内嗅皮质在疼痛感知与睡眠障碍间的中介效应分析  

Analysis of the mediating role of entorhinal cortex in the relationship between pain perception and sleep disturbance

作　　者：孙杰[1] 郑永博 李赓 常素华 李水清[1] SUN Jie;ZHENG Yongbo;LI Geng;CHANG Suhua;LI Shuiqing(Pain medicine Center,Peking University Third Hospital,Beijing 100191,China;Peking University Sixth Hospital,Peking University Institute of Mental Health,Beijing 100191,China;Peking-Tsinghua Center for Life Sciences and PKU-IDG,Peking University,Beijing 100191,China;NHC Key Laboratory of Mental Health,Peking University,Beijing 100191,China)

机构地区：[1]北京大学第三医院疼痛医学中心,北京100191 [2]北京大学第六医院,北京大学精神卫生研究所,北京100191 [3]北京大学前沿交叉科学研究院,北京100191 [4]国家卫生健康委员会精神卫生学重点实验室,北京100191

出　　处：《中国疼痛医学杂志》2023年第2期101-106,共6页Chinese Journal of Pain Medicine

基　　金：国家自然科学基金(82201644);北京大学第三医院创新转化基金(HDCXZHKC2021210)。

摘　　要：目的:本研究旨在探索疼痛感知与睡眠障碍共病的关系及潜在的脑影像学机制。方法:通过人类连接组计划,共纳入1043名受试者,收集一般人口学数据、7天内疼痛程度平均分、匹兹堡睡眠质量指数(Pittsburgh sleep quality index,PSQI)及磁共振等数据。运用偏相关探索睡眠情况与疼痛情况的相关性,使用多元线性回归探索与睡眠、疼痛相关的脑区结构,并应用中介分析探索脑区与疼痛、睡眠三者关联性。结果:发现疼痛程度评分与PSQI评分呈正相关,并且右侧内嗅皮质厚度与疼痛程度评分和PSQI评分均呈负相关,疼痛对睡眠的影响可通过右侧内嗅皮质介导。结论:疼痛症状与睡眠障碍的发生相关,疼痛评分越高,睡眠质量越差,并且右侧内嗅皮质厚度降低是疼痛情况和睡眠障碍共病的潜在神经机制。Objective:To investigate the relationship between pain perception and sleep disturbance,and further explore the underlying neuroimaging mechanism.Methods:A total of 1043 participants were recruited based on Human Connectome Project.Sociodemographic information,average pain intensity in the past 7days,Pittsburgh sleep quality index(PSQI),and structure magnetic resonance imaging were collected.Partial correlation was used to analyze the relationship between pain and sleep.Multivariable linear regression was used to assess the relationship between brain area and sleep/pain.Mediation analysis was used to explore the possible relationship between sleep/pain and brain area.Results:Pain was positively correlated with PSQI score.Right entorhinal cortex thick was negatively correlated with pain and sleep quality.Right entorhinal cortex mediated the effect of pain on sleep.Conclusion:Pain is associated with sleep disturbance,and the higher the pain score the worse the sleep.The decreased of the right entorhinal cortex thickness may be involved in the underlying mechanism of sleep disturbance and pain comorbidity.

关 键 词：慢性疼痛 睡眠障碍 脑影像 内嗅皮质 

分 类 号：R740[医药卫生—神经病学与精神病学] R402[医药卫生—临床医学]