基于磁共振成像的失眠症患者大脑功能研究

BACKGROUND: Insomnia has a significant impact on the quality of life of patients. Despite the progress in understanding the pathophysiological mechanisms of insomnia, the possibilities of its objective diagnosis remain insufficiently studied. This study can contribute to understanding the neural mechanisms of insomnia, contribute to the development of new diagnostic and treatment methods, and personalize therapeutic approaches to improve the quality of life of patients with insomnia disorders.

AIM: to evaluate changes in the brain connectome in patients with psychophysiological and paradoxical insomnia by performing functional magnetic resonance imaging.

MATERIALS AND METHODS: A total of 31 patients were examined who applied for a somnologist appointment at the Federal State Budgetary Institution Almazov National Medical Research Centre of the Ministry of Health of the Russian Federation with diagnosed chronic insomnia. All patients underwent polysomnographic examination using Embla N 7000 (Natus, USA) and SOMNO HD (SOMNOmedics, Germany) for one night with an assessment of the main characteristics of sleep according to the rules of AASM 2.5. Also, all study participants underwent magnetic resonance imaging of the brain on tomographs with a magnetic field induction force of 3.0 Tl at two time points. Statistical analysis of MRI data was performed using MathLab 2023a, CONN v22.a packages. Descriptive statistics, the Kolmogorov–Smirnov criterion were used for processing materials, depending on the characteristics of the data, the Mann–Whitney U-criterion and Pearson Chi-squared were used to analyze demographic data.

DISCUSSION: The study demonstrates the possibilities of functional magnetic resonance imaging in obtaining data on the functional connections of the brain in insomnia. The detected changes in the activity of various brain regions indirectly or directly involved in the regulation of sleep and wakefulness are consistent with the most common pathogenetic models of insomnia, in particular with the theory of hyperactivation and the model of sleep reactivity to stress.

CONCLUSION: The results of the study emphasize the relevance of studying functional changes in the brain in insomnia, opening up new opportunities for more accurate diagnosis and the development of personalized treatment methods.