健康青少年睡眠剥夺状态下低频振幅变化的功能磁共振成像研究

摘要

目的:探讨健康青少年在24 h睡眠剥夺(SD)状态下大脑局部脑区自发活动水平的变化特征.方法:通过网络及海报宣传在社区及校园招募睡眠质量良好的16名健康青少年(男性8例,女性8例;13-20岁)均分别在正常静息觉醒(RW)状态及24 h SD状态下接受注意网络测试(ANT)及静息态功能磁共振成像扫描.利用静息态低频振幅(ALFF)方法分析脑功能活动的特点.对ALFF值差异脑区进行ROC曲线分析,同时分析其与ANT中的准确率、反应时间及漏做率之间的相关性.结果:与RW状态相比,SD状态下ANT结果的准确率较低[(83±12)％vs.(97±4)％,P＜0.05],漏做率较高[(15±11)％vs.(2±7)％,P＜0.05],反应时间较长[(832±134) msvs.(715 ±97) ms,P＜0.05].相对于RW状态,SD状态显示ALFF增加脑区主要位于右侧楔叶(BA 17,BA 18),ALFF减低脑区主要位于右侧豆状核、右侧屏状体、左侧背外侧前额叶(BA 46)及左侧顶下小叶(BA 39).在SD状态,右侧屏状核与正确率呈正相关(r =0.69,P＜0.05),与漏做率呈负相关(r=-0.71,P＜0.05);左侧背外侧前额叶与反应时间呈正相关(r =0.68,P＜0.05).ALFF差异脑区右侧楔叶、右侧豆状核、右侧屏状体、左侧背外侧前额叶及左侧顶下小叶的峰下面积(AUC)分别为0.9、0.8、0.9、0.8、0.9,相应的敏感度及特异度均较高.结论:24h睡眠剥夺引起青少年的功能性神经网络-默认网络、任务正激活网络及高级认知功能相关脑区的功能异常,以及视觉网络的功能代偿.%Objective:To explore the regional brain activities in healthy adolescent subjects after sleep deprivation (SD) using amplitude of low-frequency fluctuation (ALFF) method.Methods:Total of 16 healthy adolescent subjects (8 males,8 females;aged 13-20 years) were recruited in the community and the campus through the internet and posters.Each of the 16 healthy adolescent subject underwent the attention network test and magnetic resonance imaging (MRI) session twice:once was after rested wakefulness (RW condition),and the other was after SD condition.Amplitude of low frequency fluctuation (ALFF) method was used to assess the local brain features.The mean ALFF signal values of the different brain areas were performed to investigate their relationships with the accuracy rate,reaction time and lapse rate in the attention network test,and were analyzed with a receiver operating characteristic (ROC) curve to investigate their sensitivities and specificities to distinguish the SD condition from the RW condition.Results:Subjects showed a lower response accuracy rate [(83 ± 12) ％ vs.(97 ± 4) ％,P ＜ 0.05],a longer response time [(832 ± 134) ms vs.(715 ± 97) ms,P ＜ 0.05] and a higher lapse rate [(15 ± 11)％ vs.(2.4 ±7.3)％,P ＜0.05] under SD condition than under RW condition.They showed higher ALFF area in the right cuneus (BA 17,BA 18),and lower ALFF areas in the right lentiform nucleus,right claustrum,left dorsolateral prefrontal cortex (BA 46) and left inferior parietal cortex (BA 39) under SD condition than under RW condition.Under SD condition,the mean ALFF signal value of the right claustrum showed a significant positive correlation with the accuracy rate (r =0.69,P ＜0.05),and a negative correlation with the lapse rate (r =-0.71,P ＜0.05).The mean ALFF signal value of the dorsolateral prefrontal cortex showed a significant positive correlation with the reaction time (r =0.68,P ＜ 0.05).The values of area under the curve of the right cuneus,right lentiform nucleus,right claustrum,left dorsolateral prefrontal cortex and left inferior parietal cortice were 0.9,0.8,0.9,0.8 and 0.9,respectively.These different ALFF areas also showed high degree of sensitivities and specificities.Conclusion:Sleep deprivation leads to the dysfunction in the default mode network,anticorrelated " task-positive" network,and advanced cognitive function brain areas,and the functional compensation in the visual network.