Medical College of Guangxi University, Guangxi University, Nanning, 530004, Guangxi, China; Department of Radiology, The People's Hospital of Guangxi Zhuang Autonomous Region, Guangxi Academy of Medical Sciences, 530021, Guangxi, China.
Department of Radiology, The People's Hospital of Guangxi Zhuang Autonomous Region, Guangxi Academy of Medical Sciences, 530021, Guangxi, China.
Sleep Med. 2024 Feb;114:109-118. doi: 10.1016/j.sleep.2023.12.024. Epub 2023 Dec 26.
The pathophysiology of coronasomnia remains unclear. This study aimed to investigate changes in white matter (WM) microstructure and inflammatory factors in patients with sleep disorders (SD) characterized by poor sleep quantity, quality, or timing following coronavirus disease 2019 (COVID-19) infection in the acute phase (within one month) and whether these changes could be recovered at 3-month follow-up.
29 acute COVID-19 patients with SD (COVID_SD) and 27 acute COVID-19 patients without SD (COVID_NonSD) underwent diffusion tensor imaging (DTI), tested peripheral blood inflammatory cytokines level, and measured Pittsburgh Sleep Quality Index (PSQI), and matched 30 uninfected healthy controls. Analyzed WM abnormalities between groups in acute phase and explored its changes in COVID_SD at 3-month follow-up by using tract-based spatial statistics (TBSS). Correlations between DTI and clinical data were examined using Spearman partial correlation analysis.
Both COVID_SD and COVID_NonSD exhibited widespread WM microstructure abnormalities. The COVID_SD group showed specific WM microstructure changes in right inferior fronto-occipital fasciculus (IFOF) (lower fractional anisotropy [FA]/axial diffusivity [AD] and higher radial diffusivity [RD]) and left corticospinal tract (CST) (higher FA and lower RD) and higher interleukin-1β (IL-1β) compared with COVID_NonSD group. These WM abnormalities and IL-1β levels were correlated PSQI score. After 3 months, the IFOF integrity and IL-1β levels tended to return to normal accompanied by symptom improvement in the COVID_SD relative to baseline.
Abnormalities in right IFOF and left CST and elevated IL-1β levels were important neurophenotypes correlated with COVID_SD, which might provide new insights into the pathogenesis of neuroinflammation in SD patients induced by COVID-19.
冠状病毒病 2019（COVID-19）感染急性期（1 个月内）后睡眠障碍（SD）患者的睡眠数量、质量或时间发生变化，其冠冕性失眠的病理生理学仍不清楚。本研究旨在探讨 COVID-19 后睡眠障碍患者的脑白质（WM）微观结构和炎症因子的变化，以及这些变化是否可以在 3 个月随访时恢复。
29 例急性 COVID-19 合并 SD（COVID_SD）患者和 27 例急性 COVID-19 无 SD（COVID_NonSD）患者接受弥散张量成像（DTI）检查，检测外周血炎症细胞因子水平，匹兹堡睡眠质量指数（PSQI），并匹配 30 名未感染的健康对照者。分析急性期各组间 WM 异常，并采用基于束的空间统计学（TBSS）探讨 COVID_SD 患者 3 个月随访时的变化。采用 Spearman 偏相关分析检验 DTI 与临床资料的相关性。
COVID_SD 和 COVID_NonSD 均显示 WM 微观结构广泛异常。COVID_SD 组与 COVID_NonSD 组相比，右侧下额枕束（IFOF）（较低的分数各向异性[FA]/轴向弥散度[AD]和较高的径向弥散度[RD]）和左侧皮质脊髓束（CST）（较高的 FA 和较低的 RD）WM 微观结构改变，以及白细胞介素-1β（IL-1β）水平升高。这些 WM 异常和 IL-1β 水平与 PSQI 评分相关。3 个月后，与基线相比，COVID_SD 患者的 IFOF 完整性和 IL-1β 水平趋于恢复正常，症状改善。
右侧 IFOF 和左侧 CST 异常及 IL-1β 水平升高是 COVID_SD 的重要神经表型，可能为 COVID-19 引起的 SD 患者神经炎症的发病机制提供新的见解。
