原发性失眠患者脑静息态功能磁共振研究

发布时间：2018-06-29 01:38

本文选题：原发性失眠 + 静息态功能　；参考：《南方医科大学》2017年硕士论文

【摘要】：第一部分原发性失眠患者脑低频振荡振幅异常的研究目的:利用静息态功能磁共振的低频振荡振幅(Amplitude of Low Frequency Fluctuations,ALFF)算法来研究原发性失眠患者的脑功能分化的异常。材料与方法:本研究纳入55名原发性失眠患者以及44名性别、年龄以及教育水平相匹配的正常对照被试。使用两独立样本t检验来对比两组被试ALFF的差异。使用Pearson's相关来探索异常的ALFF与临床资料以及失眠时间的相关性。结果:原发性失眠患者组左侧眶额回/额下回、右侧额中回、左侧顶下小叶以及双侧小脑后叶的ALFF值低于对照组;右侧颞中回/下回、右侧枕叶的ALFF值高于对照组。除此之外,我们发现失眠时间与左侧眶额回/额下回的ALFF值呈负相关;匹兹堡睡眠质量(Pittsburgh Sleep Quality Index,PSQI)得分与左侧顶下小叶的ALFF值呈负相关。结论:静息态功能磁共振领域对于原发性失眠患者脑功能分化的研究还十分少。本研究是对此功能分化研究的一个补充和尝试。此外,本研究的结果为原发性失眠患者的高度觉醒理论提供了部分支持证据。第二部分原发性失眠患者全脑脑区水平功能连接异常的研究目的:在全脑脑区水平探索原发性失眠患者功能连接的异常,并分析这些异常在全脑水平上的分布特征。材料与方法:50名原发性失眠患者以及40名性别、年龄以及受教育程度相匹配的对照被试被纳入本研究。我们将所有被试的脑划分为116个脑区,然后计算这116个脑区彼此之间的功能连接。通过构建一般线性模型以及两独立样本t检验来分析两组人群的功能连接差异。最后我们使用Pearson相关分析探索了异常的功能连接与相关临床资料之间的相关性。结果:失眠患者与觉醒、情绪、担忧/反思、突显/注意以及感觉-运动相关的脑区彼此间的功能连接较对照组增强;然而那些在正常情况下彼此抑制对方功能活动的脑区的功能连接较对照组减弱,比如突显网络与默认网络。相关分析表明部分增强的功能连接与抑郁量(Self-Rating Depression Scale,SDS)得分、失眠严重度量(Insomnia Severity Index,ISI)得分以及PSQI得分有统计学相关性。结论:本研究中增强的以及减弱的功能连接提示脑区之间的功能强化以及功能去抑制。一定程度上,本研究在全脑脑区水平功能连接方面为原发性失眠的高度觉醒理论提供了证据。第三部分原发性失眠患者右侧岛叶前部皮层的有效功能连接的多体素模式识别研究目的:利用多体素模式识别的方法探索右侧岛叶前部皮层的有效功能连接。材料与方法:使用静息态功能磁共振影像采集50名原发性失眠患者以及40名性别、年龄以及受教育程度相匹配的对照被试的静息态数据。格兰杰因果分析用来探索右侧岛叶前部皮层与全脑的有效功能连接。我们将有效功能连接作为特征向量。然后利用主成分分析的降维方法以及线性支持向量机进行多体素模式识别。同时研究两组被试间的有效连接差异。结果:(1)腹侧右侧前岛叶的有效功能连接可以准确的将原发性失眠患者与正常被试区分开(P≤0.008;permutation test)。(2)默认网络、中央执行网络、视听相关的以及情绪相关的部分脑区与腹侧右侧前岛叶的有效功能连接出现了异常(voxel P0.02;cluster P0.001;permutation test)。(3)腹侧右侧前岛叶与默认网络关键节点以及右侧梭状回的有效功能连接与ISI呈统计学相关(P0.05)。结论:我们的研究提示腹侧右侧前岛叶皮层(突显网络的关键节点)可能在原发性失眠中扮演重要角色。
[Abstract]:Part I study of abnormal amplitude of low frequency oscillation of brain in patients with primary insomnia: using the Amplitude of Low Frequency Fluctuations (ALFF) algorithm of resting state functional magnetic resonance (fMRI) to study the abnormalities of brain function differentiation in patients with primary insomnia. Materials and methods: This study included 55 patients with primary insomnia. The two independent sample t test was used to compare the difference between the two groups of subjects with two independent sample t tests. Use Pearson's correlation to explore the correlation between abnormal ALFF and clinical data and the time of insomnia. Results: the left orbital frontal gyrus / lower frontal gyrus, right frontal gyrus, left side, left The ALFF value of the lateral parietal lobule and bilateral posterior cerebellar leaves was lower than that of the control group; the right occipital lobe ALFF value was higher than that of the control group. Besides, we found that the time of insomnia was negatively correlated with the ALFF value of the left orbital frontal gyrus / lower frontal gyrus; the score of Pittsburgh sleep quality (Pittsburgh Sleep Quality Index, PSQI) and the left parietal lobule. The ALFF value is negatively correlated. Conclusion: the study of resting state functional magnetic resonance (fMRI) on brain function differentiation in patients with primary insomnia is still very few. This study is a supplement and attempt for the study of this functional differentiation. In addition, the results of this study provide some support evidence for the highly awakening theory of the patients with primary insomnia. The second part of the study was original. Study of abnormal horizontal functional connectivity in the whole brain and brain area in patients with recurrent insomnia. Objective: To explore the abnormalities of functional connectivity in patients with primary insomnia at the whole brain level and to analyze the distribution characteristics of these abnormality in the whole brain. Materials and methods: 50 patients with primary insomnia and 40 sex, age, and education level matched pairs. The subjects were included in this study. We divided all the subjects' brains into 116 brain regions, then calculated the functional connections between the 116 brain regions. By constructing the general linear model and the two independent sample t test, we analyzed the functional connectivity differences between the two groups. Finally, we explored the abnormal function connection using the Pearson correlation analysis. Correlation with related clinical data. Results: insomnia patients with awakening, emotion, worry / reflection, prominence / attention, and the functional connectivity of the brain regions associated with sensorimotor enhancement were enhanced than the control group; however, the functional connections in the brain areas that inhibited each other's functional activities under normal conditions were weaker than those in the control group, such as the prominence. Network and default networks. Correlation analysis showed that partially enhanced functional connections were associated with Self-Rating Depression Scale (SDS) scores, severe insomnia measurements (Insomnia Severity Index, ISI) scores and PSQI scores. Conclusion: enhanced and weakened functional connections in this study suggest functional enhancement between the brain regions And function inhibition. To a certain extent, this study provides evidence for the high awakening theory of primary insomnia in the whole brain region level functional connection. Third the multibody pattern recognition study of the effective functional connection of the anterior cortex of the right island of the primary insomniacs: exploration by the method of multibody pattern recognition Effective functional connections in the anterior cortex of the right island. Materials and methods: resting state data were collected from 50 primary insomnia patients and 40 sex, age, and educational level matched control subjects using resting state functional magnetic resonance imaging. Grainger causality analysis was used to explore the effective function of the right Island anterior cortex and the whole brain. We use the effective functional connection as a feature vector. Then we use the dimension reduction method of the principal component analysis and the linear support vector machine for multi voxel pattern recognition. At the same time, we study the effective connection difference between the two groups. Results: (1) the effective functional connection of the right ventral side of the front Isle leaf can accurately make the patients with primary insomnia and normal. The subjects were divided (P < 0.008; permutation test). (2) the default network, the central executive network, the audio-visual related part of the brain and the effective functional connection with the ventral side of the right anterior insula (voxel P0.02; cluster P0.001; permutation test). (3) the right anterior insula, the default network key node and the right shuttle. The effective functional connection of the form gyrus was statistically related to ISI (P0.05). Conclusion: our study suggests that the ventral right anterior insula cortex (the key node of the prominent network) may play an important role in primary insomnia.
【学位授予单位】：南方医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R445.2;R740

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