摘要
目的探讨慢性失眠症(chronic insomnia disorder,CID)患者的认知功能损害特征及背外侧前额叶皮质(dorsolateral prefrontal cortex,DLPFC)代谢物浓度水平,并分析其相关性。方法根据蒙特利尔认知评估量表(Montreal cognitive assessment scale,MoCA)评分将CID分为伴有轻度认知损害组(CID-MCI)27例、无认知损害组(CID-NI)29例,另入组健康对照(HC)30名。行常规MR及多体素磁共振波谱(proton magnetic resonance spectroscopy,^(1)H-MRS)扫描,分析三组DLPFC的N-乙酰天冬氨酸(N-acetylaspartate,NAA)、含胆碱化合物(choline-containing compounds,Cho)、肌醇(myo-inositol,MI)、谷氨酰胺+谷氨酸(glutamine+glutamate,Glx)和肌酸复合物(total creatine,tCr)绝对浓度。结果3组研究对象MoCA评分有统计学差异(P<0.01),其中CID-MCI组较CID-NI组和HC组低(P<0.05)。左侧DLPFC中,CID-MCI组Cho、MI浓度高于CID-NI组和HC组(P<0.05),CID-NI组Cho、MI浓度较HC组升高(P<0.05)。右侧DLPFC中,CID-MCI组Cho、MI浓度高于CID-NI组和HC组(P<0.05)。CID患者中,左侧DLPFC区Cho浓度与MoCA评分呈负相关(r=-0.35,P=0.01),右侧DLPFC区Cho浓度与MoCA评分呈负相关(r=-0.33,P=0.02)。结论部分CID患者MoCA评分降低,CID-MCI患者双侧DLPFC区Cho和MI浓度增加,MoCA评分与双侧DLPFC区Cho浓度水平存在负相关。
Objective To investigate the characteristics of cognitive impairment and the concentration of metabo-lites in dorsolateral prefr ontal cortex(DLPFC)in patients with chronic insomnia(CID).Methods According to the Montreal Cognitive Assessment Scale(MoCA)score,CID patients were divided into two groups:mild cognitive impairment group(CID-MCI,n=27)and non cognitive impairment group(CID-NI,n=29).Another 30 healthy controls(HC)were enrolled.Routine MRI and multivoxel magnetic resonance spectrum(^(1)H-MRS)scanning were performed.LCModel and SAGE software were used to quantitatively analyze the absolute concentration of N-acetylaspartate(NAA),cholinecontaining compounds(Cho),myo-inositol(MI),glutamine+glutamate(Glx)and creatine complex(total creatine,tCr)in DLPFC.Results The MOCA scores of the three groups were significantly different(P<0.05).The MOCA scores were lower in the CID-MCI group than in the CID-NI group and the HC group(P<0.05).In the left DLPFC,the concentrations of Cho and MI were higher in CID-MCI group than in CID-NI group and HC group(P<0.05),and the concentration of Cho and MI was higher in CID-NI group than in HC group(P<0.05).In the right DLPFC,the concentrations were higher in Cho and MI in CID-MCI group than in CID-NI group and HC group(P<0.05).In CID patients,Cho concentration in left DLPFC area was negatively correlated with MOCA score(r=-0.35,P=0.01),Cho concentration in right DLPFC was negatively correlated with MOCA score(r=-0.33,P=0.02).Conclusion MOCA score is decreased in CID patients and the concentrations of Cho and MI in bilateral DLPFC are increased in patients with CID-MCI.MOCA score is negatively correlated with the concentrations of Cho in bilateral DLPFC.
作者
仝太山
孙宗琼
蔡炜
程灶火
赵鹏
TONG Taishan;SUN Zongqiong;CAI Wei;CHENG Zaohuo;ZHAO Peng(Wuxi School of Medicine,Jiangnan University,Wuxi 214122,China)
出处
《中国神经精神疾病杂志》
CAS
CSCD
北大核心
2021年第7期390-394,共5页
Chinese Journal of Nervous and Mental Diseases
基金
无锡市卫生系统双百拔尖人才项目(编号:HB2020046)。
关键词
慢性失眠
认知损害
磁共振波谱
背外侧前额叶皮质
Chronic insomnia
Cognitive impairment
Magnetic resonance spectroscopy
Dorsolateral prefrontal cortex
