Effects of transcutaneous auricular vagus nerve stimulation on brain functional connectivity of medial prefrontal cortex in patients with primary insomnia
Effects of transcutaneous auricular vagus nerve stimulation on brain functional connectivity of medial prefrontal cortex in patients with primary insomnia
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经皮耳迷走神经刺激对原发性失眠患者内侧前额叶皮质脑功能连接的影响
DOI：
10.1002/ar.24785
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发表时间：
2021-10-08
影响因子：
2
通讯作者：
Rong, Pei-Jing
中科院分区：
文献类型：
--
作者：
Zhang, Shuai;He, Jia-Kai;Rong, Pei-Jing
耳针作为针刺和非药物治疗的代表，已被广泛用于治疗失眠。经皮耳迷走神经刺激（taVNS）是耳穴刺激和迷走神经刺激的结合。它不仅能有效治疗原发性失眠，而且具有无创、无痛、便携、经济等优点。内侧前额叶皮层（mPFC）是默认模式网络（DMN）的核心区域，对维持睡眠具有重要意义。然而，taVNS减轻原发性失眠（PI）的机制尚不清楚。在本研究中，我们发现taVNS不仅能有效降低PI患者的匹兹堡睡眠质量指数评分，还能降低PI患者左侧mPFC与双侧前扣带回背侧之间以及右侧mPFC与枕皮质之间的功能连接（FC）。此外，FC的下降与睡眠指数评分的下降呈正相关。因此，我们提出taVNS治疗可以通过减少DMN内、DMN与显著性网络之间、DMN与枕叶皮质之间的FC来改善PI患者的睡眠质量，延长睡眠时间。这可能是taVNS治疗PI的机制之一。
As a representative of acupuncture and nonpharmaceutical therapy, auricular acupuncture has been widely for the treatment of insomnia. Transcutaneous auricular vagus nerve stimulation (taVNS) is a combination of auricular point stimulation and vagus nerve stimulation. It can not only treat primary insomnia effectively, but also is noninvasive, painless, portable and economical. The medial prefrontal cortex (mPFC) is a core region of default mode network (DMN), which is important for maintenance of sleep. However, the mechanism of taVNS in alleviating primary insomnia (PI) remains to be clarified. In this study, we found that taVNS could not only effectively reduce the score of Pittsburgh Sleep Quality Index, but also decreased functional connection (FC) between the left mPFC and bilateral dorsal anterior cingulate gyrus as well as FC between the right mPFC and the occipital cortex in patients with PI. Furthermore, the decrease in FC was positively correlated with the decline of sleep index score. Therefore, we proposed that treatment with taVNS can improve sleep quality and prolong sleep duration in patients with PI by reducing FC within DMN, FC between DMN and salience network, as well as FC between DMN and the occipital cortex. This may be one of mechanisms of taVNS in treating PI.