Tang Wenjie, Debora Asta, Miao Shouliang, Lin Boli, Huang Qun, Yuan Zhengzhong, Yang Yunjun, Xia Nengzhi
Department of Radiology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China.
Department of Traditional Chinese Medicine, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China.
Brain Behav. 2025 Aug;15(8):e70785. doi: 10.1002/brb3.70785.
Few studies have investigated insomnia using intravoxel incoherent motion imaging. The aim ofthis study was to evaluate the classification performance of intravoxel incoherent motion diffusion-weighted imaging in differentiating between insomnia disorder patients and normal control subjects. The potential effects of microstructure and microcirculation between sleep quality and glymphatic system function were subsequently explored.
Forty-two patients with insomnia disorder and 42 normal controls were included in this study. The demographic characteristics, Pittsburgh Sleep Quality Index scores, and imaging data of the subjects were collected. Magnetic resonance imaging revealed enlarged perivascular spaces that indirectly reflect the glymphatic system. Imaging data were subjected to postprocessing, and parameters including the pure diffusion coefficient, pseudo diffusion coefficient and perfusion fraction were calculated. Partial correlation analysis and mediation analysis were used to explore the role of microcirculation between sleep quality and the perivascular space.
There were brain region-specific differences between two groups, mainly involving perfusion parameters. D* and f in the dorsal-lateral superior frontal gyrus, hippocampus, caudate nucleus, lenticular nucleus, thalamus, amygdala, and fusiform gyrus demonstrated significant differences compared to the healthy group. The support vector machine classifier based on intravoxel incoherent motion imaging parameters has good diagnostic efficiency, with an area under the curve of 0.92. In the mediation analysis, D* in the left thalamus mediated the relationship between sleep quality and enlarged perivascular spaces severity in the centrum semiovale.
These findings suggest that intravoxel incoherent motion imaging may provide important value for an accurate classification of insomnia. Cerebral microcirculation may have a mediating effect on insomnia and glymphatic system dysfunction.
很少有研究使用体素内不相干运动成像来研究失眠。本研究的目的是评估体素内不相干运动扩散加权成像在区分失眠症患者和正常对照受试者方面的分类性能。随后探讨了睡眠质量与类淋巴系统功能之间微观结构和微循环的潜在影响。
本研究纳入了42名失眠症患者和42名正常对照者。收集了受试者的人口统计学特征、匹兹堡睡眠质量指数评分和成像数据。磁共振成像显示血管周围间隙扩大，间接反映类淋巴系统。对成像数据进行后处理，并计算包括纯扩散系数、伪扩散系数和灌注分数在内的参数。采用偏相关分析和中介分析来探讨微循环在睡眠质量和血管周围间隙之间的作用。
两组之间存在脑区特异性差异，主要涉及灌注参数。与健康组相比，背外侧额上回、海马、尾状核、豆状核、丘脑、杏仁核和梭状回的D和f显示出显著差异。基于体素内不相干运动成像参数的支持向量机分类器具有良好的诊断效率，曲线下面积为0.92。在中介分析中，左丘脑的D介导了睡眠质量与半卵圆中心血管周围间隙扩大严重程度之间的关系。
这些发现表明，体素内不相干运动成像可能为失眠的准确分类提供重要价值。脑微循环可能对失眠和类淋巴系统功能障碍具有中介作用。
