Study On The Change Of Dopamine D2 Receptor In The Brain Of Patients With Insomnia And Its Behavioral Correlation

Background and purposeInsomnia is also known as primary insomnia(PI),which is considered to be the most common sleep and dormant disorder and has become a serious hazard in the absence of specific physical,mental or physical causes,which are difficult to fall asleep,maintain sleep or non restorative sleep with or without obvious daytime function impairment.The important problem of human health and quality of life.Epidemiological surveys show that the prevalence of global sleep disorders is up to 10%-31%,and the incidence of sleep disorders among adults in China is 8.2%-13.4%,and the proportion is increasing year by year.Insomnia has become a hot topic in recent years at home and abroad,and has been extensively carried out from clinical symptoms to disease levels.The etiology and pathogenesis of insomnia are extremely complex.Many scholars believe that neurobiological factors play a key role in the neurobiological mechanism of insomnia.Imaging studies in this area have previously focused on functional magnetic resonance(fMRI,functional magnetic resonance imaging)and 18 F-deoxyglucose(fluorodeoxygglucos,FDG)positron emission tomography/computer tomography(Positron emission tomography computed).The consequences of neurostructural or functional impairment caused by insomnia patients are observed,and the pathological basis of neurobiological changes that may lead to insomnia is less.The common symptoms of insomnia are excessive arousal.Some scholars believe that excessive arousal is closely related to a variety of neurotransmitters produced by the central nervous system.Each neurotransmitter plays an independent role and interact with each other.The importance of dopamine for the maintenance and promotion of the state of awakening is paid much attention to in the study of insomnia.PET/CT imaging can be used to label the changes of brain neurotransmitters and receptors in the brain,so that the changes of brain neurotransmitters in patients with sleep disorders are more intuitive.Most of the previous scholars have studied the PET/CT receptor imaging of sleep deprived animal models.It has been observed that sleep deprivation can induce abnormal expression of dopamine receptors,suggesting that changes in dopamine receptors in the brain may be closely related to sleep abnormalities,and are one of the key receptors for insomnia.In this study,the 11 C tagged dopamine receptor antagonist,lecapride(11 C-Raclopride)was used to perform PET/CT imaging in the patients with insomnia.The changes of dopamine D2 receptor binding force in the brain of patients with insomnia were observed and quantitatively analyzed,and the correlation between the level of dopamine receptor expression in the brain and the change of sleep behavior in the patients was observed.To analyze the changes and significance of dopamine transmitters in the brain of patients with insomnia,and to provide help for the study of the neurobiological pathogenesis of insomnia patients.Materials and methodsSubbject:from January 2017 to December 2017 in Zhengzhou University Hospital People’s Hospital neurology clinic patients with insomnia disorder patients(female,male,age 47.34.3+7.87 years),as the experimental group,another 15 cases of healthy volunteers(male,female,age 43.83+8.52 years),as control group,experimental group and control group the gender difference was not statistically significant(λ2=0.183,p=0.356),no significant difference in age(t=1.371,p=0.248),all subjects met the inclusion and exclusion criteria corresponding.Examination method:two weeks before the subjects stopped taking coffee,tea and other food and alcoholic beverages,maintain normal habits,first collected in experimental groups and control group,Hamilton Depression Scale(Hamilton depresssion scale,HAMD),Pittsburgh(Pittsburgh sleep quality sleep quality index,index,PSQI),instant memory,graphics memory the scale,1 days after polysomnography,followed by Siemens Prisma3.0 T MR,the 64 channel head coil magnetic resonance examination of the experimental group and control group,and 3 DTI acquisition structure such as functional magnetic resonance imaging data after 2 days of polysomnography polysomnographic examination after 2 days using Discovery TM VCT PET/CT scanner brain 11 C-raclopride(11 C-Raclopride)PET/CT,the first CT data mining,PET after launch of data acquisition,then The data were collected by attenuation correction,and 11 C-Raclopride PET/CT and fMRI images,polysomnography and behavioral data were analyzed.Data processing:The dynamic PET data and 3DT1 magnetic resonance data processing are based on the MATLAB Molecular Image Analysis Toolbox(Molecular Imaging And Kinetic Analysis Toolbox,MIAKAT),respectively,extraction,segmentation,correction,outlined areas of interest such as processing,through the model technology,The parameter maps of local or whole brain,ROI time-radiation curve and Non-Displayable Binding Potential(BPND)value of each subject were obtained.Statistical analysis:In the experimental group and the control group,the striatum(caudate nucleus,putamen)and the amygdala receptor binding ability in the left and right sides of the experimental group were significantly different from those in the experimental group and the volunteers in the ipsilateral caudate nucleus,putamen,and amygdala receptor All the differences were compared using SPSS 20.0 software,and the experimental group and control group,caudate nucleus,putamen,amygdala receptor binding capacity and HAMD depression scale,instantaneous memory,memory scale score was significantly Pearon correlation analysis(P<0.05).Result1.the scores of PSQI(t=14.231,p=0.015),HAMD(t=11.852,p=0.005),instantaneous memory(t=-5.666,p=0.035)and graphic memory(t=-3.112,p=0.028)in the experimental group were significantly different from those in the control group.2.the t=0.089,p=0.996,t=0.956,p=0.685,and amygdala(t=0.654,p=0.925)dopamine D2 receptor binding force in the left and right sides of the experimental group had no statistical difference.There was no significant difference in the binding force of dopamine D2 receptors in the left and right bilateral caudate nuclei(t=0.356,p=0.896),Z=-1.185(Z=-1.185,p=0.361)and amygdala(Z=-0.582,p=0.751)in the left and right sides of the control group.4.compared with the control group,bilateral caudate nucleus(left:t=-2.958,P=0.023,right:Z=-0.986,p=0.021),bilateral amygdala(left:t=-2.584,p=0.052 right:t=-2.632,p=0.032)and the right putamen(Z=-2.898,p=0.021)dopamine D2 receptor binding force were all decreased,the difference was statistically significant.Compared with the control group,the binding capacity of dopamine D2 receptor in the left putamen(Z=-2.931,p=0.452)decreased,but the difference was not statistically significant.5.,the correlation between dopamine D2 receptor binding force and clinical scale scores in bilateral caudate nucleus,putamen and amygdala in experimental group were analyzed.The course of insomnia had significant negative correlation with bilateral caudate nucleus,putamen and amygdala BPND(r=-0.856,-0.823;p=0.004,0.015;r=-0.925,-0.861;p=0.005,0.008;r=-0.763,-0.821;p=0.006,0.009).The PSQI score was negatively correlated with the bilateral caudate nucleus and putamen BPND(r=-0.563,-0.627,p=0.005,p=0.007;r=-0.655,-0.638,p=0.004,0.006),and there was a low negative correlation with the BPND of the left amygdala(r=-0.368,p=0.233).The HAMD score was negatively correlated with the bilateral amygdala BPND(r=-0.587,-0.612,p=0.007,0.005),and there was a low negative correlation with the right caudate nucleus and the left putamen BPND(r=-0.379,p=0.015;r=0.392,p=0.025).There was no significant correlation between dopamine D2 receptor in bilateral caudate nucleus,putamen and amygdala in the experimental group.Conclusion1.there is an abnormality in dopamine nerve channel dopamine D2 receptor binding capacity in patients with insomnia,suggesting that dopamine neurotransmitters in the brain of insomnia patients are altered.2.the decrease of dopamine D2 receptor binding force in the caudate nucleus,putamen and amygdala is negatively correlated with the course of disease,suggesting that the dysfunction of dopaminergic system in the brain of patients with insomnia may play a role in the pathogenesis of insomnia,and the abnormal ability of dopamine D2 receptor is a nerve molecule in the pathogenesis of insomnia.One of the mechanisms.3.the changes of dopamine D2 receptor binding force in the caudate nucleus,putamen and amygdala in patients with insomnia were negatively correlated with the score of PSQI scale and the score of HAMD scale,suggesting that sleep disorders and depression may have similar neuromolecular mechanisms.