基于多导睡眠图与神经心理测验:慢性失眠症患者执行功能损害的特征及其相关因素研究OA
Characteristics of executive function impairment and related factors in patients with chronic insomnia disorder:A study based on polysomnography and neuropsychological tests
目的 探讨慢性失眠症患者执行功能损害的特征及其与客观睡眠结构参数的相关性.方法 纳入92例符合《精神障碍诊断与统计手册》第五版(DSM-5)诊断标准的慢性失眠症患者及45例健康对照者;所有受试者接受焦虑抑郁评估、整夜多导睡眠监测、执行功能评估,对比分析两组受试者睡眠参数(睡眠潜伏期、睡眠效率、总睡眠时间、睡眠分期及占比等)与执行功能(Stroop色词测验、数字广度测验、连线测验)的差异及其相关性.结果 与健康对照组相比,慢性失眠症组Stroop-卡片C耗时、Stroop干扰效应、连线测试-B时间、连线测试-B-A耗时差增加,数字广度倒背分数及总分降低,差异有统计学意义(P<0.05).相关性分析显示,总睡眠时间、睡眠效率、NREM 3期时长、NREM 3期占比与Stroop-卡片C耗时、Stroop干扰效应、连线测试-B耗时、连线测试-B-A耗时差呈负相关,与数字广度-倒背分数和数字广度-总分呈正相关,差异有统计学意义(P<0.05).NREM 1期时长、NREM 1期占比与Stroop-卡片C耗时、Stroop干扰效应、连线测试-B耗时、连线测试-B-A耗时差呈正相关,与数字广度-倒背分数呈负相关,差异有统计学意义(P<0.05).结论 慢性失眠症患者存在抑制控制、工作记忆和认知灵活性等多维度执行功能损害,其与睡眠效率降低、深睡眠减少等相关.
Objective To investigate the characteristics of executive function impairment in patients with chronic insomnia disorder and its correlation with objective sleep structure parameters.Methods A total of 92 patients who met the DSM-5 diagnostic criteria for chronic insomnia disorder were enrolled as chronic insomnia disorder group,and 45 healthy controls were enrolled as healthy control group.All subjects underwent assessments for anxiety and depression,overnight polysomnography,and executive function,and the two groups were compared in terms of sleep parameters(in-cluding sleep latency,sleep efficiency,total sleep time,sleep stages,and the proportion of each stage)and executive function(Stroop Color-Word Test,digit span test,and trail making test),as well as the correlation between these param-eters.Results Compared with the healthy control group,the chronic insomnia disorder group had significant increases in Stroop Card C completion time,Stroop interference effect,trail making test-B completion time,and trail making test B-A time difference and significant reductions in the score of digit span backward task and the total score of digit span test(P<0.05).The correlation analysis showed that total sleep time,sleep efficiency,NREM stage 3 duration,and the proportion of NREM stage 3 were negatively correlated with Stroop Card C completion time,Stroop interference effect,trail making test-B completion time,and trail making test B-A time difference and were positively correlated with the score of digit span backward task and the total score of digit span test(P<0.05).Conversely,NREM stage 1 duration and the proportion of NREM stage 1 were positively correlated with Stroop Card C completion time,Stroop interference effect,trail making test-B completion time,and trail making test B-A time difference and were negatively correlated with the score of digit span backward task(P<0.05).Conclusion Patients with chronic insomnia disorder exhibit executive function impairment in multiple dimensions including inhibitory control,working memory,and cognitive flexibility,which are associated with the reductions in sleep efficiency and deep sleep.
叶圆圆;龙诗琦;陶敏;冉艳琼;李文涛;蒋晓江
上海中医药大学附属市中医医院脑病科,上海 200071重庆西区医院睡眠医学中心,重庆 400052重庆西区医院睡眠医学中心,重庆 400052重庆西区医院睡眠医学中心,重庆 400052上海中医药大学附属市中医医院脑病科,上海 200071重庆西区医院睡眠医学中心,重庆 400052
医药卫生
慢性失眠症执行功能抑制控制工作记忆认知灵活性
Chronic insomnia disorderExecutive functionInhibitory controlWorking memoryCogni-tive flexibility
《中风与神经疾病杂志》 2026 (4)
303-308,6
上海医学创新发展基金会项目"中西医结合卒中中心建设"(WL-CZZX-2022001K)
评论