Zhang Xuan, Song Bingxin, Liu Yanyan, Wan Yahui, Zhou Kaili, Xue Rong
Department of Neurology, Tianjin Medical University General Hospital Airport Site, Tianjin, China.
Department of Neurology, Tianjin Medical University General Hospital, Tianjin, China.
Brain Behav. 2021 Jun;11(6):e02068. doi: 10.1002/brb3.2068. Epub 2021 May 7.
To assess the correlation of cognitive function with sleep stability and depressive-anxious symptoms in insomnia patients.
Twenty-two insomnia patients with cognitive impairment (insomnia-CI), 21 insomnia patients with normal cognition (insomnia-CN), and 15 matched healthy control subjects (HCs) were enrolled and completed neuropsychological tests, the Hamilton Depression and Anxiety Scales (HAMD and HAMA), the Epworth Sleepiness Scale, the Pittsburgh Sleep Quality Index (PSQI),the Insomnia Severity Index (ISI), and the cardiopulmonary coupling (CPC) examination. Ratios of high-frequency coupling (HFC), low-frequency coupling (LFC), and very low-frequency coupling (VLFC) measured by CPC analysis represent stable sleep, unstable sleep, and wake/rapid eye movement (REM) sleep, respectively.
The HAMD, HAMA, PSQI, and ISI scores were higher in the insomnia-CN patients than in the HCs (all p < .01). However, no differences were found in the HFC, LFC, and VLFC ratio between the HCs and insomnia-CN groups. Compared with the insomnia-CN patients, insomnia-CI patients exhibited higher scores on the HAMD, HAMA (all p < .01), and PSQI (p < .05), performed worse on the Auditory Verbal Learning Test, Trial Making Test B, and Stroop Test B (all p < .01), had a lower HFC ratio, and had a higher LFC ratio in the CPC analysis (all p < .01). Furthermore, in the insomnia patients, poorer cognition was correlated with a decreased HFC ratio and an increased VLFC ratio (r = .356, p = .019; r = -.339, p =.026, respectively) and increased HAMD and HAMA scores (r = -.507, p < .001; r = -.561, p < .001, respectively); a higher VLFC ratio was correlated with an increased ISI score (r = .346, p = .023).
Cognitive deterioration in insomnia patients was associated with a decreased stable sleep ratio, an increased wake/REM sleep ratio and more severe symptoms of depression and anxiety. CPC analysis can reflect the severity of insomnia.
评估失眠患者认知功能与睡眠稳定性及抑郁焦虑症状之间的相关性。
招募22名伴有认知障碍的失眠患者（失眠合并认知障碍组）、21名认知功能正常的失眠患者（失眠认知正常组）和15名匹配的健康对照者，完成神经心理学测试、汉密尔顿抑郁量表和焦虑量表（HAMD和HAMA）、爱泼华嗜睡量表、匹兹堡睡眠质量指数（PSQI）、失眠严重程度指数（ISI）以及心肺耦合（CPC）检查。通过CPC分析测得的高频耦合（HFC）、低频耦合（LFC）和极低频耦合（VLFC）比率分别代表稳定睡眠、不稳定睡眠以及清醒/快速眼动（REM）睡眠。
失眠认知正常组患者的HAMD、HAMA、PSQI和ISI评分高于健康对照者（均p < 0.01）。然而，健康对照者组与失眠认知正常组之间的HFC、LFC和VLFC比率未发现差异。与失眠认知正常组患者相比，失眠合并认知障碍组患者在HAMD、HAMA上的得分更高（均p < 0.01），在PSQI上得分更高（p < 0.05），在听觉词语学习测试、连线测验B和Stroop测验B中的表现更差（均p < 0.01），在CPC分析中HFC比率更低，LFC比率更高（均p < 0.01）。此外，在失眠患者中，较差的认知与HFC比率降低、VLFC比率升高相关（r = 0.356，p = 0.019；r = -0.339，p = 0.026），与HAMD和HAMA评分升高相关（r = -0.507，p < 0.001；r = -0.561，p < 0.001）；较高的VLFC比率与ISI评分升高相关（r = 0.346，p = 0.023）。
失眠患者的认知功能恶化与稳定睡眠比率降低、清醒/REM睡眠比率升高以及更严重的抑郁和焦虑症状相关。CPC分析能够反映失眠的严重程度。
