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

مراجع

Altena, E., Vrenken, H., Van Der Werf, Y. D., van den Heuvel, O. A., & Van Someren, E. J. (2010). Reduced orbitofrontal and parietal gray matter in chronic insomnia: a voxel-based morphometric study. Biological Psychiatry, 67(2): 182-185.
Ballesio, A., Ottaviani, C., & Lombardo, C. (2019). Poor cognitive inhibition predicts rumination about insomnia in a clinical sample. Behavioral Sleep Medicine, 17(5): 672-681.
Boland, E. M., Bertulis, K., Leong, S. H., Thase, M. E., & Gehrman, P. R. (2019). Preliminary support for the role of reward relevant effort and chronotype in the depression/insomnia comorbidity. Journal of Affective Disorders, 242: 220-223.
Buysse, D. J., Reynolds, C. F., 3rd, Monk, T. H., Berman, S. R., & Kupfer, D. J. (1989). The Pittsburgh Sleep Quality Index: a new instrument for psychiatric practice and research. Psychiatry Research, 28(2): 193-213.
Cheng, W., Rolls, E. T., Ruan, H., & Feng, J. (2018). Functional Connectivities in the Brain That Mediate the Association Between Depressive Problems and Sleep Quality. JAMA Psychiatry, 75(10): 1052-1061.
Chunhua, X., Jiacui, D., Xue, L., & Kai, W. (2019). Impaired emotional memory and decision-making following primary insomnia. Medicine (Baltimore), 98(29): e16512.
du Plessis, S., Bossert, M., Vink, M., van den Heuvel, L., Bardien, S., Emsley, R., . . . Carr, J. (2018). Reward processing dysfunction in ventral striatum and orbitofrontal cortex in Parkinson's disease. Parkinsonism and Related Disorders, 48: 82-88.
Emamian, F., Khazaie, H., Okun, M. L., Tahmasian, M., & Sepehry, A. A. (2019). Link between insomnia and perinatal depressive symptoms: A meta‐analysis. Journal of Sleep Research, 28(6): e12858.
Farrahi Moghaddam, J., Nakhaee, N., Sheibani, V., Garrusi, B., & Amirkafi, A. (2012). Reliability and validity of the Persian version of the Pittsburgh Sleep Quality Index (PSQI-P). Sleep Breath, 16(1): 79-82.
Gong, L., Liao, T., Liu, D., Luo, Q., Xu, R., Huang, Q., . . . Zhang, C. (2019). Amygdala Changes in Chronic Insomnia and Their Association with Sleep and Anxiety Symptoms: Insight from Shape Analysis. Neural Plasticity, 2019: 8549237.
Grau-Rivera, O., Operto, G., Falcón, C., Sánchez-Benavides, G., Cacciaglia, R., Brugulat-Serrat, A., . . . Molinuevo, J. L. (2020). Association between insomnia and cognitive performance, gray matter volume, and white matter microstructure in cognitively unimpaired adults. Alzheimer's Research and Therapy, 12(1): 4.
Iaccarino, L., Presotto, L., Bettinardi, V., Gianolli, L., Roiter, I., Capellari, S., . . . Perani, D. (2018). An in vivo (11) C-PK PET study of microglia activation in Fatal Familial Insomnia. Annals of Clinical and Translational Neurology, 5(1): 11-18.
Kang, J. I., Park, C. I., Sohn, S. Y., Kim, H. W., Namkoong, K., & Kim, S. J. (2015). Circadian preference and trait impulsivity, sensation-seeking and response inhibition in healthy young adults. Chronobiology International, 32(2): 235-241.
Khazaie, H., Veronese, M., Noori, K., Emamian, F., Zarei, M., Ashkan, K., . . . Rosenzweig, I. (2017). Functional reorganization in obstructive sleep apnoea and insomnia: A systematic review of the resting-state fMRI. Neuroscience and Biobehavioral Reviews, 77: 219-231.
Li, C., Dong, M., Yin, Y., Hua, K., Fu, S., & Jiang, G. (2018). Aberrant Effective Connectivity of the Right Anterior Insula in Primary Insomnia. Frontiers in Neurology, 9: 317.
Meyer, H. C., & Bucci, D. J. (2016). Imbalanced activity in the orbitofrontal cortex and nucleus accumbens impairs behavioral inhibition. Current Biology, 26(20): 2834-2839.
Morin, C. M., Drake, C. L., Harvey, A. G., Krystal, A. D., Manber, R., Riemann, D., & Spiegelhalder, K. (2015). Insomnia disorder. Nature Reviews Disease Primers, 1(1): 15026.
Padoa-Schioppa, C., & Conen, K. E. (2017). Orbitofrontal Cortex: A Neural Circuit for Economic Decisions. Neuron, 96(4): 736-754.
Pang, R., Guo, R., Wu, X., Hu, F., Liu, M., Zhang, L., . . . Li, K. (2018). Altered Regional Homogeneity in Chronic Insomnia Disorder with or without Cognitive Impairment. American Journal of Neuroradiology, 39(4): 742-747.
Riemann, D. (2007). Insomnia and comorbid psychiatric disorders. Sleep Medicine, 8: S15-S20.
Schiel, J. E., Holub, F., Petri, R., Leerssen, J., Tamm, S., Tahmasian, M., . . . Spiegelhalder, K. (2020). Affect and Arousal in Insomnia: Through a Lens of Neuroimaging Studies. Current Psychiatry Reports, 22(9): 1-8.
Schwartz, F., Tahmasian, M., Maier, F., Rochhausen, L., Schnorrenberg, K. L., Samea, F., . . . Drzezga, A. (2019). Overlapping and distinct neural metabolic patterns related to impulsivity and hypomania in Parkinson’s disease. Brain Imaging and Behavior, 13(1): 241-254.
Bagherzadeh-Azbari, S., Khazaie, H., Zarei, M., Spiegelhalder, K., Walter, M.,  Leerssen, J., . . . Tahmasian, M. (2019). Neuroimaging Insights into the Link between Depression and Insomnia: A Systematic Review. Journal of Affective Disorders, 258: 133-143.
Stalnaker, T. A., Cooch, N. K., & Schoenbaum, G. (2015). What the orbitofrontal cortex does not do. Nature Neuroscience, 18(5): 620-627.
Tahmasian, M., Jamalabadi, H., Abedini, M., Ghadami, M. R., Sepehry, A. A., Knight, D. C., & Khazaie, H. (2017). Differentiation chronic post traumatic stress disorder patients from healthy subjects using objective and subjective sleep-related parameters. Neuroscience Letters, 650: 174-179.
Tahmasian, M., Noori, K., Samea, F., Zarei, M., Spiegelhalder, K., Eickhoff, S. B., . . . Eickhoff, C. R. (2018). A lack of consistent brain alterations in insomnia disorder: An activation likelihood estimation meta-analysis. Sleep Medicine Reviews 42: 111-118.
Tahmasian, M., Rochhausen, L., Maier, F., Williamson, K. L., Drzezga, A., Timmermann, L., . . . Eggers, C. (2015). Impulsivity is Associated with Increased Metabolism in the Fronto-Insular Network in Parkinson's Disease. Frontiers in Behavioral Neuroscience, 9: 317.
Tahmasian, M., Samea, F., Khazaie, H., Zarei, M., Kharabian Masouleh, S., Hoffstaedter, F., . . . Valk, S. L. (2020). The interrelation of sleep and mental and physical health is anchored in grey-matter neuroanatomy and under genetic control. Communications Biology, 3(1): 171.
Te Lindert, B. H., Itzhacki, J., van der Meijden, W. P., Kringelbach, M. L., Mendoza, J., & Van Someren, E. J. (2018). Bright environmental light ameliorates deficient subjective ‘liking’in insomnia: an experience sampling study. Sleep, 41(4).
van Mill, J. G., Hoogendijk, W. J., Vogelzangs, N., van Dyck, R., & Penninx, B. W. (2010). Insomnia and sleep duration in a large cohort of patients with major depressive disorder and anxiety disorders. Journal of Clinical Psychiatry, 71(3): 239.
Wu, T. Y., Chen, C.-P., & Jinn, T.-R. (2010). Alzheimer's disease: aging, insomnia and epigenetics. Taiwanese Journal of Obstetrics and Gynecology, 49(4): 468-472.
Yu, S., Shen, Z., Lai, R., Feng, F., Guo, B., Wang, Z., . . . Gong, L. (2018). The Orbitofrontal Cortex Gray Matter Is Associated With the Interaction Between Insomnia and Depression. Frontiers in Psychiatry, 9: 651.
 

فایل ها

هم رسانی

ارجاع به این مقاله

آمار