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睡眠疾病严重威胁着人们的日常生活,全球27%的人存在睡眠障碍,这不仅威胁健康,而且易引发各种意外事故,因而成为严重的医学及社会问题。通过对睡眠心理和生理的研究,各国学者联合制定了“睡眠疾病国际分类”[1],将睡眠疾病分为4大类(共88种):睡眠失调(包括失眠、过度睡眠等)、深眠障碍(以睡眠期间骨骼肌和自主神经功能障碍为主)、伴发睡眠障碍的其他神经精神等疾患(如焦虑症、痴呆、慢性阻塞性肺病)、其他可能的睡眠疾患(如睡眠多汗症等)。常见的睡眠疾病包括失眠、睡眠呼吸暂停综合征(sleep apnea syndrome, SAS)、不宁腿综合征(restless legs syndrome,RLS)、发作性睡病、快动眼睡眠期行为障碍(rapid eye movement sleep behaviour disorders,RBD)等。
目前,睡眠疾病主要通过临床表现、脑电图、多导睡眠图(polysomnography,PSG)及实验室检查等方法进行诊断。中枢神经系统功能影像学技术可以在活体状态下客观反映脑部细微结构、血流灌注、葡萄糖等物质代谢、神经递质及受体变化,成为目前研究睡眠疾病的发病机制、病理改变及与其他神经系统疾病关系的重要手段。本文就常见的睡眠疾病的功能影像学研究进展进行综述。
睡眠疾病的功能影像学研究进展
Functional neuroimaging of sleep disorders
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摘要: 睡眠疾病严重影响着人类的日常生活和健康,然而其发病机制及病理改变尚不清楚。功能影像学为睡眠疾病的研究提供了较好的平台,该文主要就几种常见的睡眠障碍疾病的功能影像学研究进展进行综述,同时简要介绍各种疾病的临床表现、脑部结构异常及主要病理改变。
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关键词:
- 入睡和失眠障碍 /
- 发作性睡病 /
- 睡眠呼吸暂停综合征 /
- 不宁腿综合征 /
- 快动眼睡眠期行为障碍 /
- 正电子发射断层显像术
Abstract: Sleep disorders may affect the health and normal life of human badly. However, the pathophysiology underlying adult sleep disorders is still unclear. Functional neuroimaging can be used to investigate whether sleep disorders are associated with specific changes in brain structure or regional activity. This paper reviews functional brain imaging findings in major intrinsic sleep disorders(i.e., idiopathic insomnia, narcolepsy, and obstructive sleep apnea)and in abnormal motor behavior during sleep(i.e., periodic limb movement disorder and REM sleep behavior disorder). Metabolic/functional investigations(positron emission tomography, single photon emission computed tomography, functional magnetic resonance imaging)are mainly reviewed, as well as neuroanatomical assessments (voxel-based morphometry, magnetic resonance spectroscopy). Meanwhile, here are some brief introduction of different kinds of sleep disorders. -
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