基于多模态fMRI探讨经皮耳迷走神经刺激治疗原发性失眠的脑机制研究

失眠是一种临床常见病症，大脑睡眠-觉醒系统功能或结构发生病理性改变，都可以导致失眠的产生。本课题组前期研究表明，经皮耳迷走神经刺激（taVNS）能有效治疗原发性失眠，该效应是否通过对睡眠相关脑区（特别是边缘-觉醒网络）结构和功能的调节发挥作用呢？因此，本研究提出科学假说：taVNS通过刺激耳甲部迷走神经，对脑边缘-觉醒网络结构和功能的调制，是其治疗原发性失眠的脑机制。为此，本研究拟联合运用睡眠-心理量表和多模态磁共振技术，探索原发性失眠患者的睡眠-心理特征和边缘-觉醒网络结构和功能特征，从睡眠-心理变化和脑结构、脑功能、脑血流灌注的变化等多个维度交叉验证taVNS对患者边缘-觉醒网络结构和功能的调节作用，阐释该疗法的效应脑机制，为临床应用taVNS治疗原发性失眠提供有力的科学依据。

Insomnia is a common clinical condition. Pathological changes in the function or structure of the brain sleep-wake system can lead to insomnia. Our previous studies have shown that transcutaneous auricular vagus nerve stimulation (taVNS) can effectively treat primary insomnia. Does this effect play a role in regulating the structure and function of sleep-related brain regions (especially marginal-wake network)? Therefore, this study proposes a scientific hypothesis: By stimulating the vagus nerve of the ear, the modulation of the structure and function of the brain edge-awakening network is the brain mechanism of taVNS for treating primary insomnia. This study intends to use the sleep-psychological scale and multimodal magnetic resonance technology to explore the sleep-psychological characteristics and edge-wake network structure and functional characteristics of patients with primary insomnia, and to cross-verify the role of the taVNS in the regulation of the structure and function of the patient's edge-wake network from sleep-psychological changes, brain structure , brain function, cerebral blood perfusion. The study is aim to explain the brain mechanism of the therapy, and provide a strong scientific basis for the clinical application of taVNS treatment for primary insomnia.