【摘要】 目的 探讨实时功能磁共振成像神经反馈(real-time functional magnetic resonance imaging neurofeedback, rtfMRI-NF调控失眠障碍(insomnia disorder, ID)患者杏仁核活性对大脑度中心性(degree centrality, DC)的影响。材料与方法 本研究采用rtfMRI-NF调控34例ID患者杏仁核活性，结合临床多导睡眠监测(Polysomography, PSG)、匹兹堡睡眠质量指数(Pittsburgh Sleep Quality Index, PSQI)等量表对患者进行干预前后评估。使用配对t检验分析干预前后功能成像数据的DC值差异，并探讨调控前后DC值变化及其与临床量表等数据的相关性。结果 经rtfMRI-NF调控后，ID患者的PSQI、失眠严重程度指数(Insomnia Severity Index Scale, ISI)等量表评分均显著降低(P均<0.05)。此外，右侧海马旁回的DC值显著增高(GRF校正，体素水平P<0.001，团块水平P<0.05)，并与睡眠效率差值呈负相关r=-0.478,P<0.05)；而右侧背外侧额上回等区域的DC值降低(GRF校正，体素水平P<0.001，团块水平P<0.05)，并与干预后ISI评分呈正相关(r=0.488,P<0.05)。结论 rtfMRI-NF技术可重塑ID患者特定脑区的DC值，并有效提高ID患者的睡眠质量。更多还原

【Abstract】 Objective: To investigate the effect of real-time functional magnetic resonance imaging neurofeedback(rtfMRI-NF) on the modulation of amygdala activity and its impact on the degree centrality(DC) in the brains of patients with insomnia disorder(ID).Materials and Methods: The study applied rtfMRI-NF to modulate the amygdala activity of 34 ID patients, assessing the effects before and after treatment using Polysomnography(PSG) and the Pittsburgh Sleep Quality Index(PSQI). Paired t-tests were used to analyze the differences in DC values of brain regions before and after the intervention, exploring the changes in DC values and their correlations with clinical scale data. Results: After rtfMRI-NF modulation, significant reductions were observed in the PSQI scores and Insomnia Severity Index(ISI) among ID patients(P<0.05 for both). Furthermore, an increase in the DC value of the right parahippocampal gyrus was noted(GRF corrected, voxel-level P<0.001, cluster-level P<0.05), which negatively correlated with the change in sleep efficiency(r=-0.478,P<0.05); Conversely, a decrease in the DC value of areas such as the right dorsolateral prefrontal cortex was observed(GRF corrected,voxel-level P<0.001, cluster-level P<0.05), positively correlating with the post-intervention ISI scores(r =0.488, P<0.05). Conclusions:rtfMRI-NF can reshape the DC values of specific brain regions in ID patients and effectively improve their sleep quality.更多还原