失眠障碍患者外周淋巴细胞亚群特征与其认知功能的相关性研究OA

Objective:To investigate the characteristics of peripheral lymphocyte subsets in patients with insomnia disorder(ID)and their associations with cognitive function.Methods:A total of 39 drug-naïve patients with ID and 51 healthy controls(HCs)were recruited from Wuhan First Hospital between April 2022 and March 2023.Cognitive function was assessed using the Montreal Cognitive Assessment(MoCA)and the Stroop Color-Word Test.Flow cytometry was performed to determine the proportions and absolute counts of peripheral lymphocyte subsets in both groups.Between-group comparisons,correlation analyses,and multivariable linear regression analyses were conducted to evaluate the relationships between peripheral lymphocyte subsets and cognitive function.Results:Compared with HCs,the ID group had significantly lower MoCA total scores and poorer performance in multiple cognitive domains(P＜0.05).In the Stroop test,the ID group showed reduced accuracy and prolonged Stroop-D reaction time(P＜0.05).In addition,the ID group exhibited significantly increased proportions and absolute counts of T cells,helper T lymphocytes(Th cells),B cells,and total T+B+NK cells(P＜0.05),whereas the proportion of NK cells was significantly decreased(P=0.001).Correlation analyses further showed that the MoCA total score and several domain scores were negatively correlated with the proportions and absolute counts of Th cells and B cells(P＜0.05),but positively correlated with the proportion of NK cells(P＜0.05).Moreover,the accuracy and reaction time in Stroop-C and Stroop-D were significantly correlated with T-cell-and Th-cell-related parameters(P＜0.05).Multivariable linear regression analysis showed that,after adjustment for age,education level,and BMI,Th-cell proportion,Th-cell absolute count,the Th/cytotoxic T lymphocyte(CTL)ratio,B-cell absolute count,NK-cell proportion,and total T+B+NK absolute count were independently associated with the MoCA total score.Conclusion:Patients with ID showed mild multidomain cognitive impairment,predominantly involving executive function,accompanied by a peripheral immune profile characterized by adaptive immune predominance.This imbalance in peripheral lymphocyte subsets was significantly associated with cognitive decline and may represent a potential biomarker of insomnia-related cognitive impairment.