本文選題：原發(fā)性失眠 + 靜息態(tài)功能�。� 參考：《南方醫(yī)科大學(xué)》2017年碩士論文

【摘要】：第一部分原發(fā)性失眠患者腦低頻振蕩振幅異常的研究目的:利用靜息態(tài)功能磁共振的低頻振蕩振幅(Amplitude of Low Frequency Fluctuations,ALFF)算法來(lái)研究原發(fā)性失眠患者的腦功能分化的異常。材料與方法:本研究納入55名原發(fā)性失眠患者以及44名性別、年齡以及教育水平相匹配的正常對(duì)照被試。使用兩獨(dú)立樣本t檢驗(yàn)來(lái)對(duì)比兩組被試ALFF的差異。使用Pearson's相關(guān)來(lái)探索異常的ALFF與臨床資料以及失眠時(shí)間的相關(guān)性。結(jié)果:原發(fā)性失眠患者組左側(cè)眶額回/額下回、右側(cè)額中回、左側(cè)頂下小葉以及雙側(cè)小腦后葉的ALFF值低于對(duì)照組;右側(cè)顳中回/下回、右側(cè)枕葉的ALFF值高于對(duì)照組。除此之外,我們發(fā)現(xiàn)失眠時(shí)間與左側(cè)眶額回/額下回的ALFF值呈負(fù)相關(guān);匹茲堡睡眠質(zhì)量(Pittsburgh Sleep Quality Index,PSQI)得分與左側(cè)頂下小葉的ALFF值呈負(fù)相關(guān)。結(jié)論:靜息態(tài)功能磁共振領(lǐng)域?qū)τ谠l(fā)性失眠患者腦功能分化的研究還十分少。本研究是對(duì)此功能分化研究的一個(gè)補(bǔ)充和嘗試。此外,本研究的結(jié)果為原發(fā)性失眠患者的高度覺(jué)醒理論提供了部分支持證據(jù)。第二部分原發(fā)性失眠患者全腦腦區(qū)水平功能連接異常的研究目的:在全腦腦區(qū)水平探索原發(fā)性失眠患者功能連接的異常,并分析這些異常在全腦水平上的分布特征。材料與方法:50名原發(fā)性失眠患者以及40名性別、年齡以及受教育程度相匹配的對(duì)照被試被納入本研究。我們將所有被試的腦劃分為116個(gè)腦區(qū),然后計(jì)算這116個(gè)腦區(qū)彼此之間的功能連接。通過(guò)構(gòu)建一般線性模型以及兩獨(dú)立樣本t檢驗(yàn)來(lái)分析兩組人群的功能連接差異。最后我們使用Pearson相關(guān)分析探索了異常的功能連接與相關(guān)臨床資料之間的相關(guān)性。結(jié)果:失眠患者與覺(jué)醒、情緒、擔(dān)憂/反思、突顯/注意以及感覺(jué)-運(yùn)動(dòng)相關(guān)的腦區(qū)彼此間的功能連接較對(duì)照組增強(qiáng);然而那些在正常情況下彼此抑制對(duì)方功能活動(dòng)的腦區(qū)的功能連接較對(duì)照組減弱,比如突顯網(wǎng)絡(luò)與默認(rèn)網(wǎng)絡(luò)。相關(guān)分析表明部分增強(qiáng)的功能連接與抑郁量(Self-Rating Depression Scale,SDS)得分、失眠嚴(yán)重度量(Insomnia Severity Index,ISI)得分以及PSQI得分有統(tǒng)計(jì)學(xué)相關(guān)性。結(jié)論:本研究中增強(qiáng)的以及減弱的功能連接提示腦區(qū)之間的功能強(qiáng)化以及功能去抑制。一定程度上,本研究在全腦腦區(qū)水平功能連接方面為原發(fā)性失眠的高度覺(jué)醒理論提供了證據(jù)。第三部分原發(fā)性失眠患者右側(cè)島葉前部皮層的有效功能連接的多體素模式識(shí)別研究目的:利用多體素模式識(shí)別的方法探索右側(cè)島葉前部皮層的有效功能連接。材料與方法:使用靜息態(tài)功能磁共振影像采集50名原發(fā)性失眠患者以及40名性別、年齡以及受教育程度相匹配的對(duì)照被試的靜息態(tài)數(shù)據(jù)。格蘭杰因果分析用來(lái)探索右側(cè)島葉前部皮層與全腦的有效功能連接。我們將有效功能連接作為特征向量。然后利用主成分分析的降維方法以及線性支持向量機(jī)進(jìn)行多體素模式識(shí)別。同時(shí)研究?jī)山M被試間的有效連接差異。結(jié)果:(1)腹側(cè)右側(cè)前島葉的有效功能連接可以準(zhǔn)確的將原發(fā)性失眠患者與正常被試區(qū)分開(kāi)(P≤0.008;permutation test)。(2)默認(rèn)網(wǎng)絡(luò)、中央執(zhí)行網(wǎng)絡(luò)、視聽(tīng)相關(guān)的以及情緒相關(guān)的部分腦區(qū)與腹側(cè)右側(cè)前島葉的有效功能連接出現(xiàn)了異常(voxel P0.02;cluster P0.001;permutation test)。(3)腹側(cè)右側(cè)前島葉與默認(rèn)網(wǎng)絡(luò)關(guān)鍵節(jié)點(diǎn)以及右側(cè)梭狀回的有效功能連接與ISI呈統(tǒng)計(jì)學(xué)相關(guān)(P0.05)。結(jié)論:我們的研究提示腹側(cè)右側(cè)前島葉皮層(突顯網(wǎng)絡(luò)的關(guān)鍵節(jié)點(diǎn))可能在原發(fā)性失眠中扮演重要角色。
[Abstract]:Part I study of abnormal amplitude of low frequency oscillation of brain in patients with primary insomnia: using the Amplitude of Low Frequency Fluctuations (ALFF) algorithm of resting state functional magnetic resonance (fMRI) to study the abnormalities of brain function differentiation in patients with primary insomnia. Materials and methods: This study included 55 patients with primary insomnia. The two independent sample t test was used to compare the difference between the two groups of subjects with two independent sample t tests. Use Pearson's correlation to explore the correlation between abnormal ALFF and clinical data and the time of insomnia. Results: the left orbital frontal gyrus / lower frontal gyrus, right frontal gyrus, left side, left The ALFF value of the lateral parietal lobule and bilateral posterior cerebellar leaves was lower than that of the control group; the right occipital lobe ALFF value was higher than that of the control group. Besides, we found that the time of insomnia was negatively correlated with the ALFF value of the left orbital frontal gyrus / lower frontal gyrus; the score of Pittsburgh sleep quality (Pittsburgh Sleep Quality Index, PSQI) and the left parietal lobule. The ALFF value is negatively correlated. Conclusion: the study of resting state functional magnetic resonance (fMRI) on brain function differentiation in patients with primary insomnia is still very few. This study is a supplement and attempt for the study of this functional differentiation. In addition, the results of this study provide some support evidence for the highly awakening theory of the patients with primary insomnia. The second part of the study was original. Study of abnormal horizontal functional connectivity in the whole brain and brain area in patients with recurrent insomnia. Objective: To explore the abnormalities of functional connectivity in patients with primary insomnia at the whole brain level and to analyze the distribution characteristics of these abnormality in the whole brain. Materials and methods: 50 patients with primary insomnia and 40 sex, age, and education level matched pairs. The subjects were included in this study. We divided all the subjects' brains into 116 brain regions, then calculated the functional connections between the 116 brain regions. By constructing the general linear model and the two independent sample t test, we analyzed the functional connectivity differences between the two groups. Finally, we explored the abnormal function connection using the Pearson correlation analysis. Correlation with related clinical data. Results: insomnia patients with awakening, emotion, worry / reflection, prominence / attention, and the functional connectivity of the brain regions associated with sensorimotor enhancement were enhanced than the control group; however, the functional connections in the brain areas that inhibited each other's functional activities under normal conditions were weaker than those in the control group, such as the prominence. Network and default networks. Correlation analysis showed that partially enhanced functional connections were associated with Self-Rating Depression Scale (SDS) scores, severe insomnia measurements (Insomnia Severity Index, ISI) scores and PSQI scores. Conclusion: enhanced and weakened functional connections in this study suggest functional enhancement between the brain regions And function inhibition. To a certain extent, this study provides evidence for the high awakening theory of primary insomnia in the whole brain region level functional connection. Third the multibody pattern recognition study of the effective functional connection of the anterior cortex of the right island of the primary insomniacs: exploration by the method of multibody pattern recognition Effective functional connections in the anterior cortex of the right island. Materials and methods: resting state data were collected from 50 primary insomnia patients and 40 sex, age, and educational level matched control subjects using resting state functional magnetic resonance imaging. Grainger causality analysis was used to explore the effective function of the right Island anterior cortex and the whole brain. We use the effective functional connection as a feature vector. Then we use the dimension reduction method of the principal component analysis and the linear support vector machine for multi voxel pattern recognition. At the same time, we study the effective connection difference between the two groups. Results: (1) the effective functional connection of the right ventral side of the front Isle leaf can accurately make the patients with primary insomnia and normal. The subjects were divided (P < 0.008; permutation test). (2) the default network, the central executive network, the audio-visual related part of the brain and the effective functional connection with the ventral side of the right anterior insula (voxel P0.02; cluster P0.001; permutation test). (3) the right anterior insula, the default network key node and the right shuttle. The effective functional connection of the form gyrus was statistically related to ISI (P0.05). Conclusion: our study suggests that the ventral right anterior insula cortex (the key node of the prominent network) may play an important role in primary insomnia.
【學(xué)位授予單位】：南方醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：R445.2;R740

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