Song Chun-Mei, Liu Jian-Ping, Yang Hu-Cheng, Li Qing-He, Wang Shu, Chen Hai-Juan, Wang Shu-Fang, Chen Li, Gu Si-Yu, Zhang Feng, Pan Ping-Lei
School of Nursing and Rehabilitation, Nantong University, Nantong, China.
Department of Disinfection Supply Center, Affiliated Hospital 6 of Nantong University, Yancheng Third People's Hospital, Yancheng, China.
Front Public Health. 2025 Aug 21;13:1630294. doi: 10.3389/fpubh.2025.1630294. eCollection 2025.
To investigate the neural and molecular correlates of occupational burnout in nurses by integrating resting-state fMRI (rs-fMRI), clinical assessments, brain-wide gene expression, and neurotransmitter atlases.
Fifty-one female nurses meeting burnout criteria and 51 matched healthy controls underwent 3 T rs-fMRI. We analyzed fractional amplitude of low-frequency fluctuations (fALFF) and seed-based functional connectivity (FC), correlating findings with burnout (emotional exhaustion [EE], depersonalization [DP], and personal accomplishment [PA]). The fALFF -map was spatially correlated with Allen Human Brain Atlas gene expression (followed by gene ontology enrichment) and neurotransmitter system maps.
Nurses with burnout exhibited significantly decreased precuneus fALFF and reduced precuneus-right dorsolateral prefrontal cortex (DLPFC) FC compared to controls. The fALFF in the precuneus negatively correlated with EE and DP, and positively correlated with PA, while reduced precuneus-DLPFC FC negatively correlated with EE. Genes spatially associated with fALFF alterations were enriched in pathways involving neuronal excitability, synaptic organization, stress response, and immune modulation. The fALFF alteration pattern also spatially correlated with serotonin, norepinephrine, -aminobutyric acid, glutamate, and endocannabinoid system distributions.
Nurse burnout features precuneus hypoactivity and precuneus-DLPFC hypoconnectivity, linked to EE and DP severity. Associated molecular signatures implicate altered neuronal excitability, stress/immune pathways, and multiple neurotransmitter systems. The precuneus-DLPFC circuit and identified molecular pathways represent potential targets for interventions against burnout.
通过整合静息态功能磁共振成像（rs-fMRI）、临床评估、全脑基因表达和神经递质图谱，研究护士职业倦怠的神经和分子关联。
51名符合职业倦怠标准的女性护士和51名匹配的健康对照者接受了3T的rs-fMRI检查。我们分析了低频振幅（fALFF）和基于种子点的功能连接（FC），并将结果与职业倦怠（情感耗竭[EE]、去个性化[DP]和个人成就感[PA]）相关联。fALFF图谱与艾伦人类大脑图谱基因表达（随后进行基因本体富集）和神经递质系统图谱进行空间相关性分析。
与对照组相比，职业倦怠的护士表现出楔前叶fALFF显著降低，楔前叶-右侧背外侧前额叶皮质（DLPFC）的FC减少。楔前叶的fALFF与EE和DP呈负相关，与PA呈正相关，而楔前叶-DLPFC的FC减少与EE呈负相关。与fALFF改变在空间上相关的基因在涉及神经元兴奋性、突触组织、应激反应和免疫调节的通路中富集。fALFF改变模式在空间上也与血清素、去甲肾上腺素、γ-氨基丁酸、谷氨酸和内源性大麻素系统分布相关。
护士职业倦怠的特征是楔前叶活动减退和楔前叶-DLPFC连接减弱，与EE和DP的严重程度有关。相关的分子特征表明神经元兴奋性、应激/免疫通路和多个神经递质系统发生了改变。楔前叶-DLPFC回路和确定的分子通路代表了针对职业倦怠干预的潜在靶点。
