慢性失眠伴焦虑抑郁患者认知功能障碍的γ振荡研究

Gamma oscillations of cognitive dysfunction in chronic insomnia patients with anxiety and depression

目的分析慢性失眠伴焦虑抑郁患者认知功能障碍γ振荡特点,旨在探讨其潜在神经机制。方法将符合临床诊断的慢性失眠患者根据焦虑抑郁评分分为慢性失眠伴焦虑抑郁组(n=19)与慢性失眠组(n=13);年龄、性别、教育背景相匹配的健康受试者为正常对照组(n=16);采集3组受试者在静息状态和认知负载状态下的脑电信号,应用快速傅里叶变换计算γ频段的相对功率,分析比较3组受试者γ振荡的空间分布特征模式。应用Spearman相关对脑电γ频带相对功率与睡眠量表和焦虑抑郁量表评分的相关性进行分析。结果慢性失眠伴焦虑抑郁组、慢性失眠组和正常对照组静息态脑电γ频带相对功率分别为0.1921±0.0080,0.2103±0.0096,0.2373±0.0064;3组认知负载态的脑电γ频带相对功率分别为0.2207±0.0081,0.2495±0.0098,0.2677±0.0072,与静息态相比均显著增加(均P<0.05);静息态慢性失眠伴焦虑抑郁组(0.1799±0.0097)、慢性失眠组(0.1944±0.0104)脑电节点(F3,F4,C3,C4,P3,P4,O2,F8,T4)的平均脑电γ频带相对功率均低于对照组(0.2360±0.0120)(P<0.05);认知负载态失眠伴焦虑抑郁组(0.2073±0.0097)脑电节点(F3,C3,C4,P3,P4,T4)的平均γ频带相对功率低于正常对照组(0.2591±0.0094)(P<0.05);3组受试者组内及组间公共差异节点(F3,C3,P3)的脑电γ频带相对功率与失眠、焦虑抑郁存在负相关(相关系数r=-0.467^-0.274,P<0.05)。结论慢性失眠伴焦虑抑郁患者存在认知功能障碍,左后额、左中央和左顶的γ振荡缺失可能是慢性失眠伴焦虑抑郁患者认知功能障碍的潜在神经机制之一。

Objective To analyze the characteristics of gamma oscillation in chronic insomnia patients with anxiety and depression,and to investigate its underlying neural mechanism.Methods According to the anxiety and depression scores,the subjects with chronic insomnia who met the diagnostic criteria were divided into chronic insomnia with anxiety and depression group(n=19)and chronic insomnia group(n=13).Healthy subjects matched with age,gender,and educational background were selected as the normal control group(n=16).The EEGs from the three groups under resting state and cognitive load state were collected.The relative gamma power was then calculated by fast Fourier transform.The spatial distribution pattern of the gamma oscillation in the three groups was analyzed.Spearman correlation analysis was employed to quantify the correlation between relative gamma powers and sleep scale,anxiety and depression scale scores.Results In the resting state,the relative gamma power in the chronic insomnia with anxiety and depression,chronic insomnia and normal control group was 0.1921±0.0080,0.2103±0.0096,0.2373±0.0064,respectively.In the cognitive load state,the relative gamma power in the three groups increased compared with those in the resting state(0.2207±0.0081,0.2495±0.0098,0.2677±0.0072,respectively)(all P<0.05).In the resting state,the relative gamma power(F3,F4,C3,C4,P3,P4,O2,F8,T4)in the chronic insomnia with anxiety and depression group(0.1799±0.0097)and the chronic insomnia group(0.1944±0.0104)was lower than that in control(0.2360±0.0120,P<0.05).In the cognitive load state,the relative gamma power(F3,C3,C4,P3,P4,T4)in the chronic insomnia with anxiety and depression group(0.2073±0.0097)was lower than that in control(0.2591±0.0094)(P<0.05).There was a significant negative correlation between the relative gamma power in the nodes(F3,C3,P3)and the insomnia,anxiety and depression in the three groups(correlation coefficient r=-0.467--0.274,P<0.05).Conclusion Chronic insomnia patients with anxiety and depression are often accompanied by cognitive dysfunction.The loss of gamma oscillation in left posterior,left central and left apex may be one of the potential neural mechanisms of cognitive dysfunction in chronic insomnia patients with anxiety and depression.