原发性失眠相关情绪障碍的低频振幅静息态fMRI研究  

A resting-state fMRI study of alterations in amplitude of low-frequency fluctuation in primary insomnia patients with emotional disorders

作　　者：王忠艳[1] 霍健伟 付清楠 陈鹏[3] WANG Zhongyan;HUO Jianwei;FU Qingnan;CHEN Peng(Department of Radiology,Beijing Hospital of Traditional Chinese Medicine Affiliated to Capital Medical University,Beijing 100010,China;Department of Psychosomatic Medicine,Beijing Hospital of Traditional Chinese Medicine Affiliated to Capital Medical University,Beijing 100010,China;Department of Acupuncture,Beijing Hospital of Traditional Chinese Medicine Affiliated to Capital Medical University,Beijing 100010,China)

机构地区：[1]首都医科大学附属北京中医医院放射科,北京100010 [2]首都医科大学附属北京中医医院心身医学科,北京100010 [3]首都医科大学附属北京中医医院针灸科,北京100010

出　　处：《中国中西医结合影像学杂志》2024年第2期138-143,共6页Chinese Imaging Journal of Integrated Traditional and Western Medicine

基　　金：北京市属医院科研培育项目(PZ202014)。

摘　　要：目的:探讨原发性失眠相关情绪障碍患者的脑内神经活动异常改变。方法:纳入18~60岁原发性失眠相关情绪障碍患者(失眠组)和正常受试者(对照组)各20例,对比2组低频振幅(ALFF)差异,并分析ALFF值与临床评估量表的相关性。结果:2组匹兹堡睡眠质量指数(PSQI)、焦虑自评量表(SAS)评分、抑郁自评量表(SDS)评分差异均有统计学意义(均P<0.05)。与对照组相比,失眠组ALFF值升高的脑区有左侧颞下回、右侧眶额皮质、右侧前扣带回、右侧颞中回、双侧额上回、右侧枕上回、左侧中央后回,ALFF值降低的脑区有左侧中扣带回、左侧额中回、右侧额上回(AlphaSim校正,P<0.01)。SDS评分与右侧眶额皮质的ALFF值呈正相关(r=0.528,P=0.024),SDS、SAS评分与左侧中扣带回ALFF值均呈正相关(r=0.641,0.494;均P<0.05)。结论:通过ALFF可发现原发性失眠相关情绪障碍患者的脑内异常神经活动,主要是情感、认知相关网络脑区(扣带回、眶额皮质等)存在脑自发活动异常,且部分脑区的自发活动与临床指标存在相关性。异常脑活动改变可能是原发性失眠相关情绪障碍患者的有效神经影像标志物,可为远期疾病严重性评估及疾病治疗提供影像学依据。Objective:To investigate the changes of brain nerve activity in primary insomnia patients with emotional disorders.Methods:Twenty primary insomnia patients(the insomnia group)and 20 healthy subjects(the control group)were recruited and subjected to resting-state fMRI.The amplitude of low-frequency fluctuation(ALFF)values were compared between the two groups and the correlations between ALFF values and the evaluation scales were analyzed.Results:The Pittsburgh sleep quality index(PSQI),self-rating anxiety scale(SAS),and self-rating depression scale(SDS)scores in the insomnia group were significantly different from those in the control group(all P<0.05).Compared with the control group,the primary insomnia group showed increased ALFF values in the left inferior temporal gyrus,right orbitofrontal cortex,right anterior cingulate,right middle temporal gyrus,bilateral superior frontal gyrus,right superior occipital gyrus and left posterior central gyrus,and decreased ALFF values in the left middle cingulate,left middle frontal gyrus and right superior frontal gyrus(P<0.01,AlphaSim corrected).Furthermore,the SDS scores were positive correled with ALFF values in the right orbitofrontal cortex and left cingulate gyrus(r=0.528,0.641,both P<0.05),and the SAS score had a positive correlation with ALFF value in the left cingulate gyrus(r=0.494,P=0.037).Conclusions:The changes of brain nerve activity in primary insomnia patients with emotional disorders can be analyzed by ALFF,mainly the abnormal spontaneous brain activity in the brain regions related to emotion-cognition(cingulate gyrus,orbitofertal cortex,etc.),and the spontaneous brain activity in some brain regions is correlated with clinical indicators.Abnormal spontaneous activity could be an efficient neuroimaging biomarker for primary insomnia and could establish a foundation for the assessment of disease severity and treatment recommendations.

关 键 词：原发性失眠 磁共振成像 低频振幅 

分 类 号：R740[医药卫生—神经病学与精神病学] R445.2[医药卫生—临床医学]