brain function,which involves the motor sensory cortex,emotional processing brain area and visual cortex.They participate in the maintenance of sleep structure.

关 键 词：失眠障碍 静息态 局部一致性 

分 类 号：R749.7[医药卫生—神经病学与精神病学]