慢性失眠患者大脑蓝斑的异常静息态功能连接

目的:利用功能连接方法观察慢性失眠患者静息态下蓝斑的异常功能连接。方法:采集49例慢性失眠患者以及47例性别年龄和受教育程度相匹配的健康对照组的功能磁共振图像，以蓝斑为感兴趣区域，与全脑其他体素进行功能连接分析，得到两组之间功能连接的差异脑区，再对异常连接脑区的功能连接值与临床量表分数做相关分析。结果:与对照组相比，慢性失眠患者蓝斑与右楔前叶皮质、右后扣带回皮质、左颞中回皮质、左距状沟周围皮质、右眶部额上回皮质之间的功能连接增强（P<0.05, FDR校正），并且蓝斑与左颞中回皮质之间功能连接值与抑郁自评量表呈正相关（P=0.021）。结论:慢性失眠患者蓝斑与多个脑区（主要是默认模式网络）出现的异常功能连接，可能有助于更好地理解慢性失眠的神经生物学机制，可能为失眠的高度唤醒假说提供新的影像学证据。

Abnormal resting-state functional connectivity of the locus coeruleus in patients with chronic insomnia

Abstract: Objective To investigate the abnormal resting-state functional connectivity of the locus coeruleus in patients with chronic insomnia using functional connectivity analysis. Methods A total of 49 patients with chronic insomnia and 47 gender-, age- and education-matched healthy controls were examined with resting-state functional magnetic resonance imaging (fMRI) in the study. The locus coeruleus in fMRI image was selected as the region of interest, and then functional connectivity analysis was conducted on the locus coeruleus and other voxels in the brain for obtaining the brain regions with different functional connectivity between two groups. The correlation between the functional connectivity value of the brain region with abnormal functional connectivity and clinical scale score was also analyzed. Results Compared with that in control group, the functional connectivity between the locus coeruleus and multiple brain regions (including right precuneus, right posterior cingulate cortex, left middle temporal gyrus, left calcarine periphery cortex and right superior orbitofrontal cortex) was significantly enhanced (P<0.05, FDR correction), and the functional connectivity value between the locus coeruleus and left middle temporal gyrus was positively correlated with the score of self-rating depression scale (P=0.021). Conclusion The abnormal functional connectivity between the locus coeruleus and multiple brain regions (mainly default mode network) in patients with chronic insomnia may contribute to understanding the neurobiological mechanism of chronic insomnia, and may provide new imaging evidence for the high arousal hypothesis of insomnia.