A Magnetic Resonance Spectrum Imaging Study In Frontal Lobe And Hippocampus Of Patients With Primary Insomnia

Objectives: To study magnetic resonance spectroscopy characteristics of frontal lobeand the hippocampus of patients with primary insomnia, and to explore thedistribution features of N-acetylaspartate, choline-containing compound and creatinewhich provide new ideas for the research on pathological mechanism of primaryinsomnia.Methods:21patients with primary insomnia (PI) and16normal controls(NC) wererecruited in the study through strict structural clinical interview, using the MINIInternational Neuropsychiatric terview for DSM-Ⅳ.Then the General SituationQuestionnaire, Epworth Sleepiness Scale (ESS),Multidimensional fatiguequestionnaire(MFI),Insomnia Severity Index (ISI), State-Trait AnxietyInventory(STAI), and Beck Depression Inventory(revised edition)(BDI-R), PittsburghSleep Quality Index(PSQI) and Polysomnography（PSG）were used to obtain thegeneral condition, the levels of drowsiness, fatigue, depression, anxiety and sleepquality of all subjects, respectively.After all the clinical symptoms had been expressed,the subjects were scanned by GE1.5T Signa HD MR in order to get their magneticresonance spectroscopy imaging. The SPSS13.0analysis software was used to recorda data base and perform the statistic analysis.Results:1. Compared with NC,the degrees of drowsiness,fatigue,insomnia,anxietyand depression in patients with PI were significantly different (p<0.05).2. NAA/Cr in bilateral frontal lobe lower in PI patients versus NC(t=-2.158p=0.038；t=-2.499p=0.019); Cho and Cho/Cr in right f rontal lobe were significantlyhigher in PI patients versus NC(t=2.288p=0.028). 3. NAA/Cr in left right frontal lobe was significantly higher than that in rightfrontal lobe in PI patients(t=2.071p=0.045).4. There was no significant difference in NAA，Cho，Cr，NAA/Cr and Cho/Cr levels between female patients and male ones.5.The levels of NAA，Cho，Cr，NAA/Cr and Cho/Cr were similar amongsevere insomnia level group, moderate insomnia level group and mild insomnia group.The difference was no statistically significant，respectively.6. The levels of NAA，Cho，Cr，NAA/Cr and Cho/Cr had no correlationwith sex, age, duration and the scores of STAI、BDI-R.7. The levels of Cho/Cr in right frontal lobe was positively related to SleepLatency（r=0.436，P=0.048）and sleep duration （r=0.447，P=0042）on PSQI,andCho/Cr levels in left hippocampus was also positively related to dysfunction duringthe day （r=0.519，P=0.016）on PSQI.8. The levels of NAA/Cr in right frontal lobe was negatively related to SleepLatency （r=-0.465，P=0.033）on PSG,and NAA/Cr levels in left hippocampus wasalso negatively related to sleep efficiency （r=0.523，P=0.015）on PSG but positivelyrelated to wake time after sleep onset（r=-0.518，P=0.016）Conclusions:1. NAA and Cho in bilateral frontal lobe and hippocampus maypatispate in pathogenesis of primary insomnia.2. Sleep Latency,sleep duration,dysfunction during the day,sleep ef-ficiency and wake time after sleep onset were associated with magnetic resonancespectroscopy characteristics of patients with primary insomnia.