原发性失眠患者注意偏向的神经病理机制研究

Insomnia is the most common sleep disorder in current society. However, little is known about the neuropathological mechanisms underlying insomnia. Cognitive theories suggest that attentional bias towards sleep related information is important for the generation and maintenance of insomnia. Previous studies suggested that the amygdala is critically involved in the neuropathological mechanisms of attentional bias, and frontal-parietal attention network also play an important role in the neuropathological mechanisms of attentional bias. Our previous studies have showed that the network of amygdala is dysfunctional in patients with primary insomnia. Therefore, we hypothesize that the amygdala might play an important role in the neuropathological mechanisms of attentional bias in patients with primary insomnia, and the modulation function of frontal-parietal attention network on amygdala might be abnormal in patients with primary insomnia. In the present study, we will use two different visual dot probe tasks to investigate the attentional bias towards sleep related information and emotional information. We will use resting state functional magnetic resonance imaging (fMRI) to investigate whether the frontal-parietal attention network is dysfunctional in patients with primary insomnia. Using event related fMRI, we will investigate which brain regions are involved in the attentional bias in patients with primary insomnia, and investigate the important role of the amygdala in the neuropathological mechanisms of attentional bias in patients with primary insomnia. The present study attempts to find out the key point of the neuropathological mechanisms of attentional bias in patients with primary insomnia, to elucidate the nature of insomnia to some extent and to provide an importent theoretical basis for the neuromodulation therapy for insomnia.

失眠是当今社会最常见的睡眠障碍疾病。然而，目前对其神经病理机制所知甚少。认知学家们认为，对睡眠相关信息的注意偏向在失眠的发生和维持机制中起着关键的作用。研究表明，杏仁核是参与注意偏向病理机制的关键部位，而额顶叶注意环路也是注意偏向病理机制的重要环节。我们的前期研究发现，原发性失眠患者的杏仁核神经环路存在功能异常，因此，我们推论：杏仁核可能在原发性失眠患者注意偏向的病理机制中起着关键的作用，额顶叶注意环路对杏仁核的调制作用可能存在异常。本项目将采用两种不同刺激的视觉点探实验范式，研究原发性失眠患者是否对情绪刺激和睡眠相关刺激存在注意偏向；通过静息态fMRI技术，研究原发性失眠患者注意环路是否存在功能异常；并进一步通过事件相关fMRI技术，研究有哪些脑区参与了原发性失眠患者的注意偏向，研究杏仁核在原发性失眠患者注意偏向病理机制中的关键作用，进而试图阐明原发性失眠患者注意偏向的病理生理机制。

失眠是当今社会最常见的睡眠障碍疾病，发病率高达10%-40%。然而目前我们对失眠的病理生理机制却知之甚少，致使临床上缺少特效的失眠治疗措施。本项目采用静息态功能核磁和事件相关的功能磁共振技术，研究了原发性失眠患者注意相关脑区及情绪相关脑区的功能变化。本项目发现了原发性失眠患者对负性情绪及失眠相关信息存在选择性注意偏向，且其注意功能及注意环路功能存在异常。本项目还对失眠相关疾病广泛性焦虑症及不安腿综合征的神经病理机制进行了初步研究，发现了其脑功能异常脑区。本项目为进一步揭示失眠的神经病理机制提供了新的依据，并为将来对失眠患者进行神经调控治疗提供新的理论支持。