Page 71 - 磁共振成像2024年7期电子刊

临床研究｜｜Clinical Articles 磁共振成像 2024年7月第15卷第7期 Chin J Magn Reson Imaging, Jul, 2024, Vol. 15, No. 7

基于rtfMRI-NF技术调控失眠障碍患者

杏仁核活性对大脑度中心性的影响

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谷宇昂 ，张淼 ，贾淑蕾 ，孙永兵 ，祁菲 ，武肖玲 ，邹智 ，李中林 ，周菁 ，窦社伟 ，闫峰山 ，李永丽 5*
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作者单位 1. 新乡医学院河南省人民医院，新乡 453003；2. 郑州大学人民医院，郑州 450003；3. 河南省人民医院医学影像科，郑州
450003；4.河南省人民医院/郑州大学人民医院核医学科，郑州 450003；5.郑州大学人民医院/河南省人民医院健康管理科，郑州 450003
* 通信作者 李永丽，E-mail: shyliyongli@126.com
中图分类号 R445.2；R338.63 文献标识码 A DOI 10.12015/issn.1674-8034.2024.07.011
本文引用格式 谷宇昂, 张淼, 贾淑蕾, 等. 基于rtfMRI-NF技术调控失眠障碍患者杏仁核活性对大脑度中心性的影响[J]. 磁共振成
像, 2024, 15(7): 64-69.
[摘要] 目的 探讨实时功能磁共振成像神经反馈（real-time functional magnetic resonance imaging neurofeedback, rtfMRI-NF）
调控失眠障碍（insomnia disorder, ID）患者杏仁核活性对大脑度中心性（degree centrality, DC）的影响。材料与方法 本研究采
用 rtfMRI-NF 调控 34 例 ID 患者杏仁核活性，结合临床多导睡眠监测（Polysomography, PSG）、匹兹堡睡眠质量指数（Pittsburgh
Sleep Quality Index, PSQI）等量表对患者进行干预前后评估。使用配对 t检验分析干预前后功能成像数据的 DC 值差异，并探讨
调控前后 DC 值变化及其与临床量表等数据的相关性。结果 经 rtfMRI-NF 调控后，ID 患者的 PSQI、失眠严重程度指数
（Insomnia Severity Index Scale, ISI）等量表评分均显著降低（P 均<0.05）。此外，右侧海马旁回的 DC 值显著增高（GRF 校正，
体素水平 P<0.001，团块水平 P<0.05），并与睡眠效率差值呈负相关 r=−0.478，P<0.05）；而右侧背外侧额上回等区域的 DC 值降
低（GRF 校正，体素水平 P<0.001，团块水平 P<0.05），并与干预后 ISI 评分呈正相关（r=0.488，P<0.05）。结论 rtfMRI-NF 技
术可重塑ID患者特定脑区的DC值，并有效提高ID患者的睡眠质量。
[关键词] 失眠障碍；实时功能磁共振成像神经反馈；磁共振成像；静息态功能磁共振成像；杏仁核；度中心性
Impact of regulating amygdala activity in patients with insomnia disorders using rtfMRI-NF
technology on the centrality of the brain

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GU Yuang , ZHANG Miao , JIA Shulei , SUN Yongbing , QI Fei , WU Xiaoling , ZOU Zhi , LI Zhonglin , ZHOU Jing ,
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DOU Shewei , YAN Fengshan , LI Yongli 5*
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1 Xinxiang Medical University Henan Provincial People's Hospital, Xinxiang 453003, China; Zhengzhou University People's Hospital,
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Zhengzhou 450003, China; Department of Medical Imaging, Henan Provincial People's Hospital, Zhengzhou 450003, China; Department of
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Nuclear Medicine, Henan Provincial People's Hospital/People's Hospital of Zhengzhou University, Zhengzhou 450003, China; Department of
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Health Management, People's Hospital of Zhengzhou University/Henan Provincial People's Hospital, Zhengzhou 450003, China
* Correspondence to LI Y L, E-mail: shyliyongli@126.com
Received 30 Mar 2024, Accepted 25 Jun 2024; DOI 10.12015/issn.1674-8034.2024.07.011
ACKNOWLEDGMENTS National Natural Science Foundation of China (No. 82071884); Central Plains Science and Technology
Innovation Leading Talents Program (No. 244200510016); Henan Provincial Medical Science and Technology Project (No. SBGJ202302011);
Henan Provincial Science and Technology Tackle Key Problems Project (No. 242102311018).
Cite this article as GU Y A, ZHANG M, JIA S L, et al. Impact of regulating amygdala activity in patients with insomnia disorders using
rtfMRI-NF technology on the centrality of the brain[J]. Chin J Magn Reson Imaging, 2024, 15(7): 64-69.
Abstract Objective: To investigate the effect of real-time functional magnetic resonance imaging neurofeedback (rtfMRI-NF) on the
modulation of amygdala activity and its impact on the degree centrality (DC) in the brains of patients with insomnia disorder (ID).
Materials and Methods: The study applied rtfMRI-NF to modulate the amygdala activity of 34 ID patients, assessing the effects before
and after treatment using Polysomnography (PSG) and the Pittsburgh Sleep Quality Index (PSQI). Paired t-tests were used to analyze the
differences in DC values of brain regions before and after the intervention, exploring the changes in DC values and their correlations with
clinical scale data. Results: After rtfMRI-NF modulation, significant reductions were observed in the PSQI scores and Insomnia Severity
Index (ISI) among ID patients (P<0.05 for both). Furthermore, an increase in the DC value of the right parahippocampal gyrus was noted
(GRF corrected, voxel-level P<0.001, cluster-level P<0.05), which negatively correlated with the change in sleep efficiency (r=−0.478,
P<0.05); Conversely, a decrease in the DC value of areas such as the right dorsolateral prefrontal cortex was observed (GRF corrected,
voxel-level P<0.001, cluster-level P<0.05), positively correlating with the post-intervention ISI scores (r =0.488, P<0.05). Conclusions:
rtfMRI-NF can reshape the DC values of specific brain regions in ID patients and effectively improve their sleep quality.
Key words insomnia disorder; real-time functional magnetic resonance imaging neurofeedback; magnetic resonance imaging;
resting-state functional magnetic resonance imaging; amygdala; degree centrality
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0 引言 康的公共卫生问题 。据统计约有 30% 以上的中国
失眠障碍（insomnia disorder, ID）是影响民众健 人患有失眠 。失眠不仅严重影响生活质量，还可能
[2]
收稿日期 2024-03-30 接受日期 2024-06-25
基金项目 国家自然科学基金项目（编号：82071884）；中原科技创新领军人才计划项目（编号：244200510016）；河南省医学科技计
划项目（编号：SBGJ202302011）；河南省科技攻关计划项目（编号：242102311018）

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