慢性失眠障碍中默认模式网络、执行控制网络和突显网络内部及之间的异常有效连接——迈向对高唤醒状态的识别

Aberrant Effective Connectivity Within and Between the Default Mode, Executive Control, and Salience Networks in Chronic Insomnia Disorder-Toward Identifying the Hyperarousal State.

作者信息

Georgiev Todor, Paunova Rositsa, Todeva-Radneva Anna, Avramov Krasimir, Draganova Aneliya, Kandilarova Sevdalina, Terziyski Kiril

机构信息

Department of Pathophysiology, Medical University of Plovdiv, 4002 Plovdiv, Bulgaria.

Department of Psychiatry and Medical Psychology, Medical University of Plovdiv, 4002 Plovdiv, Bulgaria.

出版信息

Biomedicines. 2025 May 24;13(6):1293. doi: 10.3390/biomedicines13061293.

Abstract

: Chronic insomnia (CID) is a highly prevalent sleep disorder, yet the precise mechanisms underlying it remain incompletely understood. The aim of this study is to analyze effective connectivity between key regions of the default mode network (DMN), executive control network (ECN), and salience network (SN) in patients with CID as potential neurologic correlates of the hyperarousal state. : Thirty-one CID patients and 24 healthy controls (HC) were recruited. All the subjects filled out the Insomnia severity index scale (ISI), Beck depression inventory (BDI), and Epworth sleepiness scale (ESS), underwent polysomnography, and were scanned on functional magnetic resonance imaging. Statistical Parametric Mapping 12 was used to analyze the results. Spectral dynamic causal modeling was applied to the chosen regions of interest. : There were three significant connections present in the CID group-inhibitory from the dorsolateral prefrontal cortex (DLPFC) to the right hippocampus (Hippocamp R); excitatory from the dorsomedial prefrontal cortex to the ventromedial prefrontal cortex; and excitatory from the common medial prefrontal cortex to the right anterior insula (AIR). Two statistically significant excitatory connections were lacking in the patients' group-from the posterior cingulate cortex (PCC) to AIR, and from precuneus to PCC. CID patients scored higher on the ISI and BDI. Significant negative correlations between DLPFC-Hippocamp R connectivity and both ISI and BDI scores were identified. : Disruptions within the DMN and between the DMN, SN, and ECN reflect an impaired ability to appropriately shift between internally and externally directed cognitive states-an imbalance that potentially underlies the hyperarousal state of CID.

摘要

慢性失眠(CID)是一种高度普遍的睡眠障碍,但其潜在的确切机制仍未完全明确。本研究旨在分析CID患者默认模式网络(DMN)、执行控制网络(ECN)和突显网络(SN)关键区域之间的有效连接,作为过度觉醒状态潜在的神经学关联。

招募了31名CID患者和24名健康对照者(HC)。所有受试者填写了失眠严重指数量表(ISI)、贝克抑郁量表(BDI)和爱泼华嗜睡量表(ESS),进行了多导睡眠监测,并接受了功能磁共振成像扫描。使用统计参数映射12分析结果。对选定的感兴趣区域应用了频谱动态因果模型。

CID组存在三种显著连接——从背外侧前额叶皮质(DLPFC)到右侧海马体(海马体R)的抑制性连接;从背内侧前额叶皮质到腹内侧前额叶皮质的兴奋性连接;以及从内侧前额叶共同皮质到右侧前岛叶(AIR)的兴奋性连接。患者组缺乏两种具有统计学意义的兴奋性连接——从后扣带回皮质(PCC)到AIR,以及从前楔叶到PCC。CID患者在ISI和BDI上得分更高。确定了DLPFC - 海马体R连接性与ISI和BDI得分之间存在显著负相关。

DMN内部以及DMN、SN和ECN之间的连接中断反映了在内部和外部导向认知状态之间适当转换的能力受损——这种失衡可能是CID过度觉醒状态的潜在原因。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1d1b/12189937/652397f6942b/biomedicines-13-01293-g001.jpg

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