失眠患者睡眠障碍特征与丘脑亚区体积关联性的年龄差异:基于MRI成像

Age-related differences in the association between sleep disorder characteristics and thalamic subregion volumes in patients with insomnia:based on MRI

目的观察不同年龄段失眠患者的睡眠障碍表现,并基于MRI成像采集各年龄段失眠患者脑核磁数据,比较其丘脑亚区的体积差异,探讨睡眠障碍与丘脑亚区体积之间的相关性。方法纳入2023年7月~2024年6月就诊于福建中医药大学附属康复医院的原发性失眠患者60例,根据年龄分为青年组(18~44岁),中年组(45~59岁)和老年组(60~75岁),20例/组,采用匹兹堡睡眠质量指数评估各组患者的睡眠质量及失眠程度,并采用西门子3.0T Prisma核磁成像系统,采集患者3D T1结构像数据,自动分割并测量丘脑及6个亚区的体积,分析比较各组患者丘脑亚区的体积差异;同时采用偏相关分析方法探讨患者睡眠障碍表现与丘脑亚区体积的相关性。结果不同年龄段的原发性失眠患者匹兹堡睡眠质量指数量表总分、入睡时间、睡眠效率及失眠程度分级的差异有统计学意义(P<0.05),内侧丘脑、外侧丘脑、后部丘脑和丘脑总体积的组间差异有统计学意义(P<0.05);偏相关分析结果显示睡眠效率与后部丘脑体积呈负相关(r=-0.274,P=0.038)。结论不同年龄段的原发性失眠患者睡眠障碍表现不同,利用MRI成像采集并分析失眠患者脑核磁数据发现可能与丘脑系统部分脑区灰质结构萎缩有关,这为患者个体化治疗、改善临床预后提供了重要的参考依据。

Objective To observe the performance of sleep disorders in insomnia patients of different ages,and to compare the volume differences of thalamic subregions in insomnia patients of all ages based on MRI acquisition of nuclear magnetic data of the brain,and to explore the correlation between sleep disorders and the volume of thalamic subregions.Methods Sixty patients with primary insomnia who attended the Rehabilitation Hospital of Fujian University of Traditional Chinese Medicine from July 2023 to June 2024 were categorized by age into young group(18-44 years old),middle-aged group(45-59 years old),and old-aged group(60-75 years old),20 cases per group.The Pittsburgh sleep quality index was used to assess the sleep quality and degree of insomnia of the patients in each group,and the Siemens 3.0T Prisma magnetic imaging system was used to collect 3D T1 structural image data of the patients,to automatically segment and measure the volumes of the thalamus and six subregions,and to analyze and compare the thalamic subregions of the patients in each group.We analyzed and compared the volume differences of the thalamic subregions in each group of patients,and explored the correlation between the patients'sleep disorders and the volume of the thalamic subregions using partial correlation analysis.Results The Pittsburgh sleep quality index total score,sleep latency,habitual sleep efficiency and insomnia degree grading differed among patients with primary insomnia of different ages(P<0.05),and significant intergroup differences existed among the medial thalamus,lateral thalamus,posterior thalamus and thalamus total volume(P<0.05).Moreover,the results of the partial correlation analysis showed that the sleep efficiency was negatively correlated to the volume of posterior thalamus(r=-0.274,P=0.038).Conclusion Primary insomnia patients of different age groups have different manifestations of sleep disorders.MRI was used to collect brain nuclear magnetic data from insomnia patients,and the analysis of the MRI data revealed that it might be related to the atrophy of grey matter structures in some brain regions of the thalamic system,which provides an important reference for individualized treatment of the patients and improvement of clinical prognosis.