静息态功能MRI应用于原发性失眠并认知障碍患者的诊断价值研究

Diagnostic Value of Resting-state Functional MRI in Patients with Primary Insomnia and Cognitive Impairment

目的:研究分析静息态功能MRI应用于原发性失眠并认知障碍患者的诊断价值。方法:选取2020年1月至2021年12月福建省厦门大学附属第一医院放射科收治的原发性失眠患者51例作为研究对象。对患者采用蒙特利尔认知评估量表(MoCA)进行认知功能评价,选择MRI图像采集进行数据分析。根据评价原发性失眠并认知障碍患者的数量,同时评价认知障碍患者与非认知障碍患者的ReHo值,判断静息态功能MRI应用于原发性失眠并认知障碍患者的诊断价值。结果:根据蒙特利尔认知评估量表(MoCA)的评估结果可知原发性失眠并认知障碍患者为21例,发生率为41.18%;认知障碍患者分别在左侧海马旁回、左侧颞中回、左侧颞下回、右侧颞下回、右侧额下回、右侧后扣带回均显著高于非认知障碍组(P<0.05);认知障碍患者分别在左侧角回、左侧顶上小叶、左侧颞上回、左侧颞下回、右侧梭状回、右侧颞上回、右侧前扣带回均显著低于非认知障碍组(P<0.05);本研究以MoCA量表的评价结果作为金标,计算静息态功能MRI的诊断效果,灵敏度、特异度、准确度分别为76.19%、76.67%、76.47%。结论:静息态功能MRI应用于原发性失眠并认知障碍患者具有理想的诊断价值,可以为临床早期诊断、早治疗提供参考依据。

Objective:To analyze the diagnostic value of resting-state functional MRI in patients with primary insomnia and cognitive impairment.Methods:A total of 51 patients with primary insomnia admitted to Department of Radiology,the First Affiliated Hospital of Xiamen University from January 2020 to December 2021 were randomly selected as the study object for the Montreal cognitive Cnitions Assessment Scale(MoCA) for cognitive function evaluation,and MRI images for data analysis.According to the number of patients with primary insomnia and cognitive impairment,and the ReHo value of patients with cognitive impairment and non-cognitive impairment were also evaluated,to judge the diagnostic value of resting-state functional MRI in patients with primary insomnia and cognitive impairment.Results:According to the evaluation results of the Montreal Cognitive Assessment Scale(MoCA),there were 21 patients with primary insomnia and cognitive impairment,so the incidence rate was 41.18%(21/51);the left parahippocampal gyrus,left middle temporal gyrus,left inferior temporal gyrus,right inferior temporal gyrus,right inferior frontal gyrus and right posterior cingulate gyrus in patients with cognitive impairment were significantly higher than those in non-cognitive impairment group(P<0.05);The left angular gyrus,left parietal lobule,left superior temporal gyrus,left inferior temporal gyrus,right fusiform gyrus,right superior temporal gyrus and right anterior cingulate gyrus in patients with cognitive impairment were significantly lower than those in non-cognitive impairment group(P<0.05).In this study,using the evaluation results of the MoCA scale as gold markers,To calculate the diagnostic effect of resting-state functional MRI,The sensitivity,specificity and accuracy were 76.19%(16/21),76.67%(23/30) and 76.47%(39/51),respectively.Conclusion:The application of resting-state functional MRI in patients with primary insomnia and cognitive impairment has ideal diagnostic value,and can provide a reference for early clinical diagnosis and treatment.