低睡眠质量抑郁症患者枕叶自发性活动与执行功能的初步研究  

A preliminary study on spontaneous activity and executive function of occipital lobe in depressive disorder patients with low sleep quality

作　　者：刘不凡 赵天宇 黄凡凡 任若佳 卢文婷[1] 李娜[1] 白美娜 刘快快 王学义[1] Liu Bufan;Zhao Tianyu;Huang Fanfan;Ren Ruojia;Lu Wentiing;Li Na;Bai Meina;Liu Kuaikuai;Wang Xueyi(Mental Health Center,the First Hospital of Hebei Medical University&Hebei Institute of Mental Health&Hebei Clinical Research Center for Mental Disorders&Hebei Technology Innovation Center for Mental and Psychological Health Assessment and Intervention,Shijiazhuang 050031,China)

机构地区：[1]河北医科大学第一医院精神卫生中心、河北省精神卫生研究所、河北省精神心理疾病临床医学研究中心、河北省精神心理健康评估与干预技术创新中心,石家庄050031

出　　处：《神经疾病与精神卫生》2024年第9期640-646,共7页Journal of Neuroscience and Mental Health

基　　金：河北省省级科技计划资助项目(21377711D);河北省引进国外智力项目(YZ202306);河北省医学科学研究课题计划(20240536)。

摘　　要：目的探讨低睡眠质量抑郁症患者脑区自发性活动变化与执行功能的关系。方法选取2021年9月—2024年4月于河北医科大学第一医院精神卫生中心住院或门诊就诊的42例抑郁症患者为研究组,同期于河北医科大学第一医院健康体检中心招募年龄、性别、受教育年限相匹配的14名体检者为健康对照组。采用17项汉密尔顿抑郁量表(HAMD-17)、匹兹堡睡眠质量指数(PSQI)及数字广度测验(DST)评估受试者的抑郁情绪、睡眠情况及认知水平。采用3.0T脑静息态功能磁共振成像扫描(rs-fMRI)计算分数低频振幅(fALFF)。根据PSQI评分,将研究组患者PSQI得分≤7分定义为高睡眠质量组(n=14)、PSQI得分>7分为低睡眠质量组(n=28)。对3组受试者的fALFF值方差分析后进行事后检验,并采用Spearman相关分析差异脑区与数字广度得分的相关性。结果3组受试者的年龄、性别、受教育程度、顺背得分比较,差异均无统计学意义(均P>0.05);而倒背得分比较,差异有统计学意义(H=26.56,P=0.03)。事后比较结果显示,低睡眠质量组倒背得分低于健康对照组(Z=-3.40,P<0.05),高睡眠质量组与低睡眠质量组(Z=-1.34,P=0.18)、健康对照组(Z=-1.35,P=0.18)比较,差异均无统计学意义。三组的右侧枕上回(MNI:x=0,y=-102,z=-31;k=37)、左侧枕中回(MNI:x=21,y=-102,z=6;k=51)、左侧楔前叶(MNI:x=-9,y=-78,z=21;k=27)的fALFF值比较,差异有统计学意义(GRF矫正,P<0.05)。与高睡眠质量组相比,低睡眠质量组的右侧枕上回fALFF值升高(Z=-3.02,P<0.05)。与健康对照组比较,高睡眠质量组左侧楔前叶fALFF值升高(Z=-2.02,P=0.04),低睡眠质量组右侧枕上回(Z=-3.47,P<0.05)、左侧枕中回(Z=-3.82,P<0.05)、左侧楔前叶(Z=-3.71,P<0.05)fALFF值均升高。相关性分析显示,右侧枕上回(r=-0.26,P<0.05)、左侧楔前叶(r=-0.38,P<0.05)与数字广度倒背得分呈负相关。结论低睡眠质量的抑郁症患者枕叶自发性活动增加,且枕叶�Objective To explore the relationship between spontaneous activity in brain regions and executive function in depressive disorder patients with low sleep quality.Methods A total of 42 patients with depressive disorder in the Mental Health Center of the First Hospital of Hebei Medical University from September 2021 to April 2024 were selected as study group.During the same period,14 matched age,gender,and education level were recruited from the Health Examination Center of the same hospital as healthy control group.Hamilton Depression Scale-17 item(HAMD-17),Pittsburgh Sleep Quality Index(PSQI),and Digital Span Test(DST)were used to assess the subjects'depressive mood,sleep quality,and cognition.3.0T restingstate functional magnetic resonance imaging(rs-fMRI)scan was used to calculate the fraction amplitude of low frequency fluctuation(fALFF).According to the PSQI score,patients in study group with a PSQI score≤7 were defined as high sleep quality group(n=14),and patients with a PSQI score>7 were defined as low sleep quality group(n=28).After conducting a variance analysis of fALFF values for three groups of subjects,a backtesting was conducted,and Spearman correlation was used to analyze the correlation between different brain regions and digital span scores.Results There was no statistically significant difference in age,gender,education level,and forward digit span scores among the three groups of subjects(P>0.05).However,there was a statistically significant difference in the scores of backwards digit span(H=26.56,P=0.03).Backtesting showed that low sleep quality group had a lower score for backwards digit span compared to healthy control group with a statistical difference(Z=-3.40,P<0.05),but there was no statistically significant difference between high sleep quality group and low sleep quality group(Z=-1.34,P=0.18)or healthy control group(Z=-1.35,P=0.18).There was a statistically significant difference in the fALFF values of the right superior occipital gyrus(MNI:x=0,y=-102,z=-31;k=37),left middle occipita

关 键 词：抑郁症 睡眠质量 静息功能磁共振 枕叶自发性活动 楔前叶 分数低频振幅 执行功能 

分 类 号：R749.4[医药卫生—神经病学与精神病学]