| Objective To investigate the diagnostic value of Tract-based spatial statistics(TBSS)in patients with mild cognitive impairment(MCI)with chronic insomnia disorder(CID)and the physiological and pathological mechanisms of the two diseases.Materials and Methods Collection of MCI patients and normal physical examiners from December 2016 to December 2019 in affiliated Hospital of Qingdao University,and group according to the following methods: A total of 44 MCI patients with CID were collected as C-MCI group,26 MCI patients without CID were collected as nC-MCI group,(MCI and CID were assessed based on clinical presentation and questionnaire results by specially trained neurologist).21 healthy subjects were collected as healthy control group.All subjects were examined by brain DTI.Tract-based spatial statistics(TBSS)was used to analyze FA values.One-way ANCOVA was used to find the brain regions with different white matter fibers in the three groups of subjects.The different brain regions were used as a mask,and the changes of FA values in the fiber bundle skeleton of the three groups of subjects were compared pair by post analysis.One-way ANOVA was used to analyze the general clinical data and laboratory examination indexes of the three groups of subjects.Pearson correlation analysis was used to analyze the correlation between FA values and MOCA,MMSE,PSQI inC-MCI group.Pearson correlation analysis was used to analyze the correlation between laboratory test indexes and MOCA,MMSE,PSQI inC-MCI group.Results(1)There was no statistical significance in age,gender and years of education among the three groups(P > 0.05),but there were statistical significance in MOCA score,MMSE score and PSQI(P < 0.05).(2)There was no statistical significance in laboratory indicators among the three groups(P > 0.05).(3)Brain regions with significant differences in FA between the three groups(P < 0.05): corpus callosum(CC),fornix(FX),Bilateral cerebral peduncle(CP),internal capsule(IC),superior corona radiata(SCR),posterior corona radiata(PCR),posterior thalamic radiation(PTR),sagittal stratum(SS),external capsule(EC),cingulum(CG),stria terminalis(ST),superior longitudinal fasciculus(SLF);right anterior corona radiata(ACR),superior fronto-occipital fasciculus(SFO);Compared with HC group,the FA values of CC,FX,Bilateral CP,IC,SCR,PCR,PTR,EC,CG,ST,SLF,Left SS,Right ACR,SFO were decreased inC-MCI group.Compared with HC group,the FA values of CC,FX,Bilateral SCR,Left PLIC,ST,Right ACR,PCR were decreased in nC-MCI group.Compared with nC-MCI group,the FA values of Bilateral RLIC,PCR,PTR,Left SCR,SLF were decreased inC-MCI group.(4)The FA values of left SS inC-MCI group was correlated with the MOCA(r=0.325,P =0.031).The FA values of Right PTR inC-MCI group was correlated with the PSQI(r=0.325,P =0.031).The HbA1c inC-MCI group was correlated with the MMSE(r=0.381,P=0.011).Conclusions Both C-MCI and nC-MCI patients had a wide range of white matter microstructural damage.Compared with nC-MCI patients,extent of damage of C-MCI patients were more extensive.The FA values of some brain regions were correlated with cognition and sleep,suggesting that long-term chronic insomnia may expand the scope of white matter damage in patients with MCI,thus further aggravating the cognitive decline,and initially revealing the internal relationship between MCI and CID.The change of FA value is suggestive to the diagnosis of MCI with CID and provides theoretical basis for the diagnosis and treatment of MCI with CID. |
