Peng Jiaxin, Yang Jing, Li Nannan, Lei Du, Li Junying, Duan Liren, Chen Chaolan, Zeng Yan, Xi Jing, Jiang Yi, Gong Qiyong, Peng Rong
Department of Neurology, West China Hospital, Sichuan University, Chengdu, China.
Department of Radiology, Huaxi MR Research Center (HMRRC), West China Hospital, Sichuan University, Chengdu, China.
Front Neurol. 2022 Apr 26;13:834277. doi: 10.3389/fneur.2022.834277. eCollection 2022.
Sleep disturbances are widespread among patients with essential tremor (ET) and may have adverse effects on patients' quality of life. However, the pathophysiology underlying poor quality of sleep (QoS) in patients with ET remains unclear. Our study aimed to identify gray matter (GM) network alterations in the topological properties of structural MRI related to QoS in patients with ET.
We enrolled 45 ET patients with poor QoS (SleET), 59 ET patients with normal QoS (NorET), and 66 healthy controls (HC), and they all underwent a three-dimensional T1-weighted MRI scan. We used a graph-theoretical approach to investigate the topological organization of GM morphological networks, and individual morphological brain networks were constructed according to the interregional similarity of GM volume distributions. Furthermore, we performed network-based statistics, and partial correlation analyses between topographic features and clinical characteristics were conducted.
Global network organization was disrupted in patients with ET. Compared with the NorET group, the SleET group exhibited disrupted topological GM network organization with a shift toward randomization. Moreover, they showed altered nodal centralities in mainly the frontal, temporal, parietal, and cerebellar lobes. Morphological connection alterations within the default mode network (DMN), salience, and basal ganglia networks were observed in the SleET group and were generally more extensive than those in the NorET and HC groups. Alterations within the cerebello-thalamo-(cortical) network were only detected in the SleET group. The nodal degree of the left thalamus was negatively correlated with the Fahn-Tolosa-Marin Tremor Rating Scale score ( = -0.354, =0.027).
Our findings suggest that potential complex interactions underlie tremor and sleep disruptions in patients with ET. Disruptions within the DMN and the cerebello-thalamo-(cortical) network may have a broader impact on sleep quality in patients with ET. Our results offer valuable insight into the neural mechanisms underlying poor QoS in patients with ET.
睡眠障碍在特发性震颤（ET）患者中普遍存在，可能对患者的生活质量产生不利影响。然而，ET患者睡眠质量（QoS）差的病理生理学机制仍不清楚。我们的研究旨在确定与ET患者QoS相关的结构MRI拓扑特性中的灰质（GM）网络改变。
我们纳入了45例QoS差的ET患者（SleET）、59例QoS正常的ET患者（NorET）和66名健康对照者（HC），他们均接受了三维T1加权MRI扫描。我们采用图论方法研究GM形态网络的拓扑组织，并根据GM体积分布的区域间相似性构建个体形态脑网络。此外，我们进行了基于网络的统计分析，并对地形特征与临床特征进行了偏相关分析。
ET患者的整体网络组织受到破坏。与NorET组相比，SleET组表现出拓扑GM网络组织破坏，向随机化转变。此外，他们主要在额叶、颞叶、顶叶和小脑叶表现出节点中心性改变。在SleET组中观察到默认模式网络（DMN）、突显网络和基底神经节网络内的形态连接改变，且通常比NorET组和HC组更广泛。仅在SleET组中检测到小脑-丘脑-（皮质）网络内的改变。左丘脑的节点度与法恩-托洛萨-马林震颤评分量表得分呈负相关（r = -0.354，P = 0.027）。
我们的研究结果表明，ET患者的震颤和睡眠障碍背后存在潜在的复杂相互作用。DMN和小脑-丘脑-（皮质）网络内的破坏可能对ET患者的睡眠质量产生更广泛的影响。我们的结果为ET患者QoS差的神经机制提供了有价值的见解。
