静息态fMRI观察基于中国人脑模板的慢性失眠患者岛叶功能连接
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摘要
目的利用功能连接分析方法观察慢性失眠(CI)患者静息状态下岛叶功能整合的改变。方法对22例CI患者(CI组)及23名健康志愿者(对照组)进行静息态fMRI,以基于中国人脑建立的模板(Chinese2020)进行空间标准化,以双侧岛叶为ROI,与全脑其他体素进行功能连接分析,获得2组间功能连接有差异脑区,并分析异常功能连接脑区与临床资料的相关性。结果与对照组相比,CI组患者与右侧岛叶功能连接增强的脑区包括双侧海马、双侧海马旁回、双侧额中回、右侧颞中回、右侧中央前回、左侧颞下回、左侧梭状回及左侧小脑后叶(P均<0.05,体素簇个数≥10个,AlphaSim校正),与左侧岛叶功能连接增强的脑区包括双侧海马、双侧海马旁回、左侧颞下回、左侧梭状回、左侧小脑后叶及右侧小脑前叶(P均<0.05,体素簇个数≥10个,AlphaSim校正)。CI组瞬时记忆评分与右侧岛叶—右侧海马、右侧岛叶—左侧海马、左侧岛叶—右侧海马及左侧岛叶—左侧海马的功能连接强度呈正相关(r=0.580、0.668、0.454、0.562,P均<0.05)。结论 CI患者双侧岛叶与多个脑区存在功能连接异常,为理解CI患者存在情绪调节、认知障碍、日间功能障碍及记忆功能受损的机制提供了影像学依据。
Objective To explore the changes of insula function integration in patients with chronic insomnia(CI)using functional connectivity(FC)analysis in resting-state fMRI.Methods Totally 22 patients with CI(CI group)and 23 healthy volunteers(control group)underwent resting-state fMRI.The templates based on Chinese brains(Chinese2020)were used for spatial standardization.The bilateral insulae were selected as ROIs,and FC analysis was performed with other voxels to obtain brain regions with abnormal FC between the two groups.Correlation analysis was performed between the brain regions with abnormal FC and clinical parameters.Results Compared with control group,the increased FC brain regions with right insula in CI group included bilateral hippocampus,bilateral parahippocampus,bilateral frontal middle gyrus,right temporal middle gyrus,right precentral gyrus,left temporal inferior gyrus,left fusiform gyrus and left posterior lobe of cerebellum(all P<0.05,number of voxel cluster≥10,AlphaSimcorrection),while the increased FC brain regions with left insula in CI group included bilateral hippocampus,bilateral parahippocampus,left fusiform gyrus,left temporal inferior gyrus,left posterior lobe of cerebellum and right anterior lobe of cerebellum(all P<0.05,number of voxel cluster≥10,AlphaSimcorrection).Correlation analysis showed the scores of instantaneous memory in CI group were positively correlated with FC of the right insula-right hippocampus,right insula-left hippocampus,left insularight hippocampus and left insula-left hippocampus (r=0.580,0.668,0.454,0.562, all P<0.05).Conclusion FC is abnormal between the bilateral insulae and multiple brain regions in CI patients,therefore providing neuroimaging evidence for understanding emotional regulation,cognitive impairment,daytime dysfunction and impaired memory mechanisms in CI.
Objective To explore the changes of insula function integration in patients with chronic insomnia(CI)using functional connectivity(FC)analysis in resting-state fMRI.Methods Totally 22 patients with CI(CI group)and 23 healthy volunteers(control group)underwent resting-state fMRI.The templates based on Chinese brains(Chinese2020)were used for spatial standardization.The bilateral insulae were selected as ROIs,and FC analysis was performed with other voxels to obtain brain regions with abnormal FC between the two groups.Correlation analysis was performed between the brain regions with abnormal FC and clinical parameters.Results Compared with control group,the increased FC brain regions with right insula in CI group included bilateral hippocampus,bilateral parahippocampus,bilateral frontal middle gyrus,right temporal middle gyrus,right precentral gyrus,left temporal inferior gyrus,left fusiform gyrus and left posterior lobe of cerebellum(all P<0.05,number of voxel cluster≥10,AlphaSimcorrection),while the increased FC brain regions with left insula in CI group included bilateral hippocampus,bilateral parahippocampus,left fusiform gyrus,left temporal inferior gyrus,left posterior lobe of cerebellum and right anterior lobe of cerebellum(all P<0.05,number of voxel cluster≥10,AlphaSimcorrection).Correlation analysis showed the scores of instantaneous memory in CI group were positively correlated with FC of the right insula-right hippocampus,right insula-left hippocampus,left insularight hippocampus and left insula-left hippocampus (r=0.580,0.668,0.454,0.562, all P<0.05).Conclusion FC is abnormal between the bilateral insulae and multiple brain regions in CI patients,therefore providing neuroimaging evidence for understanding emotional regulation,cognitive impairment,daytime dysfunction and impaired memory mechanisms in CI.
引文
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[15]聂晓,彭德昌,李海军,等.原发性失眠的不同频段低频振幅静息态功能磁共振研究.中国医学影像技术,2016,32(2):204-208.
[16]Sridharan D,Levitin DJ,Menon V.A critical role for the right fronto-insular cortex in switching between central-executive and default-mode networks.Proc Natl Acad Sci U S A,2008,105(34):12569-12574.
[2]Fox MD,Greicius M.Clinical applications of resting state functional connectivity.Front Syst Neurosci,2010,4(19):1-13.
[3]史旭波,刘梦晨,吴筠凡,等.原发性失眠患者基于静息态功能磁共振的脑岛功能连接异常区.中山大学学报,2017,38(4):608-613.
[4]Wang TY,Yan JH,Li SM,et al.Increased insular connectivity with emotional regions in primary insomnia patients:A restingstate fMRI study.Eur Radiol,2017,27(9):3703-3709.
[5]Liang PP,Shi L,Chen N,et al.Construction of brain atlases based on a multi-center MRI dataset of 2020Chinese adults.Sci Rep,2015,5:18216.
[6]美国精神医学学会.张道龙,译.精神障碍诊断与统计手册.5版.北京:北京大学出版社,2015:352-353.
[7]Arnsten AF,Jin LE,Molecular influences on working memory circuits in dorsolateral prefrontal cortex.Prog Mol Biol Transl Sci,2014,122:211-231.
[8]梁敏杰,周全,杨晓玲,等.原发性失眠患者基于局部一致性的静息态脑功能改变研究.临床放射学杂志,2014,33(1):10-14.
[9]马晓芬,曾少庆,方金,等.原发性失眠全脑度中心度的改变.中山大学学报,2017,38(3):390-394.
[10]Wu QZ,Li DM,Kang WH,et al.Abnormal regional spontaneous neural activity in treatment-refractory depression revealed by resting-state fMRI.Hum Brain Mapp,2011,32(8):1290-1299.
[11]Nofzinger EA,Buysse DJ,Germain A,et al.Functional neuroimaging evidence for hyperarousal in insomnia.Am JPsychiatry,2004,161(11):2126-2128.
[12]Bellesi M,Tononi G,Cirelli C,et al.Region-specifc dissociation between cortical noradrenaline levels and the sleep/wake cycle.Sleep,2016,39(1):143-154.
[13]Drummond SP,Walker M,Almklov E,et al.Neural correlates of working memory performance in primary insomnia.Sleep,2013,36(9):1307-1316.
[14]Riemann D,Spiegelhalder K,Feige B,et al.The hyperarousal model of insomnia:A review of the concept and its evidence.Sleep Med Rev,2010,14(1):19-31.
[15]聂晓,彭德昌,李海军,等.原发性失眠的不同频段低频振幅静息态功能磁共振研究.中国医学影像技术,2016,32(2):204-208.
[16]Sridharan D,Levitin DJ,Menon V.A critical role for the right fronto-insular cortex in switching between central-executive and default-mode networks.Proc Natl Acad Sci U S A,2008,105(34):12569-12574.