The Blue Velvet Evaluates Spatial Navigation In Patients With Chronic Insomnia

Background: Insomnia,as the most common sleep disorder,affects about 10-30% of the world’s population.Insomnia is characterized by subjective expression of difficulty in falling asleep,inability to maintain or recover sleep,and daytime dysfunction.Among them,daytime dysfunction includes fatigue or general discomfort,cognitive decline,learning,working or social decline,depression or anxiety,etc.Chronic insomnia disorder,CID)suffers from spatial learning and memory impairment,but there is no ideal detection paradigm.Recent studies have shown that the Blue Velvet Arena can assess and classify mild cognitive impairment.However,it is not known whether it can be used to evaluate the spatial learning and memory impairment of CID patients.Objective: To evaluate the feasibility of blue velvet test in detecting cognitive impairment of spatial navigation in patients with chronic insomnia.Methods: Forty-six patients with chronic insomnia were included,and 30 healthy people were taken as control group.Chinese-Beijing version of Montreal cognitive assessment(moca-c)was used to evaluate the overall cognitive function,Pittsburgh sleep quality index(psqi)to evaluate subjective sleep quality and Hamilton Depression Scale,HAMD)to evaluate depression.Using "nine-box maze" test to evaluate the subjects’ multidimensional spatial memory;Using blue velvet experiment to evaluate space navigation ability.The data of normal distribution are expressed by mean standard deviation,and the data of non-normal distribution are expressed by quartile,i.e.M(Q1,Q3).Results:(1)Background data: There was no significant difference in sex,age and years of education between CID group and control group(P > 0.05).(2)Depression: HAMD score of CID group was higher than that of healthy control group(t = 2.3±1.18,P < 0.005).(3)Sleep status: PSQI score of CID group was significantly higher than that of healthy control group(t =-19.842,P<0.005).(4)cognitive function: the score of Mo CA-C in CID group was lower(t = 4.359,P < 0.005),especially in visual space and executive function(Z =-4.078,P = 0.000),language(Z =-3.507,P = 0.000),abstraction(Z =-7.313,P = 0.000)In the nine-box maze experiment,object working memory(Z =-2.983,P = 0.003),spatial working memory(Z =-5.109,P < 0.001)and object recognition(Z =-2.580,P < 0.001)was significantly more than that of healthy control group.The navigation score of velvet experiment in CID group was significantly higher than that in healthy control group(t =5.19,P<0.01).(5)Correlation between sleep and cognition: There is no obvious correlation between navigation score and PSQI total score,but there is a positive correlation with sleep influencing factors(P<0.05).There is a significant positive correlation between navigation score and course of disease,but a significant negative correlation with Mo CA-C,among which there is a significant positive correlation between delayed recall and language and navigation score.There is a significant negative correlation between navigation scores and spatial working memory in the nine-box maze experiment.(6)ROC curve analysis: the area under ROC curve of navigation score and spatial memory errors in nine-box maze is greater than 0.7,which suggests that they are better predictors for distinguishing chronic insomnia patients from healthy people,and the sensitivity and specificity of navigation score are higher than those of spatial memory in nine-box maze.Conclusion: Blue velvet test can be used to detect the spatial cognition of insomnia patients,especially to assess the spatial memory impairment of patients.Nine-box maze experiment should be selected when patients’ multi-dimensional spatial navigation cognition needs to be evaluated,and blue velvet experiment can be selected when spatial cognition ability is simply evaluated.Compared with normal people,the spatial cognitive ability of patients with chronic insomnia is significantly damaged,and this damage is aggravated with the increase of disease course,but it has no obvious relationship with subjective sleep quality of patients.