基于静息态fMRI的原发性失眠全脑功能连接密度的改变

Changes in Whole-Brain Functional Connectivity Density in Primary Insomnia Based on Resting State Functional MRI

目的探讨原发性失眠患者与健康对照组大脑静息状态下大脑功能连接密度(FCD)的差异。资料与方法前瞻性收集2020年8月—2021年12月西电集团医院及西安中医脑病医院收治的原发性失眠35例,并招募健康对照组35例。采用FCD分析计算两组的静息态大脑FCD图并进行比较,探讨原发性失眠患者FCD值的变化与匹兹堡睡眠质量指数、睡眠状况自评量表、失眠严重指数、焦虑自评量表及抑郁自评量表的相关性。结果与健康对照组相比,原发性失眠患者右侧脑岛、双侧前扣带回、左侧眶额中回、左侧背外侧额上回、右侧内侧额上回及双侧丘脑的FCD值明显减低(t<-5.271,P_(校正)<0.05),而右侧颞上回、双侧颞中回、双侧楔前叶及左侧后扣带回的FCD值明显增加(t>4.379,P_(校正)<0.05)。双侧丘脑(r=-0.620,P<0.001;r=-0.562,P<0.005)及右侧脑岛(r=-0.651,P<0.001)的FCD值与失眠严重指数呈显著负相关。结论通过FCD观察到原发性失眠患者存在广泛的功能连接异常,该发现从功能整合及功能分离角度解释了慢性失眠背后情绪调节障碍与认知障碍的神经机制。

Purpose To investigate the difference of resting-state functional connectivity density(FCD)between chronic primary insomnia patients and healthy controls via resting state functional magnetic resonance imaging(rs-fMRI).Materials and Methods All rs-fMRI data of 35 patients with chronic primary insomnia from Xidian Group Hospital and Xi’an Encephalopathy Hospital of Traditional Chinese Medicine,and 35 healthy controls were prospectively collected from August 2020 to December 2021.The voxel-wise FCD approach was applied to explore the differences of whole-brain functional networks between chronic primary insomnia patients and healthy controls.The relationships between FCD value and Pittsburgh sleep quality index,self-rating scale of sleep,insomnia severity index,self-rating anxiety scale and self-rating depression scale in primary insomnia patients were investigated,respectively.Results Compared with healthy controls,the decreased FCD values were showed in the right insula,bilateral anterior cingulate gyrus,left orbitofrontal middle gyrus,left dorsolateral superior frontal gyrus,right medial superior frontal gyrus and bilateral thalamus(t<-5.271,P_(adjust)<0.05),while the increased FCD values showed in the right superior temporal gyrus,bilateral middle temporal gyrus,bilateral precuneus and left posterior cingulate gyrus(t>4.379,Padjust<0.05)in the chronic primary insomnia patients group.The FCD values of bilateral thalamus(r=-0.620,P<0.001;r=-0.562,P<0.005)and right insula(r=-0.651,P<0.001)were negatively correlated with insomnia severity index in the chronic primary insomnia patients group,respectively.Conclusion The extensive functional connectivity abnormalities are observed in primary insomnia patients via FCD analysis.These findings explain the neural mechanisms of underlying emotional regulation and cognitive impairment in chronic insomnia from the perspective of functional integration and functional separation.