失眠障碍患者的突显网络与睡眠差异有关：一项 EEG-fMRI 研究。

Sleep discrepancy is associated with alterations in the salience network in patients with insomnia disorder: An EEG-fMRI study.

机构信息

Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health, Beijing, China; Department of Neuropsychiatry, Behavioral Neurology and Clinical Psychology, Sleep Center, Beijing Tian Tan Hospital, Capital Medical University, Beijing, China.

Beijing City Key Laboratory for Medical Physics and Engineering, Institute of Heavy Ion Physics, School of Physics, Peking University, Beijing, China; Center for MRI Research, Academy for Advanced Interdisciplinary Studies, Peking University, Beijing, China.

出版信息

Neuroimage Clin. 2022;35:103111. doi: 10.1016/j.nicl.2022.103111. Epub 2022 Jul 14.

DOI:10.1016/j.nicl.2022.103111

PMID:35863180

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9421431/

Abstract

BACKGROUND

Positron emission tomography - computed tomography (PET-CT) research has shown that sleep discrepancy recorded by self-report and polysomnography (PSG) may be related to the altered metabolic rate of the anterior insula (aINS) during non-rapid eye movement (NREM) sleep in patients with insomnia disorder. We aim to explore the functional connectivity of aINS across wake and NREM sleep in the patients and to reveal the association between aINS connectivity and sleep discrepancy.

METHODS

Patients with insomnia disorder (n = 33) and healthy controls (n = 31) underwent simultaneous electroencephalography and functional magnetic resonance imaging (EEG-fMRI) during nighttime sleep, and aINS-based connectivity was calculated across wake and NREM sleep. A linear mixed-effects model was used to assess the main effect of group and group-by-stage (wake, NREM stages 1-3) interaction effect on aINS connectivity. Similar mixed models were used to assess the potential correlation between aINS connectivity and the sleep misperception index (MI).

RESULTS

A significant group-by-stage interaction effect on aINS-based connectivity was observed in the bilateral frontal gyrus, right inferior temporal gyrus, bilateral middle occipital gyrus and right postcentral gyrus (p < 0.05, corrected). There was also a significant group-by-MI interaction effect on aINS connectivity with the putamen and thalamus during wakefulness (p < 0.05 corrected); MI was significantly associated with aINS-putamen/thalamus connectivity in the control group, whereas the association was weak or even nonsignificant in the patient group. There was no significant main effect of group.

CONCLUSION

The waking activity of a neural pathway containing the aINS, putamen, and thalamus may underlie sleep perception, potentially providing important perspectives to reveal complex mechanisms of sleep discrepancy between self-report and PSG.

摘要

背景

正电子发射断层扫描 - 计算机断层扫描（PET-CT）研究表明，通过自我报告和多导睡眠图（PSG）记录的睡眠差异可能与失眠症患者非快速眼动（NREM）睡眠期间前岛叶（aINS）代谢率改变有关。我们旨在探索患者在清醒和 NREM 睡眠期间 aINS 的功能连接，并揭示 aINS 连接与睡眠差异之间的关联。

方法

失眠症患者（n=33）和健康对照者（n=31）在夜间睡眠期间同时进行脑电图和功能磁共振成像（EEG-fMRI），并计算跨清醒和 NREM 睡眠的 aINS 连接。线性混合效应模型用于评估组和组-阶段（清醒、NREM 1-3 期）交互效应对 aINS 连接的主要影响。类似的混合模型用于评估 aINS 连接与睡眠感知指数（MI）之间的潜在相关性。

结果

在双侧额回、右侧颞下回、双侧中枕叶和右侧后中央回观察到 aINS 连接的显著组-阶段交互效应（p<0.05，校正）。在清醒期间，aINS 连接与壳核和丘脑也存在显著的组-MI 交互效应（校正后 p<0.05）；MI 与对照组的 aINS-壳核/丘脑连接显著相关，而在患者组中，这种相关性较弱甚至不显著。组间无显著主效应。