CAJ | 학술논문

目的采用静息态fMRI(rs-fMRI)的基于体素镜像同伦连接(VMHC)方法研究原发性失眠(PI)患者两大脑半球间功能连通性.方法选取21例PI患者(PI组)和20名健康志愿者(对照组),采用匹兹堡睡眠质量指数量表(PSQI)进行评分,然后行rs-fMRI扫描,采用REST软件来计算PI组和对照组两侧大脑半球间的VMHC值,两组间VMHC值比较采用两样本t检验,最终获得VMHC值有统计差异的统计结果图.VMHC值与PSQI评分间的相关性采用Pearson相关性分析.结果 PI组与对照组分别有3例和1名图像不合格,最终分别纳入18例患者和19名志愿者.与对照组比较,PI组额中回、额上回、眶额回、海马、丘脑、岛叶及枕叶部分脑区(楔叶、舌回)VMHC显著减低(体素大小为1 269～7 425mm3,t值为-4.47-2.74,P值均＜0.05,Alphasim校正),其中双侧眶额回之间VMHC(0.324±0.247)与PSQI得分(10.1±1.7)呈显著负相关(r=-0.69,P＜0.01),其余存在显著改变的VMHC区域相关系数值与PSQI得分均无显著相关(P值均＞0.05).结论 PI患者在静息态下存在两大脑半球间的功能连接异常.两半球间的VMHC可能作为病理生理学上评估PI患者神经失连接的一种有效的辅助方法.
목적 채용정식태fMRI(rs-fMRI)적기우체소경상동륜련접(VMHC)방법연구원발성실면(PI)환자량대뇌반구간공능련통성.방법 선취21례PI환자(PI조)화20명건강지원자(대조조),채용필자보수면질량지수량표(PSQI)진행평분,연후행rs-fMRI소묘,채용REST연건래계산PI조화대조조량측대뇌반구간적VMHC치,량조간VMHC치비교채용량양본t검험,최종획득VMHC치유통계차이적통계결과도.VMHC치여PSQI평분간적상관성채용Pearson상관성분석.결과 PI조여대조조분별유3례화1명도상불합격,최종분별납입18례환자화19명지원자.여대조조비교,PI조액중회、액상회、광액회、해마、구뇌、도협급침협부분뇌구(설협、설회)VMHC현저감저(체소대소위1 269～7 425mm3,t치위-4.47-2.74,P치균＜0.05,Alphasim교정),기중쌍측광액회지간VMHC(0.324±0.247)여PSQI득분(10.1±1.7)정현저부상관(r=-0.69,P＜0.01),기여존재현저개변적VMHC구역상관계수치여PSQI득분균무현저상관(P치균＞0.05).결론 PI환자재정식태하존재량대뇌반구간적공능련접이상.량반구간적VMHC가능작위병리생이학상평고PI환자신경실련접적일충유효적보조방법.
Objective To investigate the resting-state functional connectivity between the two hemispheres in primary insomnia(PI) using voxel-mirrored homotopic connectivity(VMHC) based on restingstate functional MRI(fMRI).Methods Eighteen PI patients and 19 healthy volunteers matched for age and sex underwent resting-state fMRI scans in a 1.5T scanner.Pittsburgh sleep quality index(PSQI) was performed for all subjects.The data was pre-processed by SPM 8 and then the VMHC values were calculated by REST software.The VMHC values between the two groups were compared by two-sample t-test.The statistical map with significant differences of VMHC value was obtained.Results Compared to the controls,PI patients showed significant VMHC decreases in the middle frontal gyrus(MFG),superior frontal gyrus(SFG),orbitofrontal cortex(OFC),hippocampus,thalamus,insula and a few occipital regions including cuneus and lingual gyrus(voxel size 1 269-7 425 mm3,t=-4.47-2.74 P＜ 0.05,Alphasim corrected).Negative correlation was observed between VMHC coefficients(0.324±0.247) of OFC and the PSQI score (10.1 ± 1.7) in PI patients(r=-0.69,P＜0.01).The other regions showing significant VMHC changes had no correlation with the PSQI score(P＞0.05).Conclusions These findings suggest that the functional coordination between homotopic brain regions is impaired in PI patients.Interhemispheric RSFC may serve as a useful method for evaluating PI where neural connectivity is implicated in the pathophysiology.