青春期首发失眠障碍学生脑区比率低频振幅特征与睡眠信念的相关性

黄懿钖; 吕创; 吕兰兰; 周洋; 谢世平

doi:10.16835/j.cnki.1000-9817.2022.03.018

青春期首发失眠障碍学生脑区比率低频振幅特征与睡眠信念的相关性

doi: 10.16835/j.cnki.1000-9817.2022.03.018

1.
南京医科大学附属儿童医院, 江苏 210029
2.
北京师范大学心理学部
3.
徐州医科大学附属徐州东方医院
4.
苏州大学附属儿童医院
5.
南京医科大学附属脑科医院, 江苏 210029

基金项目:

国家重点研发计划资助项目 2016YFC1306805

详细信息

作者简介:
黄懿钖(1991-), 女, 江苏南京人, 硕士, 住院医师, 主要研究方向为儿童青少年精神病学

利益冲突声明 所有作者声明无利益冲突。
中图分类号: G444 B844.2 R445
计量
- 文章访问数: 574
- HTML全文浏览量: 239
- PDF下载量: 33
- 被引次数: 0
出版历程
- 收稿日期: 2021-09-09
- 修回日期: 2021-12-13
- 网络出版日期: 2022-03-29
- 刊出日期: 2022-03-25

Evaluation of the correlation between the fractional amplitude of low frequency fluctuation and sleep belief in adolescents with drug-naive first-episode insomnia disorder

1.
Children's Hospital of Nanjing Medical University, Nanjing (210029), China

摘要

摘要: 目的使用静息态功能磁共振成像(resting-state fMRI)技术，探讨青春期首发失眠障碍学生的脑区比率低频振幅特点及其与睡眠信念的相关性，为失眠障碍发病机制及诊疗思路提供参考。方法招募南京医科大学符合美国精神障碍诊断与统计手册第5版(DSM-5)失眠障碍诊断标准的首发未服药青春期失眠障碍学生为失眠组(21人)；与失眠组年龄、性别、教育背景相匹配的正常受试者为对照组(20人)。对两组进行匹兹堡睡眠质量指数量表(PSQI)、简式睡眠信念与态度问卷(DBAS-16)、24项汉密尔顿抑郁量表(HAMD-24)、14项汉密尔顿焦虑量表(HAMA-14)评估，以及三维脑结构及静息态功能磁共振扫描。采用比率低频振幅(fALFF)技术分析，应用Pearson相关分析法将两组有明显差异的脑区的fALFF值与量表评分进行相关分析。结果与对照组比较，失眠组fALFF值显著降低(Alphaism矫正，P < 0.01)的脑区位于左侧背外侧前额叶(L-DLPFC，MNI坐标值：-12，60，21，t=-3.85，K=495)，左侧楔前叶(left precuneus, MNI坐标值：-3，-54，51，t=-4.29，K=417)。相关分析显示，失眠组左侧背外侧前额叶fALFF值与DBAS-16评分呈正相关(r=0.47，P=0.04)。结论青春期失眠障碍学生左侧背外侧前额叶区域异常，可能存在睡眠相关情感认知活动的调节功能受损。
- 青春期 /
- 睡眠障碍 /
- 精神卫生 /
- 脑 /
- 学生
Abstract: Objective To investigate the brain function and their correlation with sleep beliefs and attitudes in adolescents with drug-naive insomnia by using fractional amplitude of low frequency fluctuation, so as to provide a reference for the mechanism and treatment of insomnia. Methods An insomnia group (n=21) recruited first-episode, drug-naive, adolescents with insomnia who met the diagnostic criteria of the American Diagnostic and Statistical Manual of Mental Disorders(DSM-V). Healthy subjects matched with age, gender, and educational background were selected as the control group (n=20). Pittsburgh Sleep Quality Index Scale (PSQI), Brief Version of Dysfunctional Beliefs and Attitudes about Sleep (DBAS-16), 24 Items-Hamilton Depression Scale (HAMD-24), 14 Items-Hamilton Anxiety Scale (HAMA-14) were evaluated. Fractional amplitude of low-frequency fluctuation was used for analysis, and Pearson correlation analysis was employed to quantify the correlation between peak values of brain regions with significant differences and the clinical scale scores of the two groups. Results Compared with the control group, ractional amplitude of low frequency fluctuation(fALFF) values in the insomnia group were significantly decreased (P < 0.01, Alphaism corrected) in the left dorsolateral prefrontal lobe (L-DLPFC, MNI coordinates: -12, 60, 21, t=-3.85, K=495) and the left precuneus (MNI coordinates: -3, -54, 51, t=-4.29, K=417). The fALFF value of L-DLPFC in the insomnia group was positively correlated with DBAS-16 score (r=0.47, P=0.04). Conclusion Abnormalities in the L-DLPFC region suggest that adolescents with insomnia may suffer from impaired regulation of emotional and cognitive activities related to sleep.
- Puberty /
- Sleep disorders /
- Mental health /
- Brain /
- Students
注释:

1) 利益冲突声明 所有作者声明无利益冲突。

HTML全文

表 1 两组受试者年龄及量表得分比较(x±s)

Table 1. Comparison of age and scale results between the two group subjects(x±s)

组别	人数	年龄/岁	PSQI	DBAS-16	HAMA-14	HAMD-24
失眠组	21	19.33±1.24	12.86±1.98	47.10±8.93	11.29±2.05	14.00±3.26
对照组	20	18.70±0.80	4.35±1.24	30.85±7.04	9.95±2.48	7.65±1.95
t值		1.93	16.43	6.45	6.11	7.52
P值		0.06	< 0.01	< 0.01	< 0.01	< 0.01

下载: 导出CSV

表 2 失眠组学生降低脑区fALFF值与量表得分的相关性分析(n=21)

Table 2. Correlation analysis between the lower fALFF value of brain regions and scale results in insomnia group(n=21)

量表	左侧背外侧前额叶		左侧楔前叶
量表	r值	P值	r值	P值
DBAS-16	0.47	0.04	0.23	0.32
HAMD-24	0.13	0.57	-0.06	0.81
HAMA-14	0.24	0.30	0.14	0.54
PSQI	-0.37	0.30	-0.23	0.30

下载: 导出CSV

参考文献(25)

[1]	TANG C, WEI Y Q, ZHAO J J, et al. The dynamic measurements of regional brain activity for resting-state fMRI: d-ALFF, d-fALF and d-ReHo[C]. International Conference on Medical Image Computing and Computer-Assisted Intervention. Springer, 2018.
[2]	SPIEGELHALDER K, REGEN W, BAGLIONI C, et al. Neuroimaging insights into insomnia[J]. Curr Neurol Neurosci Rep, 2015, 15(3): 9-15. doi: 10.1007/s11910-015-0527-3
[3]	WANG T Y, YAN J H, LI S M, et al. Increased insular connectivity with emotional regions in primary insomnia patients: a resting-state fMRI study[J]. Eur Radiol, 2017, 27(9): 3703-3709. doi: 10.1007/s00330-016-4680-0
[4]	American Psychiatric Association. Nuckols, diagnostic and statistical manual of mental disorders[M]. Fifth edition. Washington DC: American Psychiatric Association house, 2013.
[5]	刘贤臣, 唐茂芹, 胡蕾, 等. 匹兹堡睡眠质量指数的信度和效度研究[J]. 中华精神科杂志, 2016, 29(2): 103-107. https://www.cnki.com.cn/Article/CJFDTOTAL-ZHMA199602018.htm LIU X C, TANG M Q, HU L, et al. Reliability and validity of the Pittsburgh sleep quality index[J]. Chin J Psychiatry, 2016, 29(2): 103-107. https://www.cnki.com.cn/Article/CJFDTOTAL-ZHMA199602018.htm
[6]	汤毓华, 张明园. 汉密顿抑郁量表(HAMD)[J]. 上海精神医学, 1984(2): 61-64. https://www.cnki.com.cn/Article/CJFDTOTAL-JSYI198402003.htm TANG Y H, ZHANG M Y. Hamilton Depression Scale(HAMD)[J]. Shanghai Arch Psych, 1984(2): 61-64. https://www.cnki.com.cn/Article/CJFDTOTAL-JSYI198402003.htm
[7]	汤毓华, 张明园. 汉密顿焦虑量表(HAMA)[J]. 上海精神医学, 1984(2): 64-65. https://www.cnki.com.cn/Article/CJFDTOTAL-JSYI198402004.htm TANG Y H, ZHANG M Y. Hamilton Anxiety Scale(HAMA)[J]. Shanghai Arch Psych, 1984(2): 64-65. https://www.cnki.com.cn/Article/CJFDTOTAL-JSYI198402004.htm
[8]	符士翔, 欧红霞, 鲁淑红, 等. 简式睡眠信念和态度量表的信效度研究[J]. 中华行为医学与脑科学杂志, 2014, 23(4): 369-371. doi: 10.3760/cma.j.issn.1674-6554.2014.04.024 FU S X, OU H X, LU S H, et al. Reliability and validity of the brief version of dysfunctional beliefs and attitudes about sleep[J]. Chin J Behav Med Brain Sci, 2014, 23(4): 369-371. doi: 10.3760/cma.j.issn.1674-6554.2014.04.024
[9]	GLASSER M F, COALSON T S, ROBINSON E C, et al. A multi-modal parcellation of human cerebral cortex[J]. Nature, 2016, 536(7615): 171-178. doi: 10.1038/nature18933
[10]	IRINA P, WOLFGANG S, BENEDIKT B, et al. Improving working memory in schizophrenia: effects of 1mA and 2mA transcranial direct current stimulation to the left DLPFC[J]. Schizophr Res, 2018, 202: 203-209. doi: 10.1016/j.schres.2018.06.032
[11]	WITTE S D, BAEKEN C, PULOPULOS M M, et al. The effect of neurostimulation applied to the left dorsolateral prefrontal cortex on post-stress adaptation as a function of depressive brooding[J]. Prog Neuro Psychopharmacol Biol Psychiatry, 2019, 96: 109687.
[12]	ENGEN H G, ANDERSON M C. Memory control: a fundamental mechanism of emotion regulation[J]. Trends Cogn Sci, 2018, 22(11): 982-995. doi: 10.1016/j.tics.2018.07.015
[13]	VIJAYAN S, LEPAGE K Q, KOPELL N J, et al. Frontal beta-theta network during REM sleep[J]. Elife, 2017, 6: e18894. doi: 10.7554/eLife.18894
[14]	GAO L, BAI L J, ZHANG Y C, et al. Frequency-dependent changes of local resting oscillations in sleep-deprived brain[J]. PLoS One, 2015, 10(3): e0120323. doi: 10.1371/journal.pone.0120323
[15]	SATTERFIELD B C, SILVERI M M, GRANDNER M A, et al. Baseline GABA Levels predict time-on-task performance during sleep deprivation[J]. Sleep, 2019, 42: 95-97.
[16]	RESKE M, ROSENBERG J, PLAPP S, et al. fMRI identifies chronotype-specific brain activation associated with attention to motion: why we need to know when subjects go to bed[J]. Neuroimage, 2015, 111: 602-610. doi: 10.1016/j.neuroimage.2015.02.013
[17]	OZONE M, CHIBA S, ITOH H. How much does a single sleep lecture have effect on sleep-related cognition of voluntary participants[J]. Sleep Biol Rhythms, 2017, 15(2): 1-4.
[18]	LANG C, BRAND S, HOLSBOER-TRACHSLER E, et al. Validation of the German version of the short form of the dysfunctional beliefs and attitudes about sleep scale(DBAS-16)[J]. Neurol Ences, 2017, 38(6): 1-12.
[19]	YUAN H S, ZHU X, TANG W J, et al. Connectivity between the anterior insula and dorsolateral prefrontal cortex links early symptom improvement to treatment response[J]. J Affect Disorder, 2020, 260: 490-497. doi: 10.1016/j.jad.2019.09.041
[20]	李冬, 强静, 刘惠苗, 等. 经颅磁刺激治疗失眠的研究进展[J]. 中华物理医学与康复杂志. 2015, 37(2): 155-157. doi: 10.3760/cma.j.issn.0254-1424.2015.02.021 LI D, QIANG J, LIU H M, et al. Research progress of transcranial magnetic stimulation for insomnia[J]. Chin J Phys Med Rehabil, 2015, 37(2): 155-157. doi: 10.3760/cma.j.issn.0254-1424.2015.02.021
[21]	STRATEN A, ZWEERDE T, KLEIBOER A, et al. Cognitive and behavioral therapies in the treatment of insomnia: a meta-analysis[J]. Sleep Med Rev, 2018, 38: 3-16. doi: 10.1016/j.smrv.2017.02.001
[22]	MAO H J, JI Y T, XU Y, et al. Group cognitive-behavioral therapy in insomnia: a cross-sectional case-controlled study[J]. Neuropsychiatr Dis Treat, 2017, 13: 2841-2848. doi: 10.2147/NDT.S149610
[23]	KIM S J, LEE Y J, KIM N, et al. Exploration of changes in the brain response to sleep-related pictures after cognitive-behavioral therapy for psychophysiological insomnia[J]. Sci Rep, 2017, 7(1): 12528. doi: 10.1038/s41598-017-13065-0
[24]	RAICHLE M E, MACLEOD A M, SNYDER A Z, et al. A default mode of brain function[J]. Proc Natl Acad Sci U S A, 2001, 98(2): 676-682. doi: 10.1073/pnas.98.2.676
[25]	DAI X J, NIE X, SHAO Y, et al. Functional connectivity of paired default mode network subregions in primary insomnia[J]. Neuropsychiatr Dis Treat, 2015, 11: 3085-3093.