تغییرات ارتباطات عملکردی قشر حدقه ای پیشانی مغز در اختلال بی خوابی مزمن

نوع مقاله : مقاله پژوهشی

نویسندگان

1 دانشگاه شهید بهشتی

2 دانشگاه علوم پزشکی کرمانشاه

چکیده

هدف: اختلال بی‌خوابی مزمن، به عنوان یکی از شایع‌ترین اختلالات روان­پزشکی، تاکنون مکانیسم عصبی آن کاملاً شناخته نشده است. برخی از مطالعات جدید بر نقش قشر حدقه‌ای پیشانی در اختلال بی‌خوابی مزمن تأکید کرده‌اند، اما تاکنون ارتباط عملکردی این منطقه با دیگر نواحی مغز بررسی نشده است.
روش: این مطالعه تحلیلی و مورد- شاهدی با روش تصویربرداری مغناطیسی رزونانس عملکردی (fMRI) در حالت استراحت انجام شده است. با روش نمونه‌گیری در دسترس، 42 فرد مبتلا به این اختلال از کلینیک خواب دانشگاه علوم پزشکی کرمانشاه و 52 مورد سالم در این مطالعه وارد شدند. همچنین، پلی سومنوگرافی شبانه و پرسشنامة شاخص کیفیت خواب پیتسبورگ از آن‌ها گرفته شد. ارتباط عملکردی قشر حدقه‌ای پیشانی با تمام واکسل‌های مغز در دو گروه بیمار و سالم محاسبه و مقایسه گردید. یافته‌ها: نتایج نشان داد که در بیماران مبتلا به اختلال بی­خوابی مزمن در مقایسه با گروه سالم، ارتباط عملکردی درونزاد این قشرکاهش و با شکنج پایینی چپ قشر پیشانی، قشر جلویی اپرکالم راست، اینسولا راست و شکنج گیجگاهی میانی چپ کاهش یافته، و همچنین ارتباط عملکردی این قشر با شکنج پیش مرکزی افزایش یافته است  (05/0>p اصلاح­شده برای مقایسه‌های مکرر). تغییرات ارتباطات عملکردی مذکور نیز با کیفیت خواب رابطه معنی‌داری دارد. نتیجه‌گیری: یافته‌های این مطالعه حاکی از ارتباط عملکردی مختل قشر حدقه‌ای پیشانی با دیگر نواحی مغز و ارتباط آن با شاخص‌های کیفیت خواب است که می‌تواند تبیین‌کننده بخش مهمی از آسیب‌شناسی عصبی این اختلال باشد.

کلیدواژه‌ها

عنوان مقاله [English]

Functional connectivity alterations of orbitofrontal cortex in chronic insomnia

نویسندگان [English]

  • Reihaneh Ahmadi 1
  • Sama Rahimi Jafari 1
  • Masoumeh Rostampour 2
  • Khadijeh Noori 2
  • Habibolah Khazaie 2
  • Masoud Tahmasian 1
1 Institute of Medical Science and Technology, Shahid Beheshti University
2 Sleep Disorders Research Center, Kermanshah University of Medical Sciences
چکیده [English]

Aim: Many neuroimaging studies have been done, to illustrate neuropathology of chronic insomnia, as one of the most common psychological disorders. Recent studies, emphasis on the role of orbitofrontal cortex. But the functional connectivity of OFC hasn’t been studied yet. To the best of our knowledge, it is the first study to discuss about it. Methods: In a case-control study, functional connectivity of OFC with whole brain was carried out to compare the functional connectivity alterations of this region between forty-two chronic insomnia patients, obtained at sleep disorders research center in Kermanshah university of medical sciences, and fifty-two healthy controls without sleep problems. Additionally, Pittsburgh Sleep Quality Index and nocturnal polysomnography was taken from subjects.Results: Patients showed decreased inter-functional connectivity of right OFC and intra functional connectivity of right OFC with right frontal pole, right insular cortex, right and left inferior frontal gyrus, left middle temporal gyrus and right frontal operculum cortex. Additionally, the functional connectivity of right OFC with precentral gyrus was increased in patients compared with controls (p<0.05 corrected for multiple comparisons). Above mentioned alterations were significantly correlated with subjective sleep quality. Conclusion:Our results show functional connectivity alterations of OFC in patients in comparison to healthy controls and these changes are correlated with subjective sleep quality. Therefore, this cortex can discuss some signs of chronic insomnia and even same neuropathology with depression.

کلیدواژه‌ها [English]

  • chronic insomnia
  • functional connectivity
  • neuroimaging
  • prefrontal cortex

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