进行性灰质肥大与失眠障碍严重程度阶段及其与情绪症状的相关性。
Progressive gray matter hypertrophy with severity stages of insomnia disorder and its relevance for mood symptoms.
机构信息
Department of Medical Imaging, Guangdong Second Provincial General Hospital, Guangzhou, China.
Department of Neurology, BG University Hospital Bergmannsheil, Ruhr-University Bochum, Bochum, Germany.
出版信息
Eur Radiol. 2021 Aug;31(8):6312-6322. doi: 10.1007/s00330-021-07701-7. Epub 2021 Feb 3.
OBJECTIVE
To investigate the gray matter (GM) alterations in patients with insomnia disorder (ID) at different severity stages and the relationship between GM alterations and sleep, mood, and cognitive measures.
METHODS
One hundred one ID patients and 63 healthy controls (HC) were included. Each patient underwent structural MRI and completed sleep-, mood-, and cognitive-related questionnaires. The ID patients were further grouped into subthreshold insomnia (SI) group and clinical insomnia (CI) group. We investigated changes in GM volumes in ID patients via diffeomorphic anatomical registration through exponentiated lie algebra voxel-based morphometry (DARTEL-VBM). We first compared voxel-wise differences in GM volumes between the HC group and the ID group. Analysis of variance was performed on individual GM maps in the SI, CI, and HC groups to further investigate the effects of different stages of ID severity on GM volumes. Multiple regression was used to model the relationship between altered GM volumes in SI and CI groups and clinical measures.
RESULTS
GM hypertrophies in the left anterior and middle cingulate gyrus, right middle and inferior temporal gyrus, and right cerebellum Crus II were detected in ID. Increased GM volume in the right middle temporal gyrus was detected in the SI group, whereas all three regions in the CI group. Regression analysis showed that mood- and cognitive-related measures had a positive correlation with GM volumes, while sleep-related measures had a negative correlation with GM volumes in the CI group.
CONCLUSIONS
Our findings of the progressively increased GM volumes in ID suggest that a hypertrophic cortical morphological mechanism may underlie the altered neuroanatomy induced by insomnia.
KEY POINTS
• Insomnia-induced GM hypertrophies in the cingulate gyrus, temporal gyrus, and cerebellum Crus II. • The middle temporal gyrus was early detectable in the SI group. • The increased GM volumes in the CI group were correlated with clinical measures.
目的
探讨不同严重程度失眠障碍（ID）患者的灰质（GM）改变，以及 GM 改变与睡眠、情绪和认知测量的关系。
方法
纳入 101 例 ID 患者和 63 例健康对照者（HC）。每位患者均行结构 MRI 检查，并完成睡眠、情绪和认知相关问卷。将 ID 患者进一步分为亚临床失眠（SI）组和临床失眠（CI）组。我们通过基于指数李代数的可变形解剖配准体素形态学（DARTEL-VBM）研究 ID 患者 GM 体积的变化。我们首先比较了 HC 组和 ID 组之间 GM 体积的全脑差异。在 SI、CI 和 HC 组中对个体 GM 图进行方差分析，进一步探讨不同 ID 严重程度阶段对 GM 体积的影响。采用多元回归模型来对 SI 和 CI 组中改变的 GM 体积与临床测量之间的关系进行建模。
结果
ID 患者左前扣带回和中扣带回、右中颞叶和下颞叶以及右小脑 Crus II 存在 GM 肥大。在 SI 组中发现右中颞叶 GM 体积增加，而在 CI 组中则发现了所有三个区域。回归分析表明，情绪和认知相关的测量指标与 GM 体积呈正相关，而睡眠相关的测量指标与 CI 组的 GM 体积呈负相关。
结论
我们发现 ID 患者的 GM 体积逐渐增加，这表明皮质形态学的肥大机制可能是失眠引起的神经解剖改变的基础。
关键点
扣带回、颞叶和小脑 Crus II 的失眠诱导性 GM 肥大。
SI 组早期可检测到中颞叶。
CI 组中 GM 体积的增加与临床指标相关。
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