原发性失眠患者大脑背外侧前额叶的异常静息态功能连接

Abnormal resting-state functional connectivity of the dorsolateral prefrontal lobe in patients with primary insomnia

目的:利用功能连接方法观察原发性失眠患者静息态下的背外侧前额叶的异常功能连接。方法:采集33例原发性失眠患者以及33例年龄、性别和受教育程度相匹配的健康对照的功能磁共振图像,以背外侧前额叶为感兴趣区域,与全脑其他体素进行功能连接分析,得到两组之间功能连接的差异脑区,再对异常功能连接脑区与临床的量表分数做相关分析。结果:与对照组相比,发现失眠患者左侧背外侧前额叶与左侧枕下回、右侧枕下回、右侧枕中回、右侧颞叶、左侧额中回,左侧额下回以及右侧梭状回之间的功能连接增强(P<0.05,体素簇个数≥100,FDR校正),与左侧前扣带皮层、右侧海马旁回、右侧脑岛、右侧背外侧额上回、右侧顶上回、右侧中央后回以及右侧中央前回之间的功能连接减弱(P<0.05,体素簇个数≥100,FDR校正)。并且左侧背外侧前额叶与左侧枕叶下回的功能连接值与睡眠状况自评量表分数成正相关(P=0.035)。结论:原发性失眠患者背外侧前额叶与大脑多个脑区出现异常的功能连接,可能为理解原发性失眠患者的神经机制提供一些新的影像学依据。

Objective To explore the abnormal functional connectivity(FC)of the dorsolateral prefrontal lobe in patients with primary insomnia using FC analysis.Methods A total of 33 primary insomnia patients and 33 age-,gender-and educationmatched healthy subjects were examined with resting-state functional magnetic resonance imaging(fMRI).The dorsolateral prefrontal lobe in fMRI image was selected as region of interest,and then FC analysis was conducted on the dorsolateral prefrontal lobe and other voxels in the brain to obtain the brain regions with abnormal FC between two groups.The relationships between brain regions with abnormal FC and clinical scale scores were also investigated.Results Compared with control group,the FC between the left dorsolateral prefrontal lobe in patients with primary insomnia and the left inferior occipital gyrus,the right inferior occipital gyrus,the right middle occipital gyrus,the right temporal lobe,the left middle frontal gyrus,the left inferior frontal gyrus and the right fusiform gyrus were enhanced(P<0.05,number of voxels≥100,FDR correction),but the FC with the left anterior cingulate cortex,the right parahippocampal gyrus,the right insula,the right dorsolateral superior frontal gyrus,the right superior parietal gyrus,the right postcentral gyrus and the right precentral gyrus were weakened(P<0.05,number of voxels≥100,FDR correction).The FC values of the left dorsolateral prefrontal lobe and the left inferior occipital lobe were positively correlated with the scores of self-rating scale of sleep.Conclusion Abnormal FC between the dorsolateral prefrontal lobe and multiple brain regions in primary insomnia patients may provide some new imaging evidence for understanding the neurological mechanism of primary insomnia.