目的 采用静息态功能磁共振成像(rs-fMRI)-体素镜像同伦连接(VMHC)技术分析失眠障碍(ID)伴抑郁状态与ID患者大脑半球间VMHC值差异,探讨ID伴抑郁状态患者大脑半球间信息交流和整合功能受损情况.方法 2021年12月-2023年12月河南省人民医院诊治ID患者57例,rs-fMRI前行匹兹堡睡眠质量指数(PSQI)、贝克抑郁量表(BDI)、失眠严重程度指数(ISI)、汉密尔顿焦虑量表(HAMA)、汉密尔顿抑郁量表(HAMD)评分.根据BDI评分将57例患者分为ID组(BDI评分＜14分)28例和伴抑郁状态组(BDI评分≥14分)29例,比较2组PSQI、ISI、HAMA、HAMD评分;收集2组rs-fMRI数据进行VMHC分析,计算VMHC值;采用Pearson相关法分析ID伴抑郁状态患者差异脑区VMHC值与BDI、HAMA、HAMD评分的相关性.结果 伴抑郁状态组BDI评分[(25.65±8.57)分]、HAMA[(22.45±11.21)分]、HAMD[(20.51±9.41)分]评分均高于 ID 组[(7.71±4.43)、(12.75±7.43)、(12.42±6.65)分](t=9.863,P＜0.001;t=3.836,P＜0.001;t=3.734,P＜0.001),PSQI、ISI 评分[(14.86±2.47)、(17.72±4.99)分]与ID 组[(14.35±2.54)、(16.39±5.75)分]比较差异均无统计学意义(t=0.762,P=0.450;t=0.935,P=0.354).与 ID组比较,伴抑郁状态组双侧颞下回、楔叶、岛盖部额下回VMHC值降低(GRF校正,体素水平P＜0.001,团块水平P＜0.05).ID伴抑郁状态患者双侧楔叶VMHC值与BDI评分呈负相关(r=-0.437,P=0.017),双侧岛盖部额下回VMHC值与HAMD评分呈负相关(r=-0.378,P=0.042).结论 在失眠程度相近的情况下,与ID患者相比,ID伴抑郁状态患者存在大脑半球间信息交流和整合障碍,双侧颞下回、楔叶、岛盖部额下回VMHC值降低,且VMHC值与抑郁症状严重程度相关.
Analysis of interhemispheric voxel-mirrored homotopic connectivity in resting-state functional magnetic resonance imaging in insomnia disorder patients complicated with or without depressive symptoms
Objective To analyze the differences in interhemispheric voxel-mirrored homotopic connectivity(VMHC)values between insomnia disorder(ID)patients with and without depressive symptoms using resting-state functional magnetic resonance imaging(rs-fMRI),and to investigate the impairment of interhemispheric information exchange and integration functions in ID patients with depressive symptoms.Methods Fifty-seven ID patients were diagnosed and treated in Henan Provincial People's Hospital from December 2021 to December 2023.Before rs-fMRI scan,all patients received assessment using Pittsburgh Sleep Quality Index(PSQI),Beck Depression Inventory(BDI),Insomnia Severity Index Scale(ISI),Hamilton Anxiety Scale(HAMA),and Hamilton Depression Scale(HAMD).Based on the BDI score,57 patients were divided into ID group(BDI score＜14,n=28)and ID+depressive symptoms group(BDI score ≥14,n=29),and the differences in the scores of PSQI,ISI,HAMA and HAMD were compared between two groups.Rs-fMRI and structural images were collected for VMHC analysis,and the VMHC value was calculated.The correlations of VMHC values in differential brain regions with the scores of BDI,HAMA and HAMD were analyzed using Pearson's correlation method in ID patients with depressive symptoms.Results The scores of BDI,HAMA and HAMD were higher in ID+depressive symptoms group(25.65±8.57,22.45±11.21,20.51±9.41)than those in ID group(7.71±4.43,12.75±7.43,12.42±6.65)(t=9.863,P＜0.001;t=3.836,P＜0.001;t=3.734,P＜0.001),and there were no significant differences in the scores of PSQI and ISI between ID+depressive symptoms group(14.86±2.47,17.72±4.99)and ID group(14.35±2.54,16.39±5.75)(t=0.762,P=0.450;t=0.935,P=0.0354).Compared with ID group,the VMHC values of bilateral inferotemporal gyrus,cingulate gyrus,and inferior frontal gyrus of the insula decreased in ID+depressive symptoms group(GRF-adjusted,voxel level P＜0.001,mass level P＜0.05).In ID+depressive symptoms group,the VMHC value in the bilateral cingulate gyrus was negatively correlated with BDI score(r=-0.437,P=0.017),and the VMHC value in the bilateral inferior frontal gyrus of the insula was negatively correlated with HAMD score(r=-0.378,P=0.042).Conclusion Compared with ID patients,ID patients with depressive symptoms under conditions of comparable insomnia severity exhibit interhemispheric communication and integration disorders,and lower VMHC values in bilateral inferotemporal gyrus,cingulate gyrus,and inferior frontal gyrus of the insula,and the VMHC values are correlated with the severity of depressive symptoms.
insomnia disorderinsomnia disorder complicated with depressive symptomsresting-state functional magnetic resonance imagingvoxel-mirrored homotopic connectivity
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