基于脑卒中局灶性病变的失眠网络探究  

Study on Insomnia Network Based on Focal Lesions of Stroke

作　　者：音大为 何野 方义荣 孙文[2] 王朋[1] YIN Da-wei;HE Ye;FANG Yi-rong;SUN Wen;WANG Peng(Department of Radiology,The First Affiliated Hospital of USTC,Hefei 230001,Anhui Province,China;Department of Neurosurgery,The First Affiliated Hospital of USTC,Hefei 230001,Anhui Province,China)

机构地区：[1]中国科学技术大学附属第一医院(安徽省立医院)医学影像科 [2]中国科学技术大学附属第一医院(安徽省立医院)神经内科,安徽合肥230001

出　　处：《中国CT和MRI杂志》2024年第8期1-3,共3页Chinese Journal of CT and MRI

基　　金：安徽省自然科学基金项目(No.2108085MH271)。

摘　　要：目的通过分析卒中局灶性病变与卒中后失眠的关系,探讨卒中后失眠的神经解剖基础,为卒中后失眠诊断与治疗提供新的思路。方法本研究前瞻性纳入50名卒中患者为研究对象,使用失眠严重程度指数量表对其失眠状况进行评估,并将患者分为失眠组与非失眠组。使用体素病变症状映射来检验失眠与病变位置之间的关联。利用大型标准连接组数据集(N=1000)计算病变网络图,检验其与失眠之间的联系,并以此结果定位失眠网络。此外,通过分析网络损伤分数与失眠程度之间的联系,证明失眠网络的可靠性。结果体素病变症状映射分析未发现任何病变体素与失眠显著相关。然而,在病灶网络映射分析中,病变位置映射到一个以右侧丘脑为核心的大脑网络,该网络与失眠组患者局灶性病变的交叉程度显著高于无失眠组病变。结论卒中后失眠患者的病变位置未能映射到任何脑区,而是映射到一个特定的脑网络。该网络可能对卒中后失眠患者的早期诊断和治疗具有重要意义。Objective This study investigates the relationship between focal brain lesions in stroke patients and post-stroke insomnia.By exploring the neuroanatomical basis of post-stroke insomnia,we aim to provide novel insights for its diagnosis and treatment.Methods This study prospectively enrolled 50 stroke patients.Insomnia severity was quantitatively assessed using Insomnia Severity Index Scale,categorizing patients into insomnia and non-insomnia groups.Employing voxel lesion symptom mapping,we examined the association between insomnia and lesion location.We calculated lesion network maps using a large standard connectome dataset(N=1000)to test for associations with insomnia.The results were then used to locate insomnia networks.Furthermore,we demonstrated the reliability of the insomnia network by analyzing the link between the network impairment score test and insomnia.Results Voxel lesion symptom mapping did not reveal significant associations between specific lesion voxels and insomnia.However,in lesion network mapping analysis,we found that lesion locations mapped to a brain network centered around the right thalamus.This network exhibited significantly greater overlap with focal lesions in insomnia patients compared to the noninsomnia group.Conclusion Lesion locations associated with insomnia fail to map to a specific brain region but do map to a specific brain network.This network may have prognostic utility in identifying patients at risk for poststroke insomnia and therapeutic utility in refining brain stimulation targets.

关 键 词：急性缺血性脑卒中 体素病变症状映射 失眠 病灶网络映射 

分 类 号：R256.23[医药卫生—中医内科学]