Dynamic and static low-frequency amplitude combined functional connectivity in primary insomnia
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摘要:
目的 采用动态和静态低频振幅联合功能链接方法探讨原发性失眠(PI)患者静息状态下自发脑功能活动特征。 方法 收集20例原发性失眠患者(失眠组)、20例健康志愿者(对照组)的临床量表(匹兹堡睡眠质量指数量表、抑郁自评量表、焦虑自评量表，失眠患者同时完成失眠严重指数量表)评分结果和功能性磁共振成像数据，采用动态和静态低频振幅(ALFF)方法分析两组间自发脑功能活动的差异，进一步分析差异脑区的信号值与失眠的相关性。再基于动态ALFF差异脑区与全脑其余体素进行基于种子的功能连接分析。 结果 与对照组相比，PI组左侧额上回动态ALFF值增加，提示该区大脑内在活动的时间变异性升高，且其与失眠严重指数量表间呈负相关关系(r=-0.463，P=0.04)。与对照组相比，PI组右侧颞中回、左侧额上回静态ALFF值增加，左侧扣带回、左侧中央前回、右侧额叶补充运动区静态ALFF值减少。以左侧额上回为种子点进行与全脑体素的相关性分析，相对于对照组，PI组功能连接上升的脑区主要有：左侧眶部额中回、右侧尾状核、右侧眶部额中回、左侧背外侧额上回。 结论 PI患者在动态ALFF方面存在局部脑活动的改变且与失眠指数具有相关性，联合功能连接可以更全面地显示PI患者的异常脑功能活动，提示功能性磁共振成像可在一定程度上评价PI患者自发脑神经功能活动改变的情况。 Abstract:Objective To investigate the characteristics of spontaneous brain function activity in the resting state of primary insomnia (PI) patients using a combined dynamic and static low-frequency amplitude functional linkage method. Methods The scores and fMRI data of clinical scales (Pittsburgh sleep quality index scale, depression self-rating scale, anxiety self-rating scale, insomnia patients also completed the insomnia severity index scale) were collected from 20 PI patients (PI group) and 20 healthy volunteers (control group). The differences in spontaneous brain functional activity between the two groups were analyzed using dynamic and static low frequency amplitude (ALFF) methods, further analysing the correlation between the signal values of the differential brain regions and insomnia. A seed-based functional connectivity analysis was performed between the differential brain regions based on dynamic ALFF and the remaining voxels of the whole brain. Results Compared to normal controls, the PI group had increased dynamic ALFF values in the left superior frontal gyrus, suggesting increased temporal variability in intrinsic brain activity in this region. A significant negative correlation was found with insomnia severity index (r=-0.463, P=0.04). Compared to the control group, the PI group showed increased static ALFF values in the right middle temporal gyrus and left superior frontal gyrus and decreased static ALFF values in the left cingulate gyrus, left precentral gyrus and right frontal supplementary motor area. Correlation analysis with whole brain voxels was performed using the left superior frontal gyrus as the seed point, and the main brain regions with increased functional connectivity in the PI group relative to the HC group were: left orbital middle frontal gyrus, right caudate nucleus, right orbital middle frontal gyrus, and left dorsolateral superior frontal gyrus. Conclusion The presence of localised changes in brain activity in PI patients in terms of dynamic low-frequency amplitude correlates with the insomnia index, and combined functional connectivity can provide a more comprehensive picture of abnormal brain function activity in PI patients. It is suggested that fMRI can evaluate to some extent the altered spontaneous neurological activity in PI patients. -
图 1 动态ALFF时间变异性有显著差异的脑区
Figure 1. Brain regions with significant differences in dynamic ALFF temporal variability.
表 1 两组临床资料比较
Table 1. Comparison of clinical data between the two groups (n=20)
Index PI group HC group P Age (years, Mean±SD) 49.10±11.37 50± 11.44 0.15 Gender(Male/Female, n) 6/14 7/13 0.736 Years of education (years, Mean±SD) 12±3 15±2.5 0.20 Course (month) 19.65 - - ISI (Mean±SD) 14.55±2.625 - - PSQI (Mean±SD) 15.73±2.70 3.05±1.15 0.004 SAS[M(P25, P75)] 40(31, 50) 31.65±5.50 0.001 SDS[M(P25, P75)] 47(35, 55) 35±7.42 0.017 PI: Primary insomnia; ISI: Insomnia severity index; PSQI: Pittsburgh sleep quality index; SAS: Self-rating anxiety scale; SDS: Self-rating depression scale. 
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表 2 PI组与HC组的差异脑区
Table 2. Differential brain areas in the PI and HC groups
Area Serial Position T X Y Z Middle Temporal Gyrus-R 46 60 -6 -6 11.6257 Frontal Lobe-R 36 -21 51 3 9.6073 Limbic Lobe-L 72 -3 0 33 -10.6933 Precentral_L (aal) 36 -54 9 39 -10.3717 Supp_Motor_Area_R (aal) 175 6 -30 75 -10.8611
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表 3 以左侧额上回为种子点时PI组功能连接的异常脑区
Table 3. Abnormal brain areas in the PI group functional connectivity when the left superior frontal gyrus was used as the seed point.
Area Serial Position T X Y Z Frontal_Mid_Orb_L (aal) 36 -18 27 -18 4.9294 Caudate_R (aal) 49 9 13 -3 4.0569 Middle Frontal Gyrus 135 33 42 -6 4.2781 Frontal_Sup_L (aal) 141 -24 57 9 4.3894
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