Department of Radiology, Wenzhou Central Hospital, Wenzhou, 325000, China.
Department of Radiology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, 325000, China.
Brain Imaging Behav. 2022 Aug;16(4):1803-1812. doi: 10.1007/s11682-022-00653-6. Epub 2022 Mar 25.
Previous studies have reported changes in white matter microstructures in patients with insomnia. However, few neuroimaging studies have focused specifically on white matter tracts in insomnia patients after having received treatment. In this prospective study, diffusion-tensor imaging was used in two samples of heart-kidney imbalance insomnia patients who were treated with placebo or Jiao-Tai-Wan, a traditional Chinese medicine commonly used to treat heart-kidney imbalance insomnia, to assess the changes in white matter tracts. Tract-based spatial statistical analyses were first applied to compare the changes in mean diffusivity and fractional anisotropy of white matter between 75 heart-kidney imbalance insomnia patients and 41 healthy control participants. In subsequent randomized, double-blind, placebo-controlled trials, comparisons of mean diffusivity and fractional anisotropy were also performed in 24 heart-kidney imbalance insomnia patients (8 males; 16 females; 42.5 ± 10.4 years) with Jiao-Tai-Wan and 26 heart-kidney imbalance insomnia patients (11 males; 15 females; 39.7 ± 9.4 years) with a placebo, with age and sex as covariates. Fractional anisotropy values in left corticospinal tract were increased in heart-kidney imbalance insomnia patients. Heart-kidney imbalance insomnia patients showed lower mean diffusivity and fractional anisotropy values of several white matter tracts than healthy control participants, such as the bilateral anterior limb of internal capsule, bilateral superior longitudinal fasciculus and bilateral posterior corona radiata. After being treated with Jiao-Tai-Wan, heart-kidney imbalance insomnia patients showed a trend towards reduced fractional anisotropy values in the left corticospinal tract. Jiao-Tai-Wan may improve the sleep quality by reversing the structural changes of the left corticospinal tract caused by heart-kidney imbalance insomnia.
先前的研究报告称，失眠症患者的脑白质微观结构发生了变化。然而，很少有神经影像学研究专门针对接受治疗后的失眠症患者的脑白质束进行研究。在这项前瞻性研究中，我们使用弥散张量成像技术对接受安慰剂或交泰丸（一种常用于治疗心肾不交型失眠的中药）治疗的 2 组心肾不交型失眠症患者进行研究，以评估脑白质束的变化。首先，我们应用基于束的空间统计分析方法，比较了 75 例心肾不交型失眠症患者和 41 例健康对照者之间脑白质的平均弥散度和各向异性分数的变化。随后，在随机、双盲、安慰剂对照试验中，我们还比较了 24 例心肾不交型失眠症患者（男性 8 例，女性 16 例；年龄 42.5 ± 10.4 岁）服用交泰丸和 26 例心肾不交型失眠症患者（男性 11 例，女性 15 例；年龄 39.7 ± 9.4 岁）服用安慰剂后，脑白质的平均弥散度和各向异性分数的变化，将年龄和性别作为协变量。心肾不交型失眠症患者左侧皮质脊髓束的各向异性分数增加。心肾不交型失眠症患者的脑白质各向异性分数低于健康对照组，其平均弥散度也低于健康对照组，如双侧内囊前肢、双侧上纵束和双侧后冠辐射。服用交泰丸后，心肾不交型失眠症患者左侧皮质脊髓束的各向异性分数呈降低趋势。交泰丸可能通过逆转心肾不交型失眠引起的左侧皮质脊髓束的结构变化来改善睡眠质量。
