| PurposeRegional homogeneity and the Amplitude of Low Frequency Fluctuation based on resting-state functional magnetic resonance imaging were used to study the local brain activity changes in patients with early awakening insomnia.Application of arterial spin labeling imaging(ASL)technique to study cerebral perfusion characteristics in early awakening insomnia disorder.To investigate the correlation between brain neural network changes,cerebral blood flow changes characteristics and the severity of clinical insomnia and mood disorders in patients with early awakening insomnia,and to explore the possible neuroimaging mechanisms of early awakening insomnia.MethodsProspective collection of patients with early awakening insomnia in The Second Affiliated Hospital of Dalian Medical University from July 2021 to October 2022 and a normal control group matched with sex and age.Finally,34 patients with early awakening insomnia and 12 healthy controls were collected.Brain structure imaging,resting state functional magnetic resonance imaging and arterial spin labeling scanning were performed in both groups,and the Pittsburgh Sleep quality Index scale and Hamilton Depression and anxiety scale were scored on the same day.Pre-processing of rs-f MRI images and calculation of low frequency fluctuation amplitude(ALFF)and Regional homogeneity(Re Ho)using DPARSFA software based on Matlab(R2019b)platform.Pre-processing of ASL-generated cerebral blood flow(CBF)images using SPM12 software.Two-sample t-tests were performed to assess the differences in ALFF,Re Ho,and CBF between patients with early awakening insomnia and healthy subjects,sex and age are removed as covariates.Save the different brain regions as regions of interest and extract the average value.IBMSPSS25.0 statistical software was used to analyze the correlation between the values of ALFF,Re Ho,CBF in different brain regions and the score of clinical scale.Results1.Compared with the normal control group,the Re Ho values of the left middle temporal gyrus and the left inferior temporal gyrus were lower and the Re Ho values of the left inferior frontal gyrus of the left insula were higher,with statistically significant differences between the two groups(P<0.05).Re Ho values in the left middle temporal gyrus were positively correlated with HAMA scores(r=0.504,P=0.024).2.Compared with normal controls,ALFF values were lower in the bilateral precuneus,left middle temporal gyrus,and left angular gyrus,with statistically significant differences between the two groups(P<0.05).3.Compared with normal controls,CBF values were higher in the right anterior cerebellar lobe,posterior cerebellar lobe,cerebellar tonsils,bilateral inferior cerebellum,right middle temporal gyrus,syrinx,left hippocampus,corpus callosum,right caudate nucleus,right deltoid inferior frontal gyrus,right frontal lobe,right internal and collateral cingulate gyrus,and right precuneus,with statistically significant differences between the two groups(P<0.05).Left hippocampal CBF values were positively correlated with HAMD scores(r=0.358,P=0.038)and HAMA scores(r=0.513,P=0.002).;the right frontal lobe was positively correlated with PSQI scores(r=0.341,p=0.048);the right cingulate gyrus was and positively correlated with HAMD scores(r=0.354.p=0.040);the right precuneus showed a positive correlation with PSQI scores(r=0.418,p=0.014);the right precuneus showed a positive correlation with HAMA scores(r=0.432,p=0.011).ConclusionFunctional imaging based on rs-f MRI revealed abnormal Re Ho and ALFF activity in several brain regions in patients with early-waking insomnia disorder,with Re Ho values in the left middle temporal gyrus correlating with HAMA scores.Whole-brain ASL imaging revealed increased CBF values in several brain regions in patients with early awakening insomnia disorder,with abnormal cerebral blood flow changes in some of these brain regions positively correlating with clinical scale scores reflecting sleep quality and mood disorders. |
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