远程医疗提供的认知行为疗法 - - 改善睡眠质量和使纤维肌痛突出网络正常化的潜在解决方案:试点随机试验
Nguyen Thanh Nhu1,2, Cheng-Ze Wong3, Ivy Y Chen4
1International PhD Program in Medicine, College of Medicine, Taipei Medical University, Taipei, 110, Taiwan.
Brain imaging and behavior
|September 17, 2024
概括
针对失眠的远程医疗认知行为疗法 (tele-CBT-I) 改善了纤维肌痛患者的睡眠质量. 这种疗法还使突出网络功能正常化,特别是在皮质区域,与减少失眠严重程度相关.
科学领域:
- 神经科学是一个神经科学.
- 精神病学是一个精神病学.
- 医疗成像医学成像
背景情况:
- 纤维肌痛 (FM) 经常与失眠并发,影响患者的生活质量.
- 突出网络在处理感官和情感信息方面发挥着至关重要的作用,其功能障碍与FM有关.
- 对于失眠的认知行为治疗 (tele-CBT-I) 的远程医疗提供了一个可扩展的治疗选择.
研究的目的:
- 调查tele-CBT-I的临床益处与纤维肌痛患者失眠的突出网络之间的关联.
- 为了比较tele-CBT-I和常规治疗 (TAU) 组之间的临床症状和突出网络的功能连接 (FC) 的变化.
主要方法:
- 35名患有不眠症的FM患者被随机分配到电话CBT-I (n=17) 或TAU (n=18) 中.
- 临床状态使用标准化尺度进行评估;休息状态功能磁共振成像 (fMRI) 用于评估突出网络FC.
- 进行了因子分析和相关性分析,以将临床变化与FC变化联系起来.
主要成果:
- 与TAU组相比,远程CBT-I组的睡眠质量明显改善 (p=0.038).
- 与TAU相比,Tele-CBT-I导致皮质FC下降,皮质下FC在突出网络内增加.
- 在远程CBT-I组 (p=0.0002) 中,发现突出网络的皮质因子和失眠严重性指数 (ISI) 分数降低之间存在显著的关联.
结论:
- 电话-CBT-I是有效的改善纤维肌痛患者的睡眠质量,并发性失眠.
- 远程CBT-I可以在突出网络中正常化皮质和皮质下功能连接.
- 这些发现表明,远程CBT-I可能是治疗纤维肌痛失眠的有价值的辅助疗法.
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