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基于多模态功能磁共振成像的原发性失眠研究
引用本文:陈冠峰,李秀梅,孙炳庆,黄日升.基于多模态功能磁共振成像的原发性失眠研究[J].中国医学物理学杂志,2020,37(12):1534-1539.
作者姓名:陈冠峰  李秀梅  孙炳庆  黄日升
作者单位:1.福建医科大学附属泉州第一医院影像科, 福建 泉州 362000; 2.福建医科大学附属第一医院影像科, 福建 福州 350005
摘    要:目的:研究基于多模态功能磁共振成像的原发性失眠。方法:选取福建医科大学附属泉州第一医院2018年12月~2019年12月期间收治的原发性失眠患者50例为研究组,选取与研究组性别、年龄皆与之匹配的健康人群50例作为对照组,所有被研究者均进行临床匹兹堡睡眠质量指数(PSQI)、汉密顿抑郁量表(HAMD)以及汉密尔顿焦虑量表(HAMA)评分,选择PCC为种子点对静息态功能磁共振成像数据进行功能连接(FC)分析,获得被研究者的脑内功能连接参数,比较研究组和对照组的差异,并进行分析。结果:两组患者性别和年龄对比差异无统计学意义(P>0.05),但是研究组患者PSQI评分、HAMA评分以及HAMD评分显著高于对照组(P<0.05);对照组被研究者和研究组患者组间无弥散张量成像(DTI)差异,对照组与研究组比较,研究组患者的左侧海马以及右上额枕束FA值显著下降,而双侧扣带回、左下纵束、右上额枕束、左侧海马、双侧钩束的MD值显著升高(P<0.05);对照组被研究者与PCC功能连接脑部区域,包括:颞极L/颞上回/额上回/岛叶、颞极R/岛叶、枕下回R/梭状回、额下回R/额下回眶部、楔前叶L、R/后扣带回/中间扣带回、颞上回L/颞横回、枕中回R/楔前叶/顶上小叶、颞上回R,显著阈值设为P=0.000,簇≥1 355 mm3;研究组患者与PCC功能连接脑部区域,包括:额下回眶部L/颞上回/额中回、楔前叶L、R/后扣带回/中间扣带回、颞中回R/枕中回/楔前叶/角回、枕中回L/楔前叶/枕上回、额中回L、中央前回R、额上回R,显著阈值设为P=0.000,簇≥1 355 mm3。结论:联合应用静息态功能磁共振成像和扩散加权磁共振成像可以作为一种多模态的方式揭示原发性失眠患者发生的病理和生理机制。

关 键 词:原发性失眠  多模态功能磁共振成像  神经网络  匹兹堡睡眠质量指数  汉密顿抑郁量表  汉密尔顿焦虑量表

Study on primary insomnia based on multimodal functional MRI
CHEN Guanfeng,LI Xiumei,SUN Bingqing,HUANG Risheng.Study on primary insomnia based on multimodal functional MRI[J].Chinese Journal of Medical Physics,2020,37(12):1534-1539.
Authors:CHEN Guanfeng  LI Xiumei  SUN Bingqing  HUANG Risheng
Institution:1. Department of Imaging, Quanzhou First Hospital Affiliated to Fujian Medical University, Quanzhou 362000, China 2. Department of Imaging, The First Affiliated Hospital of Fujian Medical University, Fuzhou 350005, China
Abstract:Abstract: Objective To study primary insomnia based on multimodal functional magnetic resonance imaging (MFMRI). Methods 50 primary insomnia patients admitted to our hospital from December 2018 to December 2019 were selected as the research group, and 50 healthy people with matching gender and age were selected as the control group. All the subjects were evaluated by clinical PSQI, HAMD and HAMA, and PCC was chosen as seed point to make the FC analysis on resting fMRI data to obtain the brain functional connection parameters of the subjects. The differences between the study group and the control group were compared and analyzed finally. Results There was no statistical difference in gender and age between the control group and the study group, but PSQI, HAMD and HAMA scores in the research group were higher than those in the control group (P<0.05). There was no difference in DTI between the control group and the study group. Compared with the control group, the FA values of the left hippocampus and the right superior frontal occipital tract in the research group were significantly decreased, while the MD values of the bilateral cingulate gyrus, the left inferior longitudinal tract, the right superior frontal occipital tract, the left hippocampus and the bilateral uncinate tract were significantly increased (P<0.05). The functional connectivity of PCC to the subjects brain area in the control group such as temporal pole L/temporal superior gyrus/frontal superior gyrus/insular, temporal pole R/insular, suboccipital gyrus R/fusiform gyrus, frontalis inferior R/frontalis pars orbitalis, etc. was done with the threshold P=0.000 and clusters≥1 355 mm3. The functional connectivity of PCC to the subjects’ brain area such as frontalis inferior pars orbitalis L/temporal superior gyrus/frontal middle gyrus, precuneus L, R/posterior cingulate/intermediate cingulate gyrus, etc. was done with the threshold P=0.000, and clusters ≥ 1 355 mm3. Conclusion The combination of fMRI and DW-RMI can reveal the pathophysiological mechanism of primary insomnia as a multimodal way.
Keywords:Keywords: primary insomnia multimodal functional MRI neural network PSQI HAMD HAMA
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