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Bresser T, Blanken TF, de Lange SC, Leerssen J, Foster-Dingley JC, Lakbila-Kamal O, Wassing R, Ramautar JR, Stoffers D, van de Heuvel MP, van Someren EJW. Insomnia subtypes have differentiating deviations in brain structural connectivity. Biol Psychiatry 2024:S0006-3223(24)01418-5. [PMID: 38944140 DOI: 10.1016/j.biopsych.2024.06.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/07/2023] [Revised: 06/10/2024] [Accepted: 06/18/2024] [Indexed: 07/01/2024]
Abstract
OBJECTIVE Insomnia disorder is the most common sleep disorder. A better understanding of insomnia-related deviations in the brain could inspire better treatment. Insufficiently recognized heterogeneity within the insomnia population could obscure detection of involved brain circuits. The present study investigated whether structural brain connectivity deviations differ between recently discovered and validated insomnia subtypes. METHODS Structural and diffusion weighted 3-Tesla MRI data of four independent studies were harmonized. The sample consisted of 73 controls without sleep complaints and 204 participants with insomnia grouped into five subtypes based on their fingerprint of mood and personality traits assessed with the Insomnia Type Questionnaire. Linear regression correcting for age and sex evaluated group differences in structural connectivity strength, indicated by fractional anisotropy, streamline volume density and mean diffusivity, and evaluated within three different atlases. RESULTS Insomnia subtypes showed differentiating profiles of deviating structural connectivity which concentrated in different functional networks. Permutation testing against randomly drawn heterogeneous subsamples indicated significant specificity of deviation profiles in four of the five subtypes: highly distressed, moderately distressed reward sensitive, slightly distressed low reactive and slightly distressed high reactive. Connectivity deviation profile significance ranged from p= 0.001 to p=0.049 for different resolutions of brain parcellation and connectivity weight. CONCLUSIONS Our results provide a first indication that different insomnia subtypes exhibit distinct profiles of deviations in structural brain connectivity. Subtyping of insomnia could be essential for a better understanding of brain mechanisms that contribute to insomnia vulnerability.
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Affiliation(s)
- Tom Bresser
- Netherlands Institute for Neuroscience, Department of Sleep and Cognition, Amsterdam, Netherlands,; Vrije Universiteit Amsterdam, Department of Integrative Neurophysiology, Amsterdam, Netherlands; Department of Complex Trait Genetics, Center for Neurogenomics and Cognitive Research, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.
| | - Tessa F Blanken
- Netherlands Institute for Neuroscience, Department of Sleep and Cognition, Amsterdam, Netherlands,; University of Amsterdam, Department of Psychological Methods, Amsterdam, Netherlands
| | - Siemon C de Lange
- Netherlands Institute for Neuroscience, Department of Sleep and Cognition, Amsterdam, Netherlands,; Department of Complex Trait Genetics, Center for Neurogenomics and Cognitive Research, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Jeanne Leerssen
- Netherlands Institute for Neuroscience, Department of Sleep and Cognition, Amsterdam, Netherlands
| | - Jessica C Foster-Dingley
- Netherlands Institute for Neuroscience, Department of Sleep and Cognition, Amsterdam, Netherlands
| | - Oti Lakbila-Kamal
- Netherlands Institute for Neuroscience, Department of Sleep and Cognition, Amsterdam, Netherlands,; Vrije Universiteit Amsterdam, Department of Integrative Neurophysiology, Amsterdam, Netherlands; Department of Psychiatry, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, The Netherlands
| | - Rick Wassing
- Netherlands Institute for Neuroscience, Department of Sleep and Cognition, Amsterdam, Netherlands,; Woolcock Institute and School of Psychological Sciences, Faculty of Medicine, Health and Human Sciences, Macquarie University, Sydney, NSW, Australia; Sydney Local Health District, Sydney, NSW, Australia
| | - Jennifer R Ramautar
- Netherlands Institute for Neuroscience, Department of Sleep and Cognition, Amsterdam, Netherlands,; N=You Neurodevelopmental Precision Center, Amsterdam Neuroscience, Amsterdam Reproduction and Development, Amsterdam UMC, Amsterdam, The Netherlands; Child and Adolescent Psychiatry and Psychosocial Care, Emma Children's Hospital, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - Diederick Stoffers
- Netherlands Institute for Neuroscience, Department of Sleep and Cognition, Amsterdam, Netherlands,; Spinoza Centre for Neuroimaging, Amsterdam, The Netherlands
| | - Martijn P van de Heuvel
- Department of Complex Trait Genetics, Center for Neurogenomics and Cognitive Research, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands; Department of Child and Adolescent Psychiatry and Psychology, Amsterdam UMC location Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Eus J W van Someren
- Netherlands Institute for Neuroscience, Department of Sleep and Cognition, Amsterdam, Netherlands,; Vrije Universiteit Amsterdam, Department of Integrative Neurophysiology, Amsterdam, Netherlands; Department of Psychiatry, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, The Netherlands
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Wu S, Peng H, Deng H, Guo Z, Jiang Z, Mu Q. Insomnia disorder characterized by probabilistic metastable substates using blood-oxygenation-level-dependent (BOLD) phase signals. Sleep Breath 2024; 28:1409-1414. [PMID: 38451462 DOI: 10.1007/s11325-024-03018-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2023] [Revised: 02/12/2024] [Accepted: 03/01/2024] [Indexed: 03/08/2024]
Abstract
PURPOSE From a clinical point of view, how to force a transition from insomnia brain state to healthy brain state by external driven stimulation is of great interest. This needs to define brain state of insomnia disorder as metastable substates. The current study was to identify recurrent substates of insomnia disorder in terms of probability of occurrence, lifetime, and alternation profiles by using leading eigenvector dynamics analysis (LEiDA) method. METHODS We enrolled 32 patients with insomnia disorder and 30 healthy subjects. We firstly obtained the BOLD phase coherence matrix from Hilbert transform of BOLD signals and then extracted all the leading eigenvectors from the BOLD phase coherence matrix for all subjects across all time points. Lastly, we clustered the leading eigenvectors using a k-means clustering algorithm to find the probabilistic metastable substates (PMS) and calculate the probability of occurrence and associated lifetime for substates. RESULTS The resulting 3 clusters were optimal for brain state of insomnia disorder and healthy brain state, respectively. The occurred probabilities of the PMS were significantly different between the patients with insomnia disorder and healthy subjects, with 0.51 versus 0.44 for PMS-1 (p < 0.001), 0.25 versus 0.27 for PMS-2 (p = 0.051), and 0.24 versus 0.29 for PMS-3 (p < 0.001), as well as the lifetime (in TR) of 36.65 versus 33.15 for PMS-1 (p = 0.068), 14.36 versus 15.43 for PMS-2 (p = 0.117), and 14.80 versus 16.34 for PMS-3 (p = 0.042). The values of the diagonal of the transition matrix were much higher than the probabilities of switching states, indicating the metastable nature of substates. CONCLUSION The resulted probabilistic metastable substates hint the characteristic brain dynamics of insomnia disorder. The results may lay a foundation to help determine how to force a transition from insomnia brain state to healthy brain state by external driven stimulation.
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Affiliation(s)
- Suzhou Wu
- Department of Radiology, Yilong Country Hospital of Traditional Chinese Medicine, Nanchong, 637000, Sichuan, China
| | - Huaiping Peng
- Department of Radiology, Nanchong Central Hospital, The Second Clinical Medical College, North Sichuan Medical College, Institute of Brain Function, Nanchong, 637000, Sichuan, China
| | - Haobing Deng
- Department of Radiology, Nanchong Central Hospital, The Second Clinical Medical College, North Sichuan Medical College, Institute of Brain Function, Nanchong, 637000, Sichuan, China
| | - Zhiwei Guo
- Department of Radiology, Nanchong Central Hospital, The Second Clinical Medical College, North Sichuan Medical College, Institute of Brain Function, Nanchong, 637000, Sichuan, China
| | - Zhijun Jiang
- Department of Radiology, Nanchong Central Hospital, The Second Clinical Medical College, North Sichuan Medical College, Institute of Brain Function, Nanchong, 637000, Sichuan, China
| | - Qiwen Mu
- Department of Radiology, Nanchong Central Hospital, The Second Clinical Medical College, North Sichuan Medical College, Institute of Brain Function, Nanchong, 637000, Sichuan, China.
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3
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Curtis AF, Nair N, Hayse B, McGovney K, Mikula C, Halder P, Craggs JG, Kiselica A, McCrae CS. Preliminary investigation of the interactive role of physiological arousal and insomnia complaints in gray matter volume alterations in chronic widespread pain. J Clin Sleep Med 2024; 20:293-302. [PMID: 37823586 PMCID: PMC10835766 DOI: 10.5664/jcsm.10860] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Revised: 10/06/2023] [Accepted: 10/06/2023] [Indexed: 10/13/2023]
Abstract
STUDY OBJECTIVES Brain regions involved in insomnia and chronic pain are overlapping and diffuse. The interactive role of physiological arousal in associations between insomnia symptoms and neural regions is unknown. This preliminary study examined whether arousal interacted with sleep in associations with gray matter volume of frontal (dorsolateral prefrontal cortex, anterior cingulate cortex) and temporal (right/left hippocampus) regions in adults with chronic widespread pain and insomnia complaints. METHODS Forty-seven adults with chronic widespread pain and insomnia (mean age = 46.00, standard deviation = 13.88, 89% women) completed 14 daily diaries measuring sleep onset latency (SOL), wake time after sleep onset, and total sleep time (TST), as well as Holter monitor assessments of heart rate variability (measuring physiological arousal), and magnetic resonance imaging. Multiple regressions examined whether average SOL, wake time after sleep onset, or TST were independently or interactively (with arousal/heart rate variability) associated with dorsolateral prefrontal cortex, anterior cingulate cortex, and left/right hippocampus gray matter volumes. RESULTS Shorter TST was associated with lower right hippocampus volume. TST also interacted with arousal in its association with right hippocampal volume, Specifically, shorter TST was associated with lower volume at highest and average arousal levels. SOL interacted with arousal in its association with anterior cingulate cortex volume, such that, among individuals with lowest arousal, longer SOL was associated with lower volume. CONCLUSIONS Preliminary findings highlight the interactive roles of physiological arousal and insomnia symptoms in associations with neural structure in chronic widespread pain and insomnia. Individuals with the highest physiological arousal may be particularly vulnerable to the impact of shorter TST on hippocampal volume loss. Reducing SOL may only impact anterior cingulate cortex volume in those with lower physiological arousal. CITATION Curtis AF, Nair N, Hayse B, et al. Preliminary investigation of the interactive role of physiological arousal and insomnia complaints in gray matter volume alterations in chronic widespread pain. J Clin Sleep Med. 2024;20(2):293-302.
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Affiliation(s)
- Ashley F. Curtis
- College of Nursing, University of South Florida, Tampa, Florida
- Department of Psychiatry, University of Missouri-Columbia, Columbia, Missouri
- Department of Psychological Sciences, University of Missouri-Columbia, Columbia, Missouri
| | - Neetu Nair
- Department of Psychiatry, University of Missouri-Columbia, Columbia, Missouri
| | - Braden Hayse
- Department of Psychiatry, University of Missouri-Columbia, Columbia, Missouri
| | - Kevin McGovney
- Department of Psychological Sciences, University of Missouri-Columbia, Columbia, Missouri
| | - Cynthia Mikula
- Department of Health Psychology, University of Missouri-Columbia, Columbia, Missouri
| | - Puja Halder
- Department of Psychiatry, University of Missouri-Columbia, Columbia, Missouri
| | - Jason G. Craggs
- Department of Psychiatry, University of Missouri-Columbia, Columbia, Missouri
- Department of Physical Therapy, University of Missouri-Columbia, Columbia, Missouri
- Department of Psychiatry & Behavioral Neurosciences, University of South Florida, Tampa, FL
| | - Andrew Kiselica
- Department of Health Psychology, University of Missouri-Columbia, Columbia, Missouri
| | - Christina S. McCrae
- College of Nursing, University of South Florida, Tampa, Florida
- Department of Psychiatry, University of Missouri-Columbia, Columbia, Missouri
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4
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Altena E, Ellis J, Camart N, Guichard K, Bastien C. Mechanisms of cognitive behavioural therapy for insomnia. J Sleep Res 2023; 32:e13860. [PMID: 36866434 DOI: 10.1111/jsr.13860] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Revised: 02/03/2023] [Accepted: 02/03/2023] [Indexed: 03/04/2023]
Abstract
Although much is known now about behavioural, cognitive and physiological consequences of insomnia, little is known about changes after cognitive behavioural therapy for insomnia on these particular factors. We here report baseline findings on each of these factors in insomnia, after which we address findings on their changes after cognitive behavioural therapy. Sleep restriction remains the strongest determinant of insomnia treatment success. Cognitive interventions addressing dysfunctional beliefs and attitudes about sleep, sleep-related selective attention, worry and rumination further drive effectiveness of cognitive behavioural therapy for insomnia. Future studies should focus on physiological changes after cognitive behavioural therapy for insomnia, such as changes in hyperarousal and brain activity, as literature on these changes is sparse. We introduce a detailed clinical research agenda on how to address this topic.
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Affiliation(s)
| | - Jason Ellis
- Northumbria Centre for Sleep Research, Northumbria University, Newcastle, UK
| | - Nathalie Camart
- UR CLIPSYD, UFR SPSE, Département de psychologie, Université Paris Nanterre, Nanterre, France
- Cabinet Pôle Psy République, Bordeaux, France
- Nouvelle Clinique Bel Air- PEAS, Bordeaux, France
| | - Kelly Guichard
- Nouvelle Clinique Bel Air- PEAS, Bordeaux, France
- CHU Bordeaux, Centre Hypersomnies Rares, Bordeaux, France
| | - Célyne Bastien
- Ecole de Psychologie, Université Laval, Québec, Québec, Canada
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5
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Reimann GM, Küppers V, Camilleri JA, Hoffstaedter F, Langner R, Laird AR, Fox PT, Spiegelhalder K, Eickhoff SB, Tahmasian M. Convergent abnormality in the subgenual anterior cingulate cortex in insomnia disorder: A revisited neuroimaging meta-analysis of 39 studies. Sleep Med Rev 2023; 71:101821. [PMID: 37481961 DOI: 10.1016/j.smrv.2023.101821] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Revised: 07/13/2023] [Accepted: 07/13/2023] [Indexed: 07/25/2023]
Abstract
The neurobiological underpinnings of insomnia disorder (ID) are still poorly understood. A previous meta-analysis conducted by our research group in 2018 revealed no consistent regional alterations based on the limited number of eligible studies. Given the number of studies published during the last few years, we revisited the meta-analysis to provide an update to the field. Following the best-practice guidelines for conducting neuroimaging meta-analyses, we searched several databases (PubMed, Web of Science, and BrainMap) and identified 39 eligible structural and functional studies, reporting coordinates reflecting significant group differences between ID patients and healthy controls. A significant convergent regional alteration in the subgenual anterior cingulate cortex (sgACC) was observed using the activation likelihood estimation algorithm. Behavioural decoding using the BrainMap database indicated that this region is involved in fear-related emotional and cognitive processing. The sgACC showed robust task-based co-activation in meta-analytic connectivity modelling and task-free functional connectivity in a resting-state functional connectivity analysis with the main hubs of the salience and default mode networks, including the posterior cingulate cortex and dorsal ACC, amygdala, hippocampus, and medial prefrontal cortex. Collectively, the findings from this large-scale meta-analysis suggest a critical role of the sgACC in the pathophysiology of ID.
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Affiliation(s)
- Gerion M Reimann
- Institute of Neuroscience and Medicine, Brain and Behaviour (INM-7), Research Centre Jülich, Jülich, Germany
| | - Vincent Küppers
- Institute of Neuroscience and Medicine, Brain and Behaviour (INM-7), Research Centre Jülich, Jülich, Germany; Department of Nuclear Medicine, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Julia A Camilleri
- Institute of Neuroscience and Medicine, Brain and Behaviour (INM-7), Research Centre Jülich, Jülich, Germany; Institute of Systems Neuroscience, Medical Faculty, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
| | - Felix Hoffstaedter
- Institute of Neuroscience and Medicine, Brain and Behaviour (INM-7), Research Centre Jülich, Jülich, Germany; Institute of Systems Neuroscience, Medical Faculty, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
| | - Robert Langner
- Institute of Neuroscience and Medicine, Brain and Behaviour (INM-7), Research Centre Jülich, Jülich, Germany; Institute of Systems Neuroscience, Medical Faculty, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
| | - Angela R Laird
- Department of Physics, Florida International University, Miami, FL, USA
| | - Peter T Fox
- Research Imaging Institute, University of Texas Health Science Centre, San Antonio, TX, USA; South Texas Veterans Health Care System, San Antonio, TX, USA
| | - Kai Spiegelhalder
- Department of Psychiatry and Psychotherapy, Medical Centre, University of Freiburg - Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Simon B Eickhoff
- Institute of Neuroscience and Medicine, Brain and Behaviour (INM-7), Research Centre Jülich, Jülich, Germany; Institute of Systems Neuroscience, Medical Faculty, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
| | - Masoud Tahmasian
- Institute of Neuroscience and Medicine, Brain and Behaviour (INM-7), Research Centre Jülich, Jülich, Germany; Institute of Systems Neuroscience, Medical Faculty, Heinrich Heine University Düsseldorf, Düsseldorf, Germany.
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6
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Schiel JE, Tamm S, Holub F, Petri R, Dashti HS, Domschke K, Feige B, Goodman MO, Jones SE, Lane JM, Ratti PL, Ray DW, Redline S, Riemann D, Rutter MK, Saxena R, Sexton CE, Tahmasian M, Wang H, Weedon MN, Weihs A, Kyle SD, Spiegelhalder K. Associations between sleep health and grey matter volume in the UK Biobank cohort ( n = 33 356). Brain Commun 2023; 5:fcad200. [PMID: 37492488 PMCID: PMC10365832 DOI: 10.1093/braincomms/fcad200] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2023] [Revised: 06/11/2023] [Accepted: 07/11/2023] [Indexed: 07/27/2023] Open
Abstract
As suggested by previous research, sleep health is assumed to be a key determinant of future morbidity and mortality. In line with this, recent studies have found that poor sleep is associated with impaired cognitive function. However, to date, little is known about brain structural abnormalities underlying this association. Although recent findings link sleep health deficits to specific alterations in grey matter volume, evidence remains inconsistent and reliant on small sample sizes. Addressing this problem, the current preregistered study investigated associations between sleep health and grey matter volume (139 imaging-derived phenotypes) in the UK Biobank cohort (33 356 participants). Drawing on a large sample size and consistent data acquisition, sleep duration, insomnia symptoms, daytime sleepiness, chronotype, sleep medication and sleep apnoea were examined. Our main analyses revealed that long sleep duration was systematically associated with larger grey matter volume of basal ganglia substructures. Insomnia symptoms, sleep medication and sleep apnoea were not associated with any of the 139 imaging-derived phenotypes. Short sleep duration, daytime sleepiness as well as late and early chronotype were associated with solitary imaging-derived phenotypes (no recognizable pattern, small effect sizes). To our knowledge, this is the largest study to test associations between sleep health and grey matter volume. Clinical implications of the association between long sleep duration and larger grey matter volume of basal ganglia are discussed. Insomnia symptoms as operationalized in the UK Biobank do not translate into grey matter volume findings.
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Affiliation(s)
- Julian E Schiel
- Department of Psychiatry and Psychotherapy, Faculty of Medicine, Medical Center—University of Freiburg, Hauptstraße 5, 79104 Freiburg, Germany
| | - Sandra Tamm
- Department of Clinical Neuroscience, Karolinska Institutet, Retzius väg 8, 17165 Stockholm, Sweden
- Department of Psychiatry, University of Oxford, Warneford Lane, OX3 7JX Oxford, UK
| | - Florian Holub
- Department of Psychiatry and Psychotherapy, Faculty of Medicine, Medical Center—University of Freiburg, Hauptstraße 5, 79104 Freiburg, Germany
| | - Roxana Petri
- Department of Psychiatry and Psychotherapy, Faculty of Medicine, Medical Center—University of Freiburg, Hauptstraße 5, 79104 Freiburg, Germany
| | - Hassan S Dashti
- Program in Medical and Population Genetics, Broad Institute of MIT and Harvard, Main St. 415, Cambridge, MA 02142, USA
- Center for Genomic Medicine, Massachusetts General Hospital, Cambridge St. 185, Boston, MA 02114, USA
- Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital and Harvard Medical School,Fruit St. 55, Boston, MA 02114, USA
| | - Katharina Domschke
- Department of Psychiatry and Psychotherapy, Faculty of Medicine, Medical Center—University of Freiburg, Hauptstraße 5, 79104 Freiburg, Germany
| | - Bernd Feige
- Department of Psychiatry and Psychotherapy, Faculty of Medicine, Medical Center—University of Freiburg, Hauptstraße 5, 79104 Freiburg, Germany
| | - Matthew O Goodman
- Division of Sleep and Circadian Disorders, Brigham and Women’s Hospital and Harvard Medical School, Francis St. 75, Boston, MA 02115, USA
| | - Samuel E Jones
- Institute for Molecular Medicine (FIMM), University of Helsinki, Tukholmankatu 8, 00290 Helsinki, Finland
| | - Jacqueline M Lane
- Program in Medical and Population Genetics, Broad Institute of MIT and Harvard, Main St. 415, Cambridge, MA 02142, USA
- Center for Genomic Medicine, Massachusetts General Hospital, Cambridge St. 185, Boston, MA 02114, USA
- Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital and Harvard Medical School,Fruit St. 55, Boston, MA 02114, USA
| | - Pietro-Luca Ratti
- Neurocenter of Southern Switzerland, Regional Hospital of Lugano, Viale Officina 3, 6500 Bellinzona, Switzerland
| | - David W Ray
- Division of Endocrinology, Diabetes & Gastroenterology, School of Medical Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Grafton St. 46, M13 9NT Manchester, UK
| | - Susan Redline
- Division of Sleep and Circadian Disorders, Brigham and Women’s Hospital and Harvard Medical School, Francis St. 75, Boston, MA 02115, USA
| | - Dieter Riemann
- Department of Psychiatry and Psychotherapy, Faculty of Medicine, Medical Center—University of Freiburg, Hauptstraße 5, 79104 Freiburg, Germany
| | - Martin K Rutter
- Faculty of Biology, Medicine and Health, Centre for Biological Timing, University of Manchester, Grafton St. 46, M13 9NT Manchester, UK
- Diabetes, Endocrinology and Metabolism Centre, Manchester University NHS Foundation Trust, Manchester Academic Health Science Centre, Grafton St. 46, M13 9NT Manchester, UK
| | - Richa Saxena
- Program in Medical and Population Genetics, Broad Institute of MIT and Harvard, Main St. 415, Cambridge, MA 02142, USA
- Center for Genomic Medicine, Massachusetts General Hospital, Cambridge St. 185, Boston, MA 02114, USA
- Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital and Harvard Medical School,Fruit St. 55, Boston, MA 02114, USA
| | - Claire E Sexton
- Department of Psychiatry, University of Oxford, Warneford Lane, OX3 7JX Oxford, UK
- Department of Neurology, Global Brain Health Institute, Memory and Aging Center, University of California, Nelson Rising Lane 675, San Francisco, CA 94158, USA
| | - Masoud Tahmasian
- Institute of Neuroscience and Medicine, Brain and Behavior (INM-7), Research Center Jülich, Wilhelm-Johnen-Straße 14.6y, 52428 Jülich, Germany
- Medical Faculty, Institute for Systems Neuroscience, Heinrich-Heine University Düsseldorf, Moorenstraße 5, 40225 Düsseldorf, Germany
| | - Heming Wang
- Program in Medical and Population Genetics, Broad Institute of MIT and Harvard, Main St. 415, Cambridge, MA 02142, USA
- Division of Sleep and Circadian Disorders, Brigham and Women’s Hospital and Harvard Medical School, Francis St. 75, Boston, MA 02115, USA
- Department of Population and Quantitative Health Sciences, Case Western Reserve University, Euclid Ave. 10900, Cleveland, OH 44106-7288, USA
| | - Michael N Weedon
- Genetics of Complex Traits, University of Exeter Medical School, Royal Devon & Exeter Hospital, Barrack Road, EX2 5DW Exeter, UK
| | - Antoine Weihs
- Department of Psychiatry and Psychotherapy, University Medicine Greifswald, Ellernholzstraße 1-2, 17475 Greifswald, Germany
| | - Simon D Kyle
- Nuffield Department of Clinical Neurosciences, Sleep and Circadian Neuroscience Institute (SCNi), University of Oxford, South Parks Road, OX1 3QU Oxford, UK
| | - Kai Spiegelhalder
- Department of Psychiatry and Psychotherapy, Faculty of Medicine, Medical Center—University of Freiburg, Hauptstraße 5, 79104 Freiburg, Germany
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7
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Holub F, Petri R, Schiel J, Feige B, Rutter MK, Tamm S, Riemann D, Kyle SD, Spiegelhalder K. Associations between insomnia symptoms and functional connectivity in the UK Biobank cohort (n = 29,423). J Sleep Res 2023; 32:e13790. [PMID: 36528860 DOI: 10.1111/jsr.13790] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2022] [Revised: 09/13/2022] [Accepted: 11/03/2022] [Indexed: 12/23/2022]
Abstract
An increasing number of studies harness resting-state fMRI functional connectivity analysis to investigate the neurobiological mechanisms of insomnia. The results to date are inconsistent and the detection of minor and widely distributed alterations in functional connectivity requires large sample sizes. The present study investigated associations between insomnia symptoms and resting-state functional connectivity at the whole-brain level in the largest sample to date. This cross-sectional analysis used resting-state imaging data from the UK Biobank, a large scale, population-based biomedical database. The analysis included 29,423 participants (age: 63.1 ± 7.5 years, 54.3% female), comprising 9210 with frequent insomnia symptoms and 20,213 controls without. Linear models were adjusted for relevant clinical, imaging, and socio-demographic variables. The Akaike information criterion was used for model selection. Multiple comparisons were corrected using the false discovery rate with a significance level of q < 0.05. Frequent insomnia symptoms were associated with increased connectivity within the default mode network and frontoparietal network, increased negative connectivity between the default mode network and the frontoparietal network, and decreased connectivity between the salience network and a node of the default mode network. Furthermore, frequent insomnia symptoms were associated with altered functional connectivity between nodes comprising sensory areas and the cerebellum. These functional alterations of brain networks may underlie dysfunctional affective and cognitive processing in insomnia and contribute to subjectively and objectively impaired sleep. However, it must be noted that the item that was used to assess frequent insomnia symptoms in this study did not assess all the characteristics of clinically diagnosed insomnia.
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Affiliation(s)
- Florian Holub
- Department of Psychiatry and Psychotherapy, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Roxana Petri
- Department of Psychiatry and Psychotherapy, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Julian Schiel
- Department of Psychiatry and Psychotherapy, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Bernd Feige
- Department of Psychiatry and Psychotherapy, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
- Centre for Basics in NeuroModulation (NeuroModulBasics), Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Martin K Rutter
- Division of Diabetes, Endocrinology and Gastroenterology, School of Medical Sciences, University of Manchester, Manchester, UK
- Diabetes, Endocrinology and Metabolism Centre, Manchester Royal Infirmary, Manchester University NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, UK
| | - Sandra Tamm
- Department of Clinical Neuroscience, Karolinska Institute, Stockholm, Sweden
- Department of Psychiatry, University of Oxford, Oxford, UK
| | - Dieter Riemann
- Department of Psychiatry and Psychotherapy, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
- Centre for Basics in NeuroModulation (NeuroModulBasics), Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Simon D Kyle
- Sleep and Circadian Neuroscience Institute (SCNi), Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK
| | - Kai Spiegelhalder
- Department of Psychiatry and Psychotherapy, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
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8
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Haddad E, Pizzagalli F, Zhu AH, Bhatt RR, Islam T, Ba Gari I, Dixon D, Thomopoulos SI, Thompson PM, Jahanshad N. Multisite test-retest reliability and compatibility of brain metrics derived from FreeSurfer versions 7.1, 6.0, and 5.3. Hum Brain Mapp 2023; 44:1515-1532. [PMID: 36437735 PMCID: PMC9921222 DOI: 10.1002/hbm.26147] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2022] [Revised: 10/19/2022] [Accepted: 10/19/2022] [Indexed: 11/29/2022] Open
Abstract
Automatic neuroimaging processing tools provide convenient and systematic methods for extracting features from brain magnetic resonance imaging scans. One tool, FreeSurfer, provides an easy-to-use pipeline to extract cortical and subcortical morphometric measures. There have been over 25 stable releases of FreeSurfer, with different versions used across published works. The reliability and compatibility of regional morphometric metrics derived from the most recent version releases have yet to be empirically assessed. Here, we used test-retest data from three public data sets to determine within-version reliability and between-version compatibility across 42 regional outputs from FreeSurfer versions 7.1, 6.0, and 5.3. Cortical thickness from v7.1 was less compatible with that of older versions, particularly along the cingulate gyrus, where the lowest version compatibility was observed (intraclass correlation coefficient 0.37-0.61). Surface area of the temporal pole, frontal pole, and medial orbitofrontal cortex, also showed low to moderate version compatibility. We confirm low compatibility between v6.0 and v5.3 of pallidum and putamen volumes, while those from v7.1 were compatible with v6.0. Replication in an independent sample showed largely similar results for measures of surface area and subcortical volumes, but had lower overall regional thickness reliability and compatibility. Batch effect correction may adjust for some inter-version effects when most sites are run with one version, but results vary when more sites are run with different versions. Age associations in a quality controlled independent sample (N = 106) revealed version differences in results of downstream statistical analysis. We provide a reference to highlight the regional metrics that may yield recent version-related inconsistencies in published findings. An interactive viewer is provided at http://data.brainescience.org/Freesurfer_Reliability/.
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Affiliation(s)
- Elizabeth Haddad
- Imaging Genetics Center, Mark and Mary Stevens Neuroimaging and Informatics Institute, Keck School of Medicine, University of Southern California, Marina del Rey, California, USA
| | - Fabrizio Pizzagalli
- Imaging Genetics Center, Mark and Mary Stevens Neuroimaging and Informatics Institute, Keck School of Medicine, University of Southern California, Marina del Rey, California, USA.,Department of Neurosciences, University of Turin, Turin, Italy
| | - Alyssa H Zhu
- Imaging Genetics Center, Mark and Mary Stevens Neuroimaging and Informatics Institute, Keck School of Medicine, University of Southern California, Marina del Rey, California, USA
| | - Ravi R Bhatt
- Imaging Genetics Center, Mark and Mary Stevens Neuroimaging and Informatics Institute, Keck School of Medicine, University of Southern California, Marina del Rey, California, USA
| | - Tasfiya Islam
- Imaging Genetics Center, Mark and Mary Stevens Neuroimaging and Informatics Institute, Keck School of Medicine, University of Southern California, Marina del Rey, California, USA
| | - Iyad Ba Gari
- Imaging Genetics Center, Mark and Mary Stevens Neuroimaging and Informatics Institute, Keck School of Medicine, University of Southern California, Marina del Rey, California, USA
| | - Daniel Dixon
- Imaging Genetics Center, Mark and Mary Stevens Neuroimaging and Informatics Institute, Keck School of Medicine, University of Southern California, Marina del Rey, California, USA
| | - Sophia I Thomopoulos
- Imaging Genetics Center, Mark and Mary Stevens Neuroimaging and Informatics Institute, Keck School of Medicine, University of Southern California, Marina del Rey, California, USA
| | - Paul M Thompson
- Imaging Genetics Center, Mark and Mary Stevens Neuroimaging and Informatics Institute, Keck School of Medicine, University of Southern California, Marina del Rey, California, USA
| | - Neda Jahanshad
- Imaging Genetics Center, Mark and Mary Stevens Neuroimaging and Informatics Institute, Keck School of Medicine, University of Southern California, Marina del Rey, California, USA
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9
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Diagnostic identification of chronic insomnia using ALFF and FC features of resting-state functional MRI and logistic regression approach. Sci Rep 2023; 13:406. [PMID: 36624131 PMCID: PMC9829915 DOI: 10.1038/s41598-022-24837-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Accepted: 11/21/2022] [Indexed: 01/11/2023] Open
Abstract
This study investigated whether the amplitude of low-frequency fluctuation (ALFF) and functional connectivity (FC) features could be used as potentially neurological markers to identify chronic insomnia (CI) using resting-state functional MRI and machine learning method logistic regression (LR). This study included 49 CI patients and 47 healthy controls (HC). Voxel-wise features, including the amplitude of low-frequency fluctuations (ALFF) and functional connectivity (FC), were extracted from resting-state functional magnetic resonance brain images. Then, we divided the data into two independent cohorts for training (44 CI patients and 42 HC patients), and independent validation (5 CI patients and 5 HC patients) by using logistic regression. The model was evaluated using 20 rounds of fivefold cross‑validation for training. In particular, a two-sample t-test (GRF corrected, p-voxel < 0.001, p-cluster < 0.05) was used for feature selection during the model training. Finally, single‑shot testing of the final model was performed on the independent validation cohort. A correlation analysis (Bonferroni correction, p < 0.05/4) was also conducted to determine whether the features contributing to the prediction were correlated with clinical characteristics, including the Insomnia Severity Index (ISI), Pittsburgh sleep quality index (PSQI), self-rating anxiety scale (SAS), and self-rating depression scale (SDS). Results showed that resting-state features had a discrimination accuracy of 86.40%, with a sensitivity of 93.00% and specificity of 79.80%. The area under the curve (AUC) was 0.89 (all [Formula: see text]< 0.001). The ALFF and FC features showed significant differences between the CI patients and HC. The regions contributing to the prediction mainly included the anterior cingulate, prefrontal cortex, orbital part of the frontal lobe, angular gyrus, cingulate gyrus, praecuneus, parietal lobe, temporal gyrus, superior temporal gyrus, and middle temporal gyrus. Furthermore, some specific functional connectivity among related regions was positively correlated with the ISI, and also negatively related to the SDS in correlation analysis. Our current study suggested that ALFF and FC in the regions contributing to diagnostic identification might serve as potential neuromarkers for CI.
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10
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Zhu L, Dang G, Wu W, Zhou J, Shi X, Su X, Ren H, Pei Z, Lan X, Lian C, Xie P, Guo Y. Functional connectivity changes are correlated with sleep improvement in chronic insomnia patients after rTMS treatment. Front Neurosci 2023; 17:1135995. [PMID: 37139515 PMCID: PMC10149758 DOI: 10.3389/fnins.2023.1135995] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2023] [Accepted: 03/28/2023] [Indexed: 05/05/2023] Open
Abstract
Background Repetitive transcranial magnetic stimulation (rTMS) has been increasingly used as a treatment modality for chronic insomnia disorder (CID). However, our understanding of the mechanisms underlying the efficacy of rTMS is limited. Objective This study aimed to investigate rTMS-induced alterations in resting-state functional connectivity and to find potential connectivity biomarkers for predicting and tracking clinical outcomes after rTMS. Methods Thirty-seven patients with CID received a 10-session low frequency rTMS treatment applied to the right dorsolateral prefrontal cortex. Before and after treatment, the patients underwent resting-state electroencephalography recordings and a sleep quality assessment using the Pittsburgh Sleep Quality Index (PSQI). Results After treatment, rTMS significantly increased the connectivity of 34 connectomes in the lower alpha frequency band (8-10 Hz). Additionally, alterations in functional connectivity between the left insula and the left inferior eye junction, as well as between the left insula and medial prefrontal cortex, were associated with a decrease in PSQI score. Further, the correlation between the functional connectivity and PSQI persisted 1 month after the completion of rTMS as evidenced by subsequent electroencephalography (EEG) recordings and the PSQI assessment. Conclusion Based on these results, we established a link between alterations in functional connectivity and clinical outcomes of rTMS, which suggested that EEG-derived functional connectivity changes were associated with clinical improvement of rTMS in treating CID. These findings provide preliminary evidence that rTMS may improve insomnia symptoms by modifying functional connectivity, which can be used to inform prospective clinical trials and potentially for treatment optimization.
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Affiliation(s)
- Lin Zhu
- Department of Neurology, Shenzhen People’s Hospital, The Second Clinical Medical College, Jinan University, The First Affiliated Hospital, Southern University of Science and Technology, Shenzhen, Guangdong, China
| | - Ge Dang
- Department of Neurology, Shenzhen People’s Hospital, The Second Clinical Medical College, Jinan University, The First Affiliated Hospital, Southern University of Science and Technology, Shenzhen, Guangdong, China
| | - Wei Wu
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA, United States
| | - Junhong Zhou
- Hebrew Seniorlife, Hinda and Arthur Marcus Institute for Aging Research, Harvard Medical School, Boston, MA, United States
| | - Xue Shi
- Department of Neurology, Shenzhen People’s Hospital, The Second Clinical Medical College, Jinan University, The First Affiliated Hospital, Southern University of Science and Technology, Shenzhen, Guangdong, China
| | - Xiaolin Su
- Department of Neurology, Shenzhen People’s Hospital, The Second Clinical Medical College, Jinan University, The First Affiliated Hospital, Southern University of Science and Technology, Shenzhen, Guangdong, China
| | - Huixia Ren
- Department of Geriatrics, Shenzhen People’s Hospital, The Second Clinical Medical College, Jinan University, The First Affiliated Hospital, Southern University of Science and Technology, Shenzhen, Guangdong, China
| | - Zian Pei
- Shenzhen Bay Laboratory, Shenzhen, Guangdong, China
| | - Xiaoyong Lan
- Shenzhen Bay Laboratory, Shenzhen, Guangdong, China
| | | | - Peng Xie
- NHC Key Laboratory of Diagnosis and Treatment on Brain Functional Diseases, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Yi Guo
- Department of Neurology, Shenzhen People’s Hospital, The Second Clinical Medical College, Jinan University, The First Affiliated Hospital, Southern University of Science and Technology, Shenzhen, Guangdong, China
- Shenzhen Bay Laboratory, Shenzhen, Guangdong, China
- *Correspondence: Yi Guo,
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11
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Associations Between Sleep Health and Amygdala Reactivity to Negative Facial Expressions in the UK Biobank Cohort. Biol Psychiatry 2022; 92:693-700. [PMID: 35933167 DOI: 10.1016/j.biopsych.2022.05.023] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2021] [Revised: 05/05/2022] [Accepted: 05/11/2022] [Indexed: 01/22/2023]
Abstract
BACKGROUND Sleep health (SH) is considered a key determinant of human physiological and psychological well-being. In line with this, previous studies have found that poor sleep is associated with various psychiatric disorders, in particular, with anxiety and depression. Although little is known about the neural mechanisms underlying these associations, recent findings suggest that essential dimensions of SH are associated with altered amygdala reactivity (AR); however, evidence to date is inconsistent and reliant on small sample sizes. METHODS To address this problem, the current preregistered study investigated associations between SH and AR to negative facial expressions in the UK Biobank cohort (25,758 participants). Drawing on a large sample size and consistent data acquisition, 5 dimensions of SH (insomnia symptoms, sleep duration, daytime sleepiness, chronotype, and sleep medication) were examined. RESULTS Exploratory analyses revealed that short sleep duration was associated with decreased AR. The remaining SH dimensions and a composite measure of all SH dimensions were not associated with AR. CONCLUSIONS To our knowledge, this is the largest study to test associations between SH and AR. Habitual short sleep duration may be associated with decreased AR, possibly indicating compensation for impaired prefrontal processes and hampered emotion regulation.
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Watanabe K, Jansen PR, Savage JE, Nandakumar P, Wang X, Hinds DA, Gelernter J, Levey DF, Polimanti R, Stein MB, Van Someren EJW, Smit AB, Posthuma D. Genome-wide meta-analysis of insomnia prioritizes genes associated with metabolic and psychiatric pathways. Nat Genet 2022; 54:1125-1132. [PMID: 35835914 DOI: 10.1038/s41588-022-01124-w] [Citation(s) in RCA: 55] [Impact Index Per Article: 27.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2021] [Accepted: 06/06/2022] [Indexed: 12/20/2022]
Abstract
Insomnia is a heritable, highly prevalent sleep disorder for which no sufficient treatment currently exists. Previous genome-wide association studies with up to 1.3 million subjects identified over 200 associated loci. This extreme polygenicity suggested that many more loci remain to be discovered. The current study almost doubled the sample size to 593,724 cases and 1,771,286 controls, thereby increasing statistical power, and identified 554 risk loci (including 364 novel loci). To capitalize on this large number of loci, we propose a novel strategy to prioritize genes using external biological resources and functional interactions between genes across risk loci. Of all 3,898 genes naively implicated from the risk loci, we prioritize 289 and find brain-tissue expression specificity and enrichment in specific gene sets of synaptic signaling functions and neuronal differentiation. We show that this novel gene prioritization strategy yields specific hypotheses on underlying mechanisms of insomnia that would have been missed by traditional approaches.
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Affiliation(s)
- Kyoko Watanabe
- Department of Complex Trait Genetics, Center for Neurogenomics and Cognitive Research, Neuroscience Campus Amsterdam, VU University Amsterdam, Amsterdam, the Netherlands
| | - Philip R Jansen
- Department of Complex Trait Genetics, Center for Neurogenomics and Cognitive Research, Neuroscience Campus Amsterdam, VU University Amsterdam, Amsterdam, the Netherlands
- Department of Human Genetics, Section Clinical Genetics, Amsterdam University Medical Centers, Amsterdam, the Netherlands
| | - Jeanne E Savage
- Department of Complex Trait Genetics, Center for Neurogenomics and Cognitive Research, Neuroscience Campus Amsterdam, VU University Amsterdam, Amsterdam, the Netherlands
| | | | - Xin Wang
- 23andMe, Inc., Sunnyvale, CA, USA
| | | | - Joel Gelernter
- Department of Psychiatry, Yale University School of Medicine, West Haven, CT, USA
- Department of Psychiatry, Veterans Affairs Connecticut Healthcare System, West Haven, CT, USA
| | - Daniel F Levey
- Department of Psychiatry, Yale University School of Medicine, West Haven, CT, USA
- Department of Psychiatry, Veterans Affairs Connecticut Healthcare System, West Haven, CT, USA
| | - Renato Polimanti
- Department of Psychiatry, Yale University School of Medicine, West Haven, CT, USA
- Department of Psychiatry, Veterans Affairs Connecticut Healthcare System, West Haven, CT, USA
| | - Murray B Stein
- Department of Psychiatry, University of California San Diego, La Jolla, CA, USA
- Psychiatry Service, Veterans Affairs San Diego Healthcare System, San Diego, CA, USA
| | - Eus J W Van Someren
- Departments of Integrative Neurophysiology and Psychiatry InGeest, Amsterdam Neuroscience, VU University and Medical Center, Amsterdam, the Netherlands
- Department of Sleep and Cognition, Netherlands Institute for Neuroscience, an institute of the Royal Netherlands Academy of Arts and Sciences, Amsterdam, the Netherlands
| | - August B Smit
- Department of Molecular and Cellular Neurobiology, Center for Neurogenomics and Cognitive Research, Neuroscience Campus Amsterdam, VU University Amsterdam, Amsterdam, the Netherlands
| | - Danielle Posthuma
- Department of Complex Trait Genetics, Center for Neurogenomics and Cognitive Research, Neuroscience Campus Amsterdam, VU University Amsterdam, Amsterdam, the Netherlands.
- Department of Child and Adolescent Psychiatry and Pediatric Psychology, Section Complex Trait Genetics, Amsterdam Neuroscience, Vrije Universiteit Medical Center, Amsterdam University Medical Centers, Amsterdam, the Netherlands.
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13
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Peng J, Yang J, Li N, Lei D, Li J, Duan L, Chen C, Zeng Y, Xi J, Jiang Y, Gong Q, Peng R. Topologically Disrupted Gray Matter Networks in Drug-Naïve Essential Tremor Patients With Poor Sleep Quality. Front Neurol 2022; 13:834277. [PMID: 35557617 PMCID: PMC9086904 DOI: 10.3389/fneur.2022.834277] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Accepted: 03/14/2022] [Indexed: 11/16/2022] Open
Abstract
Background Sleep disturbances are widespread among patients with essential tremor (ET) and may have adverse effects on patients' quality of life. However, the pathophysiology underlying poor quality of sleep (QoS) in patients with ET remains unclear. Our study aimed to identify gray matter (GM) network alterations in the topological properties of structural MRI related to QoS in patients with ET. Method We enrolled 45 ET patients with poor QoS (SleET), 59 ET patients with normal QoS (NorET), and 66 healthy controls (HC), and they all underwent a three-dimensional T1-weighted MRI scan. We used a graph-theoretical approach to investigate the topological organization of GM morphological networks, and individual morphological brain networks were constructed according to the interregional similarity of GM volume distributions. Furthermore, we performed network-based statistics, and partial correlation analyses between topographic features and clinical characteristics were conducted. Results Global network organization was disrupted in patients with ET. Compared with the NorET group, the SleET group exhibited disrupted topological GM network organization with a shift toward randomization. Moreover, they showed altered nodal centralities in mainly the frontal, temporal, parietal, and cerebellar lobes. Morphological connection alterations within the default mode network (DMN), salience, and basal ganglia networks were observed in the SleET group and were generally more extensive than those in the NorET and HC groups. Alterations within the cerebello-thalamo-(cortical) network were only detected in the SleET group. The nodal degree of the left thalamus was negatively correlated with the Fahn-Tolosa-Marin Tremor Rating Scale score (r = −0.354, p =0.027). Conclusion Our findings suggest that potential complex interactions underlie tremor and sleep disruptions in patients with ET. Disruptions within the DMN and the cerebello-thalamo-(cortical) network may have a broader impact on sleep quality in patients with ET. Our results offer valuable insight into the neural mechanisms underlying poor QoS in patients with ET.
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Affiliation(s)
- Jiaxin Peng
- Department of Neurology, West China Hospital, Sichuan University, Chengdu, China
| | - Jing Yang
- Department of Radiology, Huaxi MR Research Center (HMRRC), West China Hospital, Sichuan University, Chengdu, China
| | - Nannan Li
- Department of Neurology, West China Hospital, Sichuan University, Chengdu, China
| | - Du Lei
- Department of Radiology, Huaxi MR Research Center (HMRRC), West China Hospital, Sichuan University, Chengdu, China
| | - Junying Li
- Department of Neurology, West China Hospital, Sichuan University, Chengdu, China
| | - Liren Duan
- Department of Neurology, West China Hospital, Sichuan University, Chengdu, China
| | - Chaolan Chen
- Department of Neurology, West China Hospital, Sichuan University, Chengdu, China
| | - Yan Zeng
- Department of Neurology, West China Hospital, Sichuan University, Chengdu, China
| | - Jing Xi
- Department of Neurology, West China Hospital, Sichuan University, Chengdu, China
| | - Yi Jiang
- Department of Neurology, West China Hospital, Sichuan University, Chengdu, China
| | - Qiyong Gong
- Department of Radiology, Huaxi MR Research Center (HMRRC), West China Hospital, Sichuan University, Chengdu, China
| | - Rong Peng
- Department of Neurology, West China Hospital, Sichuan University, Chengdu, China
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14
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Peng J, Yang J, Li J, Lei D, Li N, Suo X, Duan L, Chen C, Zeng Y, Xi J, Jiang Y, Gong Q, Peng R. Disrupted Brain Functional Network Topology in Essential Tremor Patients With Poor Sleep Quality. Front Neurosci 2022; 16:814745. [PMID: 35360181 PMCID: PMC8960629 DOI: 10.3389/fnins.2022.814745] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2021] [Accepted: 01/14/2022] [Indexed: 11/30/2022] Open
Abstract
Sleep disturbances, especially poor quality of sleep (QoS), are common among essential tremor (ET) patients and may have adverse effects on their quality of life, but the etiology driving the poor QoS in these individuals remains inadequately understood. Few data are available on the neuroimaging alterations of ET with poor QoS. Thirty-eight ET patients with poor QoS (SleET), 48 ET patients with normal QoS (NorET), and 80 healthy controls (HCs) participated in this study. All subjects underwent a 3.0-T magnetic resonance imaging (MRI) scan for resting-state functional MRI data collection. Then, the whole-brain functional connectome was constructed by thresholding the partial correlation matrices of 116 brain regions. Graph theory and network-based statistical analyses were performed. We used a non-parametric permutation test for group comparisons of topological metrics. Partial correlation analyses between the topographical features and clinical characteristics were conducted. The SleET and NorET groups exhibited decreased clustering coefficients, global efficiency, and local efficiency and increased the characteristic path length. Both of these groups also showed reduced nodal degree and nodal efficiency in the left superior dorsolateral frontal gyrus, superior frontal medial gyrus (SFGmed), posterior cingulate gyrus (PCG), lingual gyrus, superior occipital gyrus, right middle occipital gyrus, and right fusiform gyrus. The SleET group additionally presented reduced nodal degrees and nodal efficiency in the right SFGmed relative to the NorET and HC groups, and nodal efficiency in the right SFGmed was negatively correlated with the Pittsburgh Sleep Quality Index score. The observed impaired topographical organizations of functional brain networks within the central executive network (CEN), default mode network (DMN), and visual network serve to further our knowledge of the complex interactions between tremor and sleep, adding to our understanding of the underlying neural mechanisms of ET with poor QoS.
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Affiliation(s)
- Jiaxin Peng
- Department of Neurology, West China Hospital, Sichuan University, Chengdu, China
| | - Jing Yang
- Department of Radiology, Huaxi MR Research Center (HMRRC), West China Hospital, Sichuan University, Chengdu, China
| | - Junying Li
- Department of Neurology, West China Hospital, Sichuan University, Chengdu, China
| | - Du Lei
- Department of Radiology, Huaxi MR Research Center (HMRRC), West China Hospital, Sichuan University, Chengdu, China
| | - Nannan Li
- Department of Neurology, West China Hospital, Sichuan University, Chengdu, China
| | - Xueling Suo
- Department of Radiology, Huaxi MR Research Center (HMRRC), West China Hospital, Sichuan University, Chengdu, China
| | - Liren Duan
- Department of Neurology, West China Hospital, Sichuan University, Chengdu, China
| | - Chaolan Chen
- Department of Neurology, West China Hospital, Sichuan University, Chengdu, China
| | - Yan Zeng
- Department of Neurology, West China Hospital, Sichuan University, Chengdu, China
| | - Jing Xi
- Department of Neurology, West China Hospital, Sichuan University, Chengdu, China
| | - Yi Jiang
- Department of Neurology, West China Hospital, Sichuan University, Chengdu, China
| | - Qiyong Gong
- Department of Radiology, Huaxi MR Research Center (HMRRC), West China Hospital, Sichuan University, Chengdu, China
- *Correspondence: Qiyong Gong,
| | - Rong Peng
- Department of Neurology, West China Hospital, Sichuan University, Chengdu, China
- Rong Peng,
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15
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Li X, Li Z, Zou Z, Wu X, Gao H, Wang C, Zhou J, Qi F, Zhang M, He J, Qi X, Yan F, Dou S, Zhang H, Tong L, Li Y. Real-Time fMRI Neurofeedback Training Changes Brain Degree Centrality and Improves Sleep in Chronic Insomnia Disorder: A Resting-State fMRI Study. Front Mol Neurosci 2022; 15:825286. [PMID: 35283729 PMCID: PMC8904428 DOI: 10.3389/fnmol.2022.825286] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Accepted: 01/31/2022] [Indexed: 11/13/2022] Open
Abstract
BackgroundChronic insomnia disorder (CID) is considered a major public health problem worldwide. Therefore, innovative and effective technical methods for studying the pathogenesis and clinical comprehensive treatment of CID are urgently needed.MethodsReal-time fMRI neurofeedback (rtfMRI-NF), a new intervention, was used to train 28 patients with CID to regulate their amygdala activity for three sessions in 6 weeks. Resting-state fMRI data were collected before and after training. Then, voxel-based degree centrality (DC) method was used to explore the effect of rtfMRI-NF training. For regions with altered DC, we determined the specific connections to other regions that most strongly contributed to altered functional networks based on DC. Furthermore, the relationships between the DC value of the altered regions and changes in clinical variables were determined.ResultsPatients with CID showed increased DC in the right postcentral gyrus, Rolandic operculum, insula, and superior parietal gyrus and decreased DC in the right supramarginal gyrus, inferior parietal gyrus, angular gyrus, middle occipital gyrus, and middle temporal gyrus. Seed-based functional connectivity analyses based on the altered DC regions showed more details about the altered functional networks. Clinical scores in Pittsburgh sleep quality index, insomnia severity index (ISI), Beck depression inventory, and Hamilton anxiety scale decreased. Furthermore, a remarkable positive correlation was found between the changed ISI score and DC values of the right insula.ConclusionsThis study confirmed that amygdala-based rtfMRI-NF training altered the intrinsic functional hubs, which reshaped the abnormal functional connections caused by insomnia and improved the sleep of patients with CID. These findings contribute to our understanding of the neurobiological mechanism of rtfMRI-NF in insomnia treatment. However, additional double-blinded controlled clinical trials with larger sample sizes need to be conducted to confirm the effect of rtfMRI-NF from this initial study.
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Affiliation(s)
- Xiaodong Li
- Department of Radiology, Henan Provincial People’s Hospital, People’s Hospital of Zhengzhou University, Zhengzhou, China
| | - Zhonglin Li
- Department of Radiology, Henan Provincial People’s Hospital, People’s Hospital of Zhengzhou University, Zhengzhou, China
| | - Zhi Zou
- Department of Radiology, Henan Provincial People’s Hospital, People’s Hospital of Zhengzhou University, Zhengzhou, China
| | - Xiaolin Wu
- Department of Nuclear Medicine, Henan Provincial People’s Hospital, People’s Hospital of Zhengzhou University, Zhengzhou, China
| | - Hui Gao
- Henan Key Laboratory of Imaging and Intelligent Processing, PLA Strategic Support Force Information Engineering University, Zhengzhou, China
| | - Caiyun Wang
- Department of Radiology, Henan Provincial People’s Hospital, People’s Hospital of Zhengzhou University, Zhengzhou, China
| | - Jing Zhou
- Health Management Center, Henan Provincial People’s Hospital, People’s Hospital of Zhengzhou University, Zhengzhou, China
| | - Fei Qi
- Department of Radiology, Henan Provincial People’s Hospital, People’s Hospital of Zhengzhou University, Zhengzhou, China
| | - Miao Zhang
- Department of Radiology, Henan Provincial People’s Hospital, People’s Hospital of Zhengzhou University, Zhengzhou, China
| | - Junya He
- Department of Radiology, Henan Provincial People’s Hospital, People’s Hospital of Zhengzhou University, Zhengzhou, China
| | - Xin Qi
- Department of Radiology, Henan Provincial People’s Hospital, People’s Hospital of Zhengzhou University, Zhengzhou, China
| | - Fengshan Yan
- Department of Radiology, Henan Provincial People’s Hospital, People’s Hospital of Zhengzhou University, Zhengzhou, China
| | - Shewei Dou
- Department of Radiology, Henan Provincial People’s Hospital, People’s Hospital of Zhengzhou University, Zhengzhou, China
| | - Hongju Zhang
- Department of Neurology, Henan Provincial People’s Hospital, People’s Hospital of Zhengzhou University, Zhengzhou, China
| | - Li Tong
- Henan Key Laboratory of Imaging and Intelligent Processing, PLA Strategic Support Force Information Engineering University, Zhengzhou, China
- *Correspondence: Li Tong,
| | - Yongli Li
- Health Management Center, Henan Provincial People’s Hospital, People’s Hospital of Zhengzhou University, Zhengzhou, China
- Yongli Li,
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16
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Federico G, Alfano V, Garramone F, Mele G, Salvatore M, Aiello M, Cavaliere C. Self-Reported Sleep Quality Across Age Modulates Resting-State Functional Connectivity in Limbic and Fronto-Temporo-Parietal Networks: An Exploratory Cross-Sectional fMRI Study. Front Aging Neurosci 2022; 14:806374. [PMID: 35197843 PMCID: PMC8859450 DOI: 10.3389/fnagi.2022.806374] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2021] [Accepted: 01/12/2022] [Indexed: 11/13/2022] Open
Abstract
Sleep problems are increasingly present in the general population at any age, and they are frequently concurrent with—or predictive of—memory disturbances, anxiety, and depression. In this exploratory cross-sectional study, 54 healthy participants recruited in Naples (Italy; 23 females; mean age = 37.1 years, range = 20–68) completed the Pittsburgh Sleep Quality Index (PSQI) and a neurocognitive assessment concerning both verbal and visuospatial working memory as well as subjective measures of anxiety and depression. Then, 3T fMRI images with structural and resting-state functional sequences were acquired. A whole-brain seed-to-seed functional connectivity (FC) analysis was conducted by contrasting good (PSQI score <5) vs. bad (PSQI score ≥5) sleepers. Results highlighted FC differences in limbic and fronto-temporo-parietal brain areas. Also, bad sleepers showed an anxious/depressive behavioural phenotype and performed worse than good sleepers at visuospatial working-memory tasks. These findings may help to reveal the effects of sleep quality on daily-life cognitive functioning and further elucidate pathophysiological mechanisms of sleep disorders.
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Li Z, Liu J, Chen B, Wu X, Zou Z, Gao H, Wang C, Zhou J, Qi F, Zhang M, He J, Qi X, Yan F, Dou S, Tong L, Zhang H, Han X, Li Y. Improved Regional Homogeneity in Chronic Insomnia Disorder After Amygdala-Based Real-Time fMRI Neurofeedback Training. Front Psychiatry 2022; 13:863056. [PMID: 35845454 PMCID: PMC9279663 DOI: 10.3389/fpsyt.2022.863056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2022] [Accepted: 05/31/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Chronic insomnia disorder (CID) is a highly prevalent sleep disorder, which influences people's daily life and is even life threatening. However, whether the resting-state regional homogeneity (ReHo) of disrupted brain regions in CID can be reshaped to normal after treatment remains unclear. METHODS A novel intervention real-time functional magnetic resonance imaging neurofeedback (rtfMRI-NF) was used to train 28 CID patients to regulate the activity of the left amygdala for three sessions in 6 weeks. The ReHo methodology was adopted to explore its role on resting-state fMRI data, which were collected before and after training. Moreover, the relationships between changes of clinical variables and ReHo value of altered regions were determined. RESULTS Results showed that the bilateral dorsal medial pre-frontal cortex, supplementary motor area (SMA), and left dorsal lateral pre-frontal cortex had decreased ReHo values, whereas the bilateral cerebellum anterior lobe (CAL) had increased ReHo values after training. Some clinical scores markedly decreased, including Pittsburgh Sleep Quality Index, Insomnia Severity Index, Beck Depression Inventory, and Hamilton Anxiety Scale (HAMA). Additionally, the ReHo values of the left CAL were positively correlated with the change in the Hamilton depression scale score, and a remarkable positive correlation was found between the ReHo values of the right SMA and the HAMA score. CONCLUSION Our study provided an objective evidence that amygdala-based rtfMRI-NF training could reshape abnormal ReHo and improve sleep in patients with CID. The improved ReHo in CID provides insights into the neurobiological mechanism for the effectiveness of this intervention. However, larger double-blinded sham-controlled trials are needed to confirm our results from this initial study.
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Affiliation(s)
- Zhonglin Li
- Department of Radiology, Henan Provincial People's Hospital and People's Hospital of Zhengzhou University, Zhengzhou, China
| | - Jiao Liu
- Department of Nuclear Medicine, First Affiliated Hospital of Zhengzhou University, Zhengzhou, China.,Henan Medical Key Laboratory of Molecular Imaging, Zhengzhou, China
| | - Bairu Chen
- Department of Medical Imaging, Fifth Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Xiaoling Wu
- Department of Nuclear Medicine, Henan Provincial People's Hospital and People's Hospital of Zhengzhou University, Zhengzhou, China
| | - Zhi Zou
- Department of Radiology, Henan Provincial People's Hospital and People's Hospital of Zhengzhou University, Zhengzhou, China
| | - Hui Gao
- Henan Key Laboratory of Imaging and Intelligent Processing, PLA Strategic Support Force Information Engineering University, Zhengzhou, China
| | - Caiyun Wang
- Department of Radiology, Henan Provincial People's Hospital and People's Hospital of Zhengzhou University, Zhengzhou, China
| | - Jing Zhou
- Health Management Center, Henan Provincial People's Hospital and People's Hospital of Zhengzhou University, Zhengzhou, China
| | - Fei Qi
- Department of Radiology, Henan Provincial People's Hospital and People's Hospital of Zhengzhou University, Zhengzhou, China
| | - Miao Zhang
- Department of Radiology, Henan Provincial People's Hospital and People's Hospital of Zhengzhou University, Zhengzhou, China
| | - Junya He
- Department of Radiology, Henan Provincial People's Hospital and People's Hospital of Zhengzhou University, Zhengzhou, China
| | - Xin Qi
- Department of Radiology, Henan Provincial People's Hospital and People's Hospital of Zhengzhou University, Zhengzhou, China
| | - Fengshan Yan
- Department of Radiology, Henan Provincial People's Hospital and People's Hospital of Zhengzhou University, Zhengzhou, China
| | - Shewei Dou
- Department of Radiology, Henan Provincial People's Hospital and People's Hospital of Zhengzhou University, Zhengzhou, China
| | - Li Tong
- Henan Key Laboratory of Imaging and Intelligent Processing, PLA Strategic Support Force Information Engineering University, Zhengzhou, China
| | - Hongju Zhang
- Department of Neurology, Henan Provincial People's Hospital and People's Hospital of Zhengzhou University, Zhengzhou, China
| | - Xingmin Han
- Department of Nuclear Medicine, First Affiliated Hospital of Zhengzhou University, Zhengzhou, China.,Henan Medical Key Laboratory of Molecular Imaging, Zhengzhou, China
| | - Yongli Li
- Health Management Center, Henan Provincial People's Hospital and People's Hospital of Zhengzhou University, Zhengzhou, China
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18
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Li C, Liu Y, Yang N, Lan Z, Huang S, Wu Y, Ma X, Jiang G. Functional Connectivity Disturbances of the Locus Coeruleus in Chronic Insomnia Disorder. Nat Sci Sleep 2022; 14:1341-1350. [PMID: 35942365 PMCID: PMC9356738 DOI: 10.2147/nss.s366234] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2022] [Accepted: 07/14/2022] [Indexed: 11/25/2022] Open
Abstract
INTRODUCTION In recent years, people have gained a profound understanding of chronic insomnia disorder (CID), but the pathophysiological mechanism of CID is still unclear. There is some evidence that the locus coeruleus (LC) is involved in the regulation of wakefulness in CID, but there have been few studies using brain functional imaging. The purpose of this study was to evaluate the resting-state functional connectivity (FC) between the LC and other brain voxels in CID and whether these abnormal FC are involved in the regulation of wakefulness. METHODS A total of 49 patients with chronic insomnia disorder and 47 healthy controls (HC) matched for gender, age, and education were examined with rs-fMRI in this study. The LC was selected as the region of interest, and then seed-based analysis was conducted on the LC and other voxels to obtain the brain regions with abnormal FC. The correlation between the FC value of the abnormal connection area and the clinical scale score was analyzed. RESULTS Compared with the HC, the FC between the LC and right precuneus, right posterior cingulate cortex, left middle temporal gyrus, left calcarine, and right superior orbitofrontal cortex was significantly enhanced (p < 0.05, FDR correction), and the functional connectivity signal value between the locus coeruleus and left middle temporal gyrus was positively correlated with the Self-Rating Depression Scale (p = 0.021). CONCLUSION The abnormal FC between the LC and multiple brain regions may contribute to a better understanding of the neurobiological mechanism of CID.
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Affiliation(s)
- Chunlong Li
- Department of Medical Imaging, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, People' s Republic of China
| | - Yuexia Liu
- Department of Ultrasound, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, People' s Republic of China
| | - Ning Yang
- Department of Medical Imaging, Guangdong Second Provincial General Hospital, Guangzhou, People's Republic of China
| | - Zhihong Lan
- Department of Medical Imaging, Zhuhai City People's Hospital, Zhuhai, People's Republic of China
| | - Shumei Huang
- Department of Medical Imaging, Guangdong Second Provincial General Hospital, Guangzhou, People's Republic of China
| | - Yunfan Wu
- Department of Medical Imaging, Guangdong Second Provincial General Hospital, Guangzhou, People's Republic of China
| | - Xiaofen Ma
- Department of Medical Imaging, Guangdong Second Provincial General Hospital, Guangzhou, People's Republic of China
| | - Guihua Jiang
- Department of Medical Imaging, Guangdong Second Provincial General Hospital, Guangzhou, People's Republic of China
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19
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Tahmasian M, Aleman A, Andreassen OA, Arab Z, Baillet M, Benedetti F, Bresser T, Bright J, Chee MW, Chylinski D, Cheng W, Deantoni M, Dresler M, Eickhoff SB, Eickhoff CR, Elvsåshagen T, Feng J, Foster-Dingley JC, Ganjgahi H, Grabe HJ, Groenewold NA, Ho TC, Hong SB, Houenou J, Irungu B, Jahanshad N, Khazaie H, Kim H, Koshmanova E, Kocevska D, Kochunov P, Lakbila-Kamal O, Leerssen J, Li M, Luik AI, Muto V, Narbutas J, Nilsonne G, O’Callaghan VS, Olsen A, Osorio RS, Poletti S, Poudel G, Reesen JE, Reneman L, Reyt M, Riemann D, Rosenzweig I, Rostampour M, Saberi A, Schiel J, Schmidt C, Schrantee A, Sciberras E, Silk TJ, Sim K, Smevik H, Soares JC, Spiegelhalder K, Stein DJ, Talwar P, Tamm S, Teresi GI, Valk SL, Van Someren E, Vandewalle G, Van Egroo M, Völzke H, Walter M, Wassing R, Weber FD, Weihs A, Westlye LT, Wright MJ, Wu MJ, Zak N, Zarei M. ENIGMA-Sleep: Challenges, opportunities, and the road map. J Sleep Res 2021; 30:e13347. [PMID: 33913199 PMCID: PMC8803276 DOI: 10.1111/jsr.13347] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2021] [Revised: 03/14/2021] [Accepted: 03/16/2021] [Indexed: 12/26/2022]
Abstract
Neuroimaging and genetics studies have advanced our understanding of the neurobiology of sleep and its disorders. However, individual studies usually have limitations to identifying consistent and reproducible effects, including modest sample sizes, heterogeneous clinical characteristics and varied methodologies. These issues call for a large-scale multi-centre effort in sleep research, in order to increase the number of samples, and harmonize the methods of data collection, preprocessing and analysis using pre-registered well-established protocols. The Enhancing NeuroImaging Genetics through Meta-Analysis (ENIGMA) consortium provides a powerful collaborative framework for combining datasets across individual sites. Recently, we have launched the ENIGMA-Sleep working group with the collaboration of several institutes from 15 countries to perform large-scale worldwide neuroimaging and genetics studies for better understanding the neurobiology of impaired sleep quality in population-based healthy individuals, the neural consequences of sleep deprivation, pathophysiology of sleep disorders, as well as neural correlates of sleep disturbances across various neuropsychiatric disorders. In this introductory review, we describe the details of our currently available datasets and our ongoing projects in the ENIGMA-Sleep group, and discuss both the potential challenges and opportunities of a collaborative initiative in sleep medicine.
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Affiliation(s)
- Masoud Tahmasian
- Institute of Medical Science and Technology, Shahid Beheshti University, Tehran, Iran
| | - André Aleman
- University Medical Center Groningen, University of Groningen, Groningen, Netherlands
| | - Ole A. Andreassen
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital, Inst of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Zahra Arab
- Institute of Medical Science and Technology, Shahid Beheshti University, Tehran, Iran
| | - Marion Baillet
- GIGA-Institute, Cyclotron Research Center/In Vivo Imaging, Sleep and Chronobiology Lab, University of Liège, Liège, Belgium
| | - Francesco Benedetti
- Psychiatry & Clinical Psychobiology, Division of Neuroscience, IRCCS Scientific Institute Ospedale San Raffaele, Milano, Italy
- Vita-Salute San Raffaele University, Milano, Italy
| | - Tom Bresser
- Department of Sleep and Cognition, Netherlands Institute for Neuroscience (NIN), an Institute of the Royal Netherlands Academy of Arts and Sciences, Amsterdam, The Netherlands
- Department of Integrative Neurophysiology, Center for Neurogenomics and Cognitive Research (CNCR), Amsterdam Neuroscience, VU University Amsterdam, Amsterdam, Netherlands
| | - Joanna Bright
- Imaging Genetics Center, Mark and Mary Stevens Neuroimaging and Informatics Institute, Keck School of Medicine, University of Southern California, Marina del Rey, CA, USA
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Michael W.L. Chee
- Centre for Sleep and Cognition, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Daphne Chylinski
- GIGA-Institute, Cyclotron Research Center/In Vivo Imaging, Sleep and Chronobiology Lab, University of Liège, Liège, Belgium
| | - Wei Cheng
- Institute of Science and Technology for Brain-inspired intelligence, Fudan University, Shanghai, China
- Key Laboratory of Computational Neuroscience and Brain-Inspired Intelligence, Ministry of Education, Fudan University, Shanghai, China
| | - Michele Deantoni
- GIGA-Institute, Cyclotron Research Center/In Vivo Imaging, Sleep and Chronobiology Lab, University of Liège, Liège, Belgium
| | - Martin Dresler
- Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - Simon B. Eickhoff
- Institute of Neuroscience and Medicine, Brain & Behaviour (INM-7), Research Centre Jülich, Jülich, Germany
- Institute of Systems Neuroscience, Medical Faculty,, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
| | - Claudia R. Eickhoff
- Institute of Neuroscience and Medicine, Structural and functional organisation of the brain (INM-1), Research Centre Jülich, Jülich, Germany
- Institute of Clinical Neuroscience and Medical Psychology, Medical Faculty, University of Düsseldorf, Düsseldorf, Germany
| | - Torbjørn Elvsåshagen
- Norwegian Centre for Mental Disorders Research, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- Department of Neurology, Oslo University Hospital, Oslo, Norway
| | - Jianfeng Feng
- Institute of Science and Technology for Brain-inspired intelligence, Fudan University, Shanghai, China
- Key Laboratory of Computational Neuroscience and Brain-Inspired Intelligence, Ministry of Education, Fudan University, Shanghai, China
- Department of Computer Science, University of Warwick, Coventry, UK
| | - Jessica C. Foster-Dingley
- Department of Sleep and Cognition, Netherlands Institute for Neuroscience (NIN), an Institute of the Royal Netherlands Academy of Arts and Sciences, Amsterdam, The Netherlands
| | - Habib Ganjgahi
- Department of Statistics, University of Oxford, Oxford, UK
| | - Hans J. Grabe
- Department of Psychiatry and Psychotherapy, University Medicine Greifswald, Greifswald, Germany
- German Center for Neurodegenerative Diseases (DZNE), Site Rostock/Greifswald, Greifswald, Germany
| | - Nynke A. Groenewold
- SA MRC Unit on Risk & Resilience in Mental Disorders, Department of Psychiatry & Neuroscience Institute, University of Cape Town, Cape Town, South Africa
| | - Tiffany C. Ho
- Department of Psychiatry and Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA, USA
| | - Seung Bong Hong
- Department of Neurology, Samsung Medical Center, SBRI (Samsung Biomedical Research Institute), Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Josselin Houenou
- Univ Paris Saclay, NeuroSpin neuroimaging platform, Psychiatry Team, UNIACT Lab, CEA Saclay, Gif-Sur-Yvette Cedex, France
- DMU IMPACT de Psychiatrie et d'Addictologie, APHP, Hôpitaux Universitaires Mondor, Créteil, France
- Univ Paris Est Créteil, INSERM U 955, IMRB Team 15 « Translational Neuropsychiatry », Foundation FondaMental, Créteil, France
| | - Benson Irungu
- Department of Psychiatry & Behavioral Sciences, The University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Neda Jahanshad
- Imaging Genetics Center, Mark and Mary Stevens Neuroimaging and Informatics Institute, Keck School of Medicine, University of Southern California, Marina del Rey, CA, USA
| | - Habibolah Khazaie
- Sleep Disorders Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Hosung Kim
- Laboratory of Neuro Imaging at USC Stevens Neuroimaging and Informatics Institute, Keck School of Medicine of USC, University of Southern California, Los Angeles, CA, USA
| | - Ekaterina Koshmanova
- GIGA-Institute, Cyclotron Research Center/In Vivo Imaging, Sleep and Chronobiology Lab, University of Liège, Liège, Belgium
| | - Desi Kocevska
- Department of Sleep and Cognition, Netherlands Institute for Neuroscience (NIN), an Institute of the Royal Netherlands Academy of Arts and Sciences, Amsterdam, The Netherlands
| | - Peter Kochunov
- Maryland Psychiatric Research Center, Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Oti Lakbila-Kamal
- Department of Sleep and Cognition, Netherlands Institute for Neuroscience (NIN), an Institute of the Royal Netherlands Academy of Arts and Sciences, Amsterdam, The Netherlands
- Department of Integrative Neurophysiology, Center for Neurogenomics and Cognitive Research (CNCR), Amsterdam Neuroscience, VU University Amsterdam, Amsterdam, Netherlands
| | - Jeanne Leerssen
- Department of Sleep and Cognition, Netherlands Institute for Neuroscience (NIN), an Institute of the Royal Netherlands Academy of Arts and Sciences, Amsterdam, The Netherlands
- Department of Integrative Neurophysiology, Center for Neurogenomics and Cognitive Research (CNCR), Amsterdam Neuroscience, VU University Amsterdam, Amsterdam, Netherlands
| | - Meng Li
- Clinical Affective Neuroimaging Laboratory, Otto von Guericke University, Magdeburg, Germany
- Department of Psychiatry and Psychotherapy, Jena University Hospital, Jena, Germany
- Department of Psychiatry and Psychotherapy, University of Tübingen, Tübingen, Germany
| | - Annemarie I. Luik
- Department of Epidemiology, Erasmus MC University Medical Center Rotterdam, Rotterdam, The Netherlands
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus MC University Medical Center Rotterdam, Rotterdam, Netherlands
| | - Vincenzo Muto
- GIGA-Institute, Cyclotron Research Center/In Vivo Imaging, Sleep and Chronobiology Lab, University of Liège, Liège, Belgium
| | - Justinas Narbutas
- GIGA-Institute, Cyclotron Research Center/In Vivo Imaging, Sleep and Chronobiology Lab, University of Liège, Liège, Belgium
| | - Gustav Nilsonne
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
- Department of Psychology, Stress Research Institute, Stockholm University, Stockholm, Sweden
| | | | - Alexander Olsen
- Department of Physical Medicine and Rehabilitation, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway
- Department of Psychology, Norwegian University of Science and Technology, Trondheim, Norway
| | - Ricardo S. Osorio
- Healthy Brain Aging and Sleep Center, Department of Psychiatry, NYU Grossman School of Medicine, New York, NY, USA
- Nathan S. Kline Institute for Psychiatric Research, Orangeburg, NY, USA
| | - Sara Poletti
- Psychiatry & Clinical Psychobiology, Division of Neuroscience, IRCCS Scientific Institute Ospedale San Raffaele, Milano, Italy
- Vita-Salute San Raffaele University, Milano, Italy
| | - Govinda Poudel
- Mary Mackillop Institute for Health Research, Australian Catholic University, Melbourne, Vic., Australia
| | - Joyce E. Reesen
- Department of Sleep and Cognition, Netherlands Institute for Neuroscience (NIN), an Institute of the Royal Netherlands Academy of Arts and Sciences, Amsterdam, The Netherlands
- Department of Integrative Neurophysiology, Center for Neurogenomics and Cognitive Research (CNCR), Amsterdam Neuroscience, VU University Amsterdam, Amsterdam, Netherlands
| | - Liesbeth Reneman
- Department of Radiology and Nuclear Medicine, Amsterdam University Medical Centers, AMC, Amsterdam, The Netherlands
| | - Mathilde Reyt
- GIGA-Institute, Cyclotron Research Center/In Vivo Imaging, Sleep and Chronobiology Lab, University of Liège, Liège, Belgium
- Psychology and Neuroscience of Cognition Research Unit, Faculty of Psychology and Educational Sciences, University of Liège, Liège, Belgium
| | - Dieter Riemann
- Department of Psychiatry and Psychotherapy, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg im Breisgau, Germany
| | - Ivana Rosenzweig
- Sleep and Brain Plasticity Centre, Department of Neuroimaging, Institute of Psychiatry, Psychology and Neuroscience (IoPPN), King’s College London, London, UK
- Sleep Disorders Centre, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - Masoumeh Rostampour
- Sleep Disorders Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Amin Saberi
- Institute of Medical Science and Technology, Shahid Beheshti University, Tehran, Iran
| | - Julian Schiel
- Department of Psychiatry and Psychotherapy, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg im Breisgau, Germany
| | - Christina Schmidt
- GIGA-Institute, Cyclotron Research Center/In Vivo Imaging, Sleep and Chronobiology Lab, University of Liège, Liège, Belgium
- Psychology and Neuroscience of Cognition Research Unit, Faculty of Psychology and Educational Sciences, University of Liège, Liège, Belgium
| | - Anouk Schrantee
- Department of Radiology and Nuclear Medicine, Amsterdam University Medical Centers, AMC, Amsterdam, The Netherlands
| | - Emma Sciberras
- Department of Paediatrics, University of Melbourne, Parkville, Vic., Australia
- Murdoch Children's Research Institute, Parkville, Vic., Australia
- School of Psychology, Deakin University, Geelong, Vic., Australia
| | - Tim J. Silk
- Department of Paediatrics, University of Melbourne, Parkville, Vic., Australia
- Murdoch Children's Research Institute, Parkville, Vic., Australia
- School of Psychology, Deakin University, Geelong, Vic., Australia
| | - Kang Sim
- Institute of Mental Health, Buangkok, Singapore
| | - Hanne Smevik
- Department of Psychology, Norwegian University of Science and Technology, Trondheim, Norway
| | - Jair C. Soares
- Department of Psychiatry & Behavioral Sciences, The University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Kai Spiegelhalder
- Department of Psychiatry and Psychotherapy, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg im Breisgau, Germany
| | - Dan J. Stein
- SA MRC Unit on Risk & Resilience in Mental Disorders, Department of Psychiatry & Neuroscience Institute, University of Cape Town, Cape Town, South Africa
| | - Puneet Talwar
- GIGA-Institute, Cyclotron Research Center/In Vivo Imaging, Sleep and Chronobiology Lab, University of Liège, Liège, Belgium
| | - Sandra Tamm
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
- Department of Psychology, Stress Research Institute, Stockholm University, Stockholm, Sweden
- Department of Psychiatry, University of Oxford, Oxford, UK
| | - Giana I. Teresi
- Department of Psychology, Stanford University, Stanford, CA, USA
| | - Sofie L. Valk
- Institute of Neuroscience and Medicine, Brain & Behaviour (INM-7), Research Centre Jülich, Jülich, Germany
- Institute of Systems Neuroscience, Medical Faculty,, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
- Otto Hahn Group Cognitive Neurogenetics, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany
| | - Eus Van Someren
- Department of Sleep and Cognition, Netherlands Institute for Neuroscience (NIN), an Institute of the Royal Netherlands Academy of Arts and Sciences, Amsterdam, The Netherlands
- Department of Integrative Neurophysiology, Center for Neurogenomics and Cognitive Research (CNCR), Amsterdam Neuroscience, VU University Amsterdam, Amsterdam, Netherlands
- Vrije Universiteit, Psychiatry, Amsterdam Neuroscience, Amsterdam UMC, Amsterdam, The Netherlands
| | - Gilles Vandewalle
- GIGA-Institute, Cyclotron Research Center/In Vivo Imaging, Sleep and Chronobiology Lab, University of Liège, Liège, Belgium
| | - Maxime Van Egroo
- GIGA-Institute, Cyclotron Research Center/In Vivo Imaging, Sleep and Chronobiology Lab, University of Liège, Liège, Belgium
| | - Henry Völzke
- Institute for Community Medicine, Department SHIP/Clinical Epidemiological Research, University Medicine Greifswald, Greifswald, Germany
- German Centre for Cardiovascular Research (DZHK), Greifswald, Germany
| | - Martin Walter
- Clinical Affective Neuroimaging Laboratory, Otto von Guericke University, Magdeburg, Germany
- Department of Psychiatry and Psychotherapy, Jena University Hospital, Jena, Germany
- Department of Psychiatry and Psychotherapy, University of Tübingen, Tübingen, Germany
- Leibniz Institute for Neurobiology, Magdeburg, Germany
- Department of Psychiatry and Psychotherapy, Otto-von-Guericke University Magdeburg, Magdeburg, Germany
- Department of Psychiatry and Psychotherapy, Jena University Hospital, Jena, Germany
| | - Rick Wassing
- Department of Sleep and Circadian Research, Woolcock Institute of Medical Research, The University of Sydney, Sydney, Australia
| | - Frederik D. Weber
- Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - Antoine Weihs
- Department of Psychiatry and Psychotherapy, University Medicine Greifswald, Greifswald, Germany
| | - Lars Tjelta Westlye
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital, Inst of Clinical Medicine, University of Oslo, Oslo, Norway
- Department of Psychology, University of Oslo, Oslo, Norway
- K.G Jebsen Center for Neurodevelopmental Disorders, University of Oslo, Oslo, Norway
| | - Margaret J. Wright
- Queensland Brain Institute, The University of Queensland, Brisbane, Qld, Australia
- Centre for Advanced Imaging, The University of Queensland, St Lucia, Qld, Australia
| | - Mon-Ju Wu
- Department of Psychology and Center for Magnetic Resonance Research, University of Minnesota, Minneapolis, MN, USA
| | - Nathalia Zak
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital, Inst of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Mojtaba Zarei
- Institute of Medical Science and Technology, Shahid Beheshti University, Tehran, Iran
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20
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Pesonen AK, Makkonen T, Elovainio M, Halonen R, Räikkönen K, Kuula L. Presleep physiological stress is associated with a higher cortical arousal in sleep and more consolidated REM sleep. Stress 2021; 24:667-675. [PMID: 33461366 DOI: 10.1080/10253890.2020.1869936] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
Abstract
How sleep regulates physiological stress in healthy individuals is not well understood. We explored the associations between naturally occurring pre-sleep physiological arousal and EEG power spectral density together with rapid eye movement sleep (REMS) continuity. One hundred and fifty-four individuals (mean age 16.9, SD 0.1 years) collected five samples of saliva between the evening (mean time 18:20) and bedtime (mean 23:00) by using swabs, and underwent an overnight in-home polysomnography. We calculated spectral density for REMS and non-rapid eye movement sleep (non-REMS), and the number and duration of REMS arousals (<15 s) during sleep. An observational design allowed for measurement of natural variation in physiological and sleep arousal. Increasing cortisol levels toward bedtime were associated with higher EEG power spectral density at all frequency ranges in frontal locations, the highest association being for the beta1 frequency band. In central locations, the associations were pronounced for beta1 and beta2 bands. Higher overall cortisol levels in the evening were associated with less fragmented REMS. Presleep arousal was not associated with sleep staging. Physiological arousal toward bedtime was associated with EEG power spectral density values during sleep specifically at high EEG frequencies. This may represent a compensatory mechanism that serves as an adaptation to stress, since the REMS was more continuous along a higher physiological arousal level in the evening. Although causality cannot be inferred, a design with nonmanipulated physiological stress followed by naturally timed sleep at home provides new insights into stress regulation homeostasis.
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Affiliation(s)
- Anu-Katriina Pesonen
- Research Program Unit, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Tommi Makkonen
- Research Program Unit, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Marko Elovainio
- Research Program Unit, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Risto Halonen
- Research Program Unit, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Katri Räikkönen
- Research Program Unit, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Liisa Kuula
- Research Program Unit, Faculty of Medicine, University of Helsinki, Helsinki, Finland
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21
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Cosgrave J, Phillips J, Haines R, Foster RG, Steinsaltz D, Wulff K. Revisiting nocturnal heart rate and heart rate variability in insomnia: A polysomnography-based comparison of young self-reported good and poor sleepers. J Sleep Res 2021; 30:e13278. [PMID: 33622029 PMCID: PMC8577225 DOI: 10.1111/jsr.13278] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2020] [Revised: 12/14/2020] [Accepted: 12/28/2020] [Indexed: 01/08/2023]
Abstract
Primary insomnia is often considered a disorder of 24-hr hyperarousal. Numerous attempts have been made to investigate nocturnal heart rate (HR) and its variability (HRV) as potential pathophysiological hallmarks of altered arousal levels in insomnia, with mixed results. We have aimed to overcome some of the pitfalls of previous studies by using a young, medication-free, age- and gender-matched population consisting of 43 students aged 18-30 years half with a subthreshold insomnia complaint. We employed at-home ambulatory polysomnography and compared this attenuated insomnia group to a good sleeping group. The poor sleepers had significantly higher wake after sleep onset, arousal count, mean HR in all sleep stages (with the exception of Stage 1) and lower sleep efficiency. Consistent with previous research, we also found a significant group-by-sleep stage interaction in the prediction of nocturnal HR, highlighting the insomnia group to have a lower wake-sleep HR reduction compared to good sleepers. When restricting our analyses to insomnia with objectively determined short sleep duration, we found significantly lower standard deviation of RR intervals (SDNN; a measure of HRV) compared to good sleepers. Taken together, this lends credence to the hyperarousal model of insomnia and may at least partially explain the increased prevalence of cardiovascular morbidity and mortality observed in patients with insomnia.
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Affiliation(s)
- Jan Cosgrave
- Sleep and Circadian Neuroscience InstituteNDCNThe Sir William Dunn School of PathologyUniversity of OxfordOxfordUK
- Department of Clinical, Educational and Health PsychologyUniversity College LondonLondonUK
| | | | - Ross Haines
- Department of StatisticsUniversity of OxfordOxfordUK
| | - Russell G. Foster
- Sleep and Circadian Neuroscience InstituteNDCNThe Sir William Dunn School of PathologyUniversity of OxfordOxfordUK
| | - David Steinsaltz
- Department of Clinical, Educational and Health PsychologyUniversity College LondonLondonUK
| | - Katharina Wulff
- Departments of Radiation Sciences and Molecular BiologyUmeå UniversityUmeåSweden
- Wallenberg Centre for Molecular Medicine (WCMM)Umeå UniversityUmeåSweden
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22
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Yu S, Feng F, Zhang Q, Shen Z, Wang Z, Hu Y, Gong L. Gray matter hypertrophy in primary insomnia: a surface-based morphometric study. Brain Imaging Behav 2021; 14:1309-1317. [PMID: 30511119 DOI: 10.1007/s11682-018-9992-z] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
Studies have explored brain structural abnormalities in patients with primary insomnia (PI). However, most of them are based on volumetric measures, in a specific region of interest, and have small sample sizes. Here, we investigated changes in cortical morphology (thickness and volume) in PI using an advanced surface-based morphometric method. Sixty-seven patients with PI and 55 matched healthy controls were recruited for this study and underwent a structural magnetic resonance imaging scan. The reconstructed cortical surface was processed by Freesurfer 6.0. A general linear model was used to explore group differences in surface-based morphometric features. Furthermore, the association between these cortical features and clinical characteristics were assessed in the PI group. Compared to controls, PI patients showed cortical thickening in the left orbital frontal cortex (OFC), right rostral anterior cingulate cortex (rACC), left middle cingulate cortex (MCC), bilateral insula, left superior parietal lobule (SPL), and right fusiform area (FFA), and showed increased cortical volume in the left OFC, right rACC, bilateral rostral middle frontal gyrus, and right FFA. Cortical thickness in the right OFC and FFA was positively correlated with the severity of insomnia in the PI group, suggesting a right-lateralized relationship. This study was the first to explore multiple-scale cortical morphometric changes in a relatively large sample of PI patients. Our results suggest that hypertrophic cortical morphology may underlie the neuropathology of primary insomnia.
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Affiliation(s)
- Siyi Yu
- Department of Acupuncture & Tuina, Chengdu University of Traditional Chinese Medicine, No. 37 Shierqiao Road, Chengdu, 610075, Sichuan, China
| | - Fen Feng
- Affiliated Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu University of Traditional Chinese Medicine, Chengdu, 610075, Sichuan, China
| | - Qi Zhang
- Department of Acupuncture & Tuina, Chengdu University of Traditional Chinese Medicine, No. 37 Shierqiao Road, Chengdu, 610075, Sichuan, China
| | - Zhifu Shen
- Department of Acupuncture & Tuina, Chengdu University of Traditional Chinese Medicine, No. 37 Shierqiao Road, Chengdu, 610075, Sichuan, China
| | - Zhengyan Wang
- Department of Pain Management, Sichuan Integrative Medicine Hospital, Chengdu, 610041, Sichuan, China
| | - Youping Hu
- Department of Acupuncture & Tuina, Chengdu University of Traditional Chinese Medicine, No. 37 Shierqiao Road, Chengdu, 610075, Sichuan, China.
| | - Liang Gong
- Department of Neurology, Chengdu Second People's Hospital, No. 10 Qingyunnan Road, Chengdu, 610017, Sichuan, China. .,Department of Neurology, Affiliated ZhongDa Hospital, School of Medicine, Southeast University, Nanjing, 210009, Jiangsu, China.
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23
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Bresser T, Foster-Dingley JC, Wassing R, Leerssen J, Ramautar JR, Stoffers D, Lakbila-Kamal O, van den Heuvel M, van Someren EJW. Consistent altered internal capsule white matter microstructure in insomnia disorder. Sleep 2021; 43:5775301. [PMID: 32123914 PMCID: PMC7447859 DOI: 10.1093/sleep/zsaa031] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2019] [Revised: 02/01/2020] [Indexed: 12/18/2022] Open
Abstract
STUDY OBJECTIVES Suggested neural correlates of insomnia disorder have been hard to replicate. Even the most consistent finding, altered white matter microstructure in the anterior limb of the internal capsule, is based on handful studies. The urge for replicable targets to understand the underlying mechanisms of insomnia made us study white matter fractional anisotropy (FA) across three samples of cases and controls. METHODS 3-Tesla MRI diffusion tensor imaging data of three independent samples were combined for analysis, resulting in n = 137 participants, of whom 73 were diagnosed with insomnia disorder and 64 were matched controls without sleep complaints. Insomnia severity was measured with the Insomnia Severity Index (ISI). White matter microstructure was assessed with FA. White matter tracts were skeletonized and analyzed using tract-based spatial statistics. We performed a region-of-interest analysis using linear mixed-effect models to evaluate case-control differences in internal capsule FA as well as associations between internal capsule FA and insomnia severity. RESULTS FA in the right limb of the anterior internal capsule was lower in insomnia disorder than in controls (β = -9.76e-3; SE = 4.17e-3, p = .034). In the entire sample, a higher ISI score was associated with a lower FA value of the right internal capsule (β = -8.05e- 4 FA/ISI point, SE = 2.60e- 4, p = .008). Ancillary whole brain voxel-wise analyses showed no significant group difference or association with insomnia severity after correction for multiple comparisons. CONCLUSIONS The internal capsule shows small but consistent insomnia-related alterations. The findings support a circuit-based approach to underlying mechanisms since this tract connects many brain areas previously implicated in insomnia.
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Affiliation(s)
- Tom Bresser
- Department of Sleep and Cognition, Netherlands Institute for Neuroscience, Amsterdam, The Netherlands.,Department of Integrative Neurophysiology, Center for Neurogenomics and Cognitive Research (CNCR), Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Jessica C Foster-Dingley
- Department of Sleep and Cognition, Netherlands Institute for Neuroscience, Amsterdam, The Netherlands
| | - Rick Wassing
- Department of Sleep and Cognition, Netherlands Institute for Neuroscience, Amsterdam, The Netherlands
| | - Jeanne Leerssen
- Department of Sleep and Cognition, Netherlands Institute for Neuroscience, Amsterdam, The Netherlands
| | - Jennifer R Ramautar
- Department of Sleep and Cognition, Netherlands Institute for Neuroscience, Amsterdam, The Netherlands
| | - Diederick Stoffers
- Department of Sleep and Cognition, Netherlands Institute for Neuroscience, Amsterdam, The Netherlands
| | - Oti Lakbila-Kamal
- Department of Sleep and Cognition, Netherlands Institute for Neuroscience, Amsterdam, The Netherlands
| | - Martijn van den Heuvel
- Dutch Connectome Lab, Department of Complex Trait Genetics, Center for Neurogenomics and Cognitive Research, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.,Department of Clinical Genetics, Amsterdam Neuroscience, VU University Medical Center, Amsterdam, The Netherlands
| | - Eus J W van Someren
- Department of Sleep and Cognition, Netherlands Institute for Neuroscience, Amsterdam, The Netherlands.,Department of Integrative Neurophysiology, Center for Neurogenomics and Cognitive Research (CNCR), Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.,Department of Psychiatry, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, The Netherlands
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24
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黄 伟, 李 志, 吴 水, 洪 静, 文 戈. [Small-world network of patients with primary insomnia: a resting-state functional magnetic resonance imaging study]. NAN FANG YI KE DA XUE XUE BAO = JOURNAL OF SOUTHERN MEDICAL UNIVERSITY 2021; 41:424-429. [PMID: 33849835 PMCID: PMC8075793 DOI: 10.12122/j.issn.1673-4254.2021.03.16] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 09/25/2020] [Indexed: 06/12/2023]
Abstract
OBJECTIVE To explore the changes of small-world network properties in patients with primary insomnia based on resting-state functional magnetic resonance imaging (rs-fMRI). OBJECTIVE The rs-MRI data and neurological scale data of 65 patients and 60 matched healthy controls were collected. The brain network was constructed using GRENTA software. SPSS software and network-based statistical analysis methods were used for statistical analysis. OBJECTIVE There was no significant difference between the two groups in terms of age, gender or education level (P > 0.05), but PSQI, HAMA and HAMD scale scores differed significantly between the two groups (P < 0.05). Both of the groups showed attributes of the small-world network. Compared with the control group, the patients with insomnia showed lower Cp, γ, Eloc, λ, connectivity, and σ of the small world network (P < 0.05). OBJECTIVE Patients with primary insomnia have lower global and local efficiencies than healthy individuals, and their ability to transmit information on the surface topology is impaired. Our data provide objective imaging evidences for the neuropathological mechanism of patients with primary insomnia.
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Affiliation(s)
- 伟康 黄
- 南方医科大学南方医院增城分院(增城区中心医院),广东 广州 511340Zengcheng Branch of Nanfang Hospital, Southern Medical University, Guangzhou 511340, China
| | - 志铭 李
- 广州医科大学第二附属医院,广东 广州 510260Department of Radiology, Second Affiliated Hospital of Guangzhou Medical College, Guangzhou 510260, China
| | - 水天 吴
- 南方医科大学南方医院增城分院(增城区中心医院),广东 广州 511340Zengcheng Branch of Nanfang Hospital, Southern Medical University, Guangzhou 511340, China
| | - 静静 洪
- 南方医科大学南方医院增城分院(增城区中心医院),广东 广州 511340Zengcheng Branch of Nanfang Hospital, Southern Medical University, Guangzhou 511340, China
| | - 戈 文
- 南方医科大学南方医院增城分院(增城区中心医院),广东 广州 511340Zengcheng Branch of Nanfang Hospital, Southern Medical University, Guangzhou 511340, China
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25
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Emamian F, Mahdipour M, Noori K, Rostampour M, Mousavi SB, Khazaie H, Khodaie-Ardakani M, Tahmasian M, Zarei M. Alterations of Subcortical Brain Structures in Paradoxical and Psychophysiological Insomnia Disorder. Front Psychiatry 2021; 12:661286. [PMID: 34025484 PMCID: PMC8139557 DOI: 10.3389/fpsyt.2021.661286] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2021] [Accepted: 04/07/2021] [Indexed: 12/29/2022] Open
Abstract
Insomnia disorder (ID) is a common illness associated with mood and cognitive impairments. Subtyping ID is an ongoing debate in sleep medicine, but the underlying mechanisms of each subtype is poorly understood. Growing evidence suggests that subcortical brain structures play the key roles in pathophysiology of ID and its subtypes. Here, we aimed to investigate structural alteration of subcortical regions in patients with two common ID subtypes i.e., paradoxical and psychophysiological insomnia. Fifty-five patients and 49 healthy controls were recruited for this study and T1-weighted images and subjective and objective sleep parameters (i.e., Pittsburgh Sleep Quality Index and polysomnography) were collected from participants. Subcortical structures including the hippocampus, amygdala, caudate, putamen, globus pallidus, nucleus accumbens, and thalamus were automatically segmented in FSL. Volume and shape (using surface vertices) of each structure were compared between the groups, controlled for covariates, and corrected for multiple comparisons. In addition, correlations of sleep parameters and surface vertices or volumes were calculated. The caudate's volume was smaller in patients than controls. Compared with controls, we found regional shrinkage in the caudate, nucleus accumbens, posterior putamen, hippocampus, thalamus, and amygdala in paradoxical insomnia and shrinkage in the amygdala, caudate, hippocampus, and putamen in psychophysiological insomnia. Interestingly, comparing two patients groups, shape alteration in the caudate, putamen, and nucleus accumbens in paradoxical insomnia and shrinkage in the thalamus, amygdala, and hippocampus in psychophysiological insomnia were observed. Both subjective and objective sleep parameters were associated with these regional shape alterations in patients. Our results support the differential role of subcortical brain structures in pathophysiology of paradoxical and psychophysiological insomnia.
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Affiliation(s)
- Farnoosh Emamian
- Department of Psychiatry, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran.,Sleep Disorders Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Mostafa Mahdipour
- Institute of Medical Science and Technology, Shahid Beheshti University, Tehran, Iran
| | - Khadijeh Noori
- Sleep Disorders Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Masoumeh Rostampour
- Sleep Disorders Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - S Bentolhoda Mousavi
- Psychosis Research Center, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Habibolah Khazaie
- Sleep Disorders Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | | | - Masoud Tahmasian
- Institute of Medical Science and Technology, Shahid Beheshti University, Tehran, Iran
| | - Mojtaba Zarei
- Institute of Medical Science and Technology, Shahid Beheshti University, Tehran, Iran
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26
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Najafpour Z, Fatemi A, Goudarzi Z, Goudarzi R, Shayanfard K, Noorizadeh F. Cost-effectiveness of neuroimaging technologies in management of psychiatric and insomnia disorders: A meta-analysis and prospective cost analysis. J Neuroradiol 2021; 48:348-358. [PMID: 33383065 DOI: 10.1016/j.neurad.2020.12.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2020] [Revised: 12/12/2020] [Accepted: 12/15/2020] [Indexed: 01/10/2023]
Abstract
BACKGROUND The optimal diagnostic strategy for patients with psychiatric and insomnia disorders has not been established yet. PURPOSE The purpose of this study was to perform cost-effectiveness analysis of six neuroimaging technologies in diagnosis of patients with psychiatric and insomnia disorders. METHODS An economic evaluation study was conducted in three parts, including a systematic review for determining diagnostic accuracy, a descriptive cross-sectional study with Activity-Based Costing (ABC) technique for tracing resource consumption, and a cost-effectiveness analysis using a short-term decision-analytic model. RESULTS In the first phase, 93 diagnostic accuracy studies were included in the systematic review. The accumulated results (meta-analysis) showed that the highest diagnostic accuracy for psychiatric and insomnia disorders was attributed to PET (sensitivity of 90% and specificity of 80%) and MRI (sensitivity of 76% and specificity of 78%) respectively. In the second phase of the study, we calculated the cost of each technology. The results showed that MRI has the lowest cost. Based on the results in the model of cost-effectiveness sMRI ($ 50.08 per accurate diagnosis) and MRI ($ 58.54 per accurate diagnosis) were more cost-effective neuroimaging technologies. CONCLUSION In psychiatric disorders, no single strategy was characterized by both low cost and high accuracy. However, MRI and PET scan had lower cost and higher accuracy for psychiatric disorders, respectively. MRI was the least costly with the highest diagnostic accuracy in insomnia disorders. Based on our model, sMRI in psychiatric disorders and MRI in insomnia disorders were the most cost-effective technologies.
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Affiliation(s)
- Zhila Najafpour
- Department of Health Care Management, School of Public Health, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
| | - Asieh Fatemi
- Dpartment of Pharmacoeconomics and Pharmaceutical Administration, Faculty of Pharmacy, Tehran University of Medical Sciences, Faculty of Paramedical sciences, Rafsanjan University of Medical Sciences, Iran.
| | - Zahra Goudarzi
- Department of Pharmacoeconomics and Pharmaceutical Administration, Faculty of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran.
| | - Reza Goudarzi
- Health Services Management Research Center, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran.
| | | | - Farsad Noorizadeh
- Basir Eye Health Research Center, Exceptional Talents Development Center, Tehran University of Medical Sciences, Tehran, Iran.
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27
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Zou G, Li Y, Liu J, Zhou S, Xu J, Qin L, Shao Y, Yao P, Sun H, Zou Q, Gao JH. Altered thalamic connectivity in insomnia disorder during wakefulness and sleep. Hum Brain Mapp 2020; 42:259-270. [PMID: 33048406 PMCID: PMC7721231 DOI: 10.1002/hbm.25221] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Revised: 09/16/2020] [Accepted: 09/20/2020] [Indexed: 01/16/2023] Open
Abstract
Insomnia disorder is the most common sleep disorder and has drawn increasing attention. Many studies have shown that hyperarousal plays a key role in the pathophysiology of insomnia disorder. However, the specific brain mechanisms underlying insomnia disorder remain unclear. To elucidate the neuropathophysiology of insomnia disorder, we investigated the brain functional networks of patients with insomnia disorder and healthy controls across the sleep–wake cycle. EEG‐fMRI data from 33 patients with insomnia disorder and 31 well‐matched healthy controls during wakefulness and nonrapid eye movement sleep, including N1, N2 and N3 stages, were analyzed. A medial and anterior thalamic region was selected as the seed considering its role in sleep–wake regulation. The functional connectivity between the thalamic seed and voxels across the brain was calculated. ANOVA with factors “group” and “stage” was performed on thalamus‐based functional connectivity. Correlations between the misperception index and altered functional connectivity were explored. A group‐by‐stage interaction was observed at widespread cortical regions. Regarding the main effect of group, patients with insomnia disorder demonstrated decreased thalamic connectivity with the left amygdala, parahippocampal gyrus, putamen, pallidum and hippocampus across wakefulness and all three nonrapid eye movement sleep stages. The thalamic connectivity in the subcortical cluster and the right temporal cluster in N1 was significantly correlated with the misperception index. This study demonstrated the brain functional basis in insomnia disorder and illustrated its relationship with sleep misperception, shedding new light on the brain mechanisms of insomnia disorder and indicating potential therapeutic targets for its treatment.
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Affiliation(s)
- Guangyuan Zou
- Beijing City Key Lab for Medical Physics and Engineering, Institute of Heavy Ion Physics, School of Physics, Peking University, Beijing, China.,Center for MRI Research, Academy for Advanced Interdisciplinary Studies, Peking University, Beijing, China
| | - Yuezhen Li
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, China.,Department of Neuropsychiatry, Behavioral Neurology and Sleep Center, Beijing Tian Tan Hospital, Capital Medical University, Beijing, China
| | - Jiayi Liu
- Beijing City Key Lab for Medical Physics and Engineering, Institute of Heavy Ion Physics, School of Physics, Peking University, Beijing, China.,Center for MRI Research, Academy for Advanced Interdisciplinary Studies, Peking University, Beijing, China
| | - Shuqin Zhou
- Center for MRI Research, Academy for Advanced Interdisciplinary Studies, Peking University, Beijing, China
| | - Jing Xu
- Center for MRI Research, Academy for Advanced Interdisciplinary Studies, Peking University, Beijing, China.,Laboratory of Applied Brain and Cognitive Sciences, College of International Business, Shanghai International Studies University, Shanghai, China
| | - Lang Qin
- Center for MRI Research, Academy for Advanced Interdisciplinary Studies, Peking University, Beijing, China
| | - Yan Shao
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, China
| | - Ping Yao
- Department of Physiology, College of Basic Medicine, Inner Mongolia Medical University, Hohhot, China
| | - Hongqiang Sun
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, China
| | - Qihong Zou
- Center for MRI Research, Academy for Advanced Interdisciplinary Studies, Peking University, Beijing, China
| | - Jia-Hong Gao
- Beijing City Key Lab for Medical Physics and Engineering, Institute of Heavy Ion Physics, School of Physics, Peking University, Beijing, China.,Center for MRI Research, Academy for Advanced Interdisciplinary Studies, Peking University, Beijing, China.,McGovern Institute for Brain Research, Peking University, Beijing, China
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28
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Shen C, Luo Q, Chamberlain SR, Morgan S, Romero-Garcia R, Du J, Zhao X, Touchette É, Montplaisir J, Vitaro F, Boivin M, Tremblay RE, Zhao XM, Robaey P, Feng J, Sahakian BJ. What Is the Link Between Attention-Deficit/Hyperactivity Disorder and Sleep Disturbance? A Multimodal Examination of Longitudinal Relationships and Brain Structure Using Large-Scale Population-Based Cohorts. Biol Psychiatry 2020; 88:459-469. [PMID: 32414481 PMCID: PMC7445427 DOI: 10.1016/j.biopsych.2020.03.010] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/17/2019] [Revised: 03/17/2020] [Accepted: 03/17/2020] [Indexed: 12/12/2022]
Abstract
BACKGROUND Attention-deficit/hyperactivity disorder (ADHD) comorbid with sleep disturbances can produce profound disruption in daily life and negatively impact quality of life of both the child and the family. However, the temporal relationship between ADHD and sleep impairment is unclear, as are underlying common brain mechanisms. METHODS This study used data from the Quebec Longitudinal Study of Child Development (n = 1601, 52% female) and the Adolescent Brain Cognitive Development Study (n = 3515, 48% female). Longitudinal relationships between symptoms were examined using cross-lagged panel models. Gray matter volume neural correlates were identified using linear regression. The transcriptomic signature of the identified brain-ADHD-sleep relationship was characterized by gene enrichment analysis. Confounding factors, such as stimulant drugs for ADHD and socioeconomic status, were controlled for. RESULTS ADHD symptoms contributed to sleep disturbances at one or more subsequent time points in both cohorts. Lower gray matter volumes in the middle frontal gyrus and inferior frontal gyrus, amygdala, striatum, and insula were associated with both ADHD symptoms and sleep disturbances. ADHD symptoms significantly mediated the link between these structural brain abnormalities and sleep dysregulation, and genes were differentially expressed in the implicated brain regions, including those involved in neurotransmission and circadian entrainment. CONCLUSIONS This study indicates that ADHD symptoms and sleep disturbances have common neural correlates, including structural changes of the ventral attention system and frontostriatal circuitry. Leveraging data from large datasets, these results offer new mechanistic insights into this clinically important relationship between ADHD and sleep impairment, with potential implications for neurobiological models and future therapeutic directions.
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Affiliation(s)
- Chun Shen
- Institute of Science and Technology for Brain-Inspired Intelligence, MOE Key Laboratory of Computational Neuroscience and Brain-Inspired Intelligence, Fudan University, Shanghai, China; Shanghai Research Center for Brain Science and Brain-Inspired Intelligence, Institute of Brain-Intelligence Technology, Zhangjiang Laboratory, Shanghai, China
| | - Qiang Luo
- Institute of Science and Technology for Brain-Inspired Intelligence, MOE Key Laboratory of Computational Neuroscience and Brain-Inspired Intelligence, Fudan University, Shanghai, China; State Key Laboratory of Medical Neurobiology and MOE Frontiers Center for Brain Science, Institutes of Brain Science and Human Phenome Institute, Fudan University, Shanghai, China; Behavioural and Clinical Neuroscience Institute, Department of Psychology, University of Cambridge, Cambridge, United Kingdom; Shanghai Research Center for Brain Science and Brain-Inspired Intelligence, Institute of Brain-Intelligence Technology, Zhangjiang Laboratory, Shanghai, China.
| | | | - Sarah Morgan
- Department of Psychiatry, University of Cambridge, Cambridge, United Kingdom; Alan Turing Institute, London, United Kingdom
| | | | - Jingnan Du
- Institute of Science and Technology for Brain-Inspired Intelligence, MOE Key Laboratory of Computational Neuroscience and Brain-Inspired Intelligence, Fudan University, Shanghai, China
| | - Xingzhong Zhao
- Institute of Science and Technology for Brain-Inspired Intelligence, MOE Key Laboratory of Computational Neuroscience and Brain-Inspired Intelligence, Fudan University, Shanghai, China
| | - Évelyne Touchette
- Department of Psychoeducation, Université du Québec à Trois-Rivières, Trois-Rivières, Québec, Canada
| | - Jacques Montplaisir
- Department of Psychiatry, Université de Montréal, Montréal, Québec, Canada; Center for Advanced Research in Sleep Medicine, CIUSSS-NIM, Montréal, Québec, Canada
| | - Frank Vitaro
- School of Psychoeducation, Université de Montréal, Montréal, Québec, Canada
| | - Michel Boivin
- School of Psychology, Université Laval, Québec City, Québec, Canada
| | - Richard E Tremblay
- Department of Pediatrics and Psychology, Université de Montréal, Montréal, Québec, Canada; School of Public Health, Physiotherapy and Sports Science, University College Dublin, Dublin, Ireland
| | - Xing-Ming Zhao
- Institute of Science and Technology for Brain-Inspired Intelligence, MOE Key Laboratory of Computational Neuroscience and Brain-Inspired Intelligence, Fudan University, Shanghai, China
| | - Philippe Robaey
- Department of Psychiatry, Université de Montréal, Montréal, Québec, Canada; Department of Psychiatry, University of Ottawa, Ottawa, Ontario, Canada; Children's Hospital of Eastern Ontario, Ottawa, Ontario, Canada
| | - Jianfeng Feng
- Institute of Science and Technology for Brain-Inspired Intelligence, MOE Key Laboratory of Computational Neuroscience and Brain-Inspired Intelligence, Fudan University, Shanghai, China; Collaborative Innovation Center for Brain Science, Fudan University, Shanghai, China; School of Mathematical Sciences, Fudan University, Shanghai, China; Department of Computer Science, University of Warwick, Coventry, United Kingdom; Shanghai Research Center for Brain Science and Brain-Inspired Intelligence, Institute of Brain-Intelligence Technology, Zhangjiang Laboratory, Shanghai, China.
| | - Barbara J Sahakian
- Institute of Science and Technology for Brain-Inspired Intelligence, MOE Key Laboratory of Computational Neuroscience and Brain-Inspired Intelligence, Fudan University, Shanghai, China; Behavioural and Clinical Neuroscience Institute, Department of Psychology, University of Cambridge, Cambridge, United Kingdom; Department of Psychiatry, University of Cambridge, Cambridge, United Kingdom
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29
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Van Someren EJW. Brain mechanisms of insomnia: new perspectives on causes and consequences. Physiol Rev 2020; 101:995-1046. [PMID: 32790576 DOI: 10.1152/physrev.00046.2019] [Citation(s) in RCA: 154] [Impact Index Per Article: 38.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
While insomnia is the second most common mental disorder, progress in our understanding of underlying neurobiological mechanisms has been limited. The present review addresses the definition and prevalence of insomnia and explores its subjective and objective characteristics across the 24-hour day. Subsequently, the review extensively addresses how the vulnerability to develop insomnia is affected by genetic variants, early life stress, major life events, and brain structure and function. Further supported by the clear mental health risks conveyed by insomnia, the integrated findings suggest that the vulnerability to develop insomnia could rather be found in brain circuits regulating emotion and arousal than in circuits involved in circadian and homeostatic sleep regulation. Finally, a testable model is presented. The model proposes that in people with a vulnerability to develop insomnia, the locus coeruleus is more sensitive to-or receives more input from-the salience network and related circuits, even during rapid eye movement sleep, when it should normally be sound asleep. This vulnerability may ignite a downward spiral of insufficient overnight adaptation to distress, resulting in accumulating hyperarousal, which, in turn, impedes restful sleep and moreover increases the risk of other mental health adversity. Sensitized brain circuits are likely to be subjectively experienced as "sleeping with one eye open". The proposed model opens up the possibility for novel intervention studies and animal studies, thus accelerating the ignition of a neuroscience of insomnia, which is direly needed for better treatment.
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Affiliation(s)
- Eus J W Van Someren
- Department of Sleep and Cognition, Netherlands Institute for Neuroscience, Royal Netherlands Academy of Arts and Sciences, Amsterdam, The Netherlands; Department of Integrative Neurophysiology, Center for Neurogenomics and Cognitive Research, Amsterdam Neuroscience, Vrije Universiteit University Amsterdam, Amsterdam, The Netherlands; and Amsterdam UMC, Vrije Universiteit, Psychiatry, Amsterdam Neuroscience, Amsterdam, The Netherlands
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Johann AF, Hertenstein E, Feige B, Akram U, Holub F, Baglioni C, Domschke K, Schramm E, Nissen C, Kyle SD, Riemann D, Biermann J, Spiegelhalder K. Cognitive behavioural therapy for insomnia does not appear to have a substantial impact on early markers of cardiovascular disease: A preliminary randomized controlled trial. J Sleep Res 2020; 29:e13102. [PMID: 32596882 DOI: 10.1111/jsr.13102] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2019] [Revised: 05/04/2020] [Accepted: 05/13/2020] [Indexed: 11/29/2022]
Abstract
According to the World Health Organization, cardiovascular diseases are the leading cause of death in the world. Therefore, early prevention of these diseases is a public health priority. Epidemiological data suggest that insomnia may be a modifiable risk factor for cardiovascular diseases. A randomized controlled trial in a sample of insomnia patients without cardiovascular disease was conducted to investigate the effects of insomnia treatment on early markers of cardiovascular diseases assessed by 24-hr ambulatory blood pressure, heart rate and heart rate variability monitoring, and morning fasting blood samples. Forty-six patients with insomnia disorder were randomized to cognitive behavioural therapy for insomnia (CBT-I; n = 23) or a waitlist control condition (n = 23). Contrary to the hypothesis, intention-to-treat analyses did not show any significant treatment effects on early markers of cardiovascular disease (d = 0.0-0.6) despite successful insomnia treatment (d = 1.3). Potential methodological and conceptual reasons for these negative findings are discussed. Future studies might include larger sample sizes that are at risk of cardiovascular diseases and focus on other cardiovascular markers.
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Affiliation(s)
- Anna Friederike Johann
- Department of Psychiatry and Psychotherapy, Faculty of Medicine, Medical Center - University of Freiburg, University of Freiburg, Freiburg, Germany.,Medical Psychology and Medical Sociology, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | | | - Bernd Feige
- Department of Psychiatry and Psychotherapy, Faculty of Medicine, Medical Center - University of Freiburg, University of Freiburg, Freiburg, Germany
| | - Umair Akram
- Department of Psychology, Sociology and Politics, Sheffield Hallam University, Sheffield, UK.,Nuffield Department of Clinical Neurosciences, Sleep and Circadian Neuroscience Institute (SCNi), University of Oxford, Oxford, UK
| | - Florian Holub
- Department of Psychiatry and Psychotherapy, Faculty of Medicine, Medical Center - University of Freiburg, University of Freiburg, Freiburg, Germany
| | - Chiara Baglioni
- Department of Psychiatry and Psychotherapy, Faculty of Medicine, Medical Center - University of Freiburg, University of Freiburg, Freiburg, Germany.,Department of Human Sciences, University of Rome 'G. Marconi' - Telematic, Rome, Italy
| | - Katharina Domschke
- Department of Psychiatry and Psychotherapy, Faculty of Medicine, Medical Center - University of Freiburg, University of Freiburg, Freiburg, Germany
| | - Elisabeth Schramm
- Department of Psychiatry and Psychotherapy, Faculty of Medicine, Medical Center - University of Freiburg, University of Freiburg, Freiburg, Germany
| | - Christoph Nissen
- University Hospital of Psychiatry and Psychotherapy, Bern, Switzerland
| | - Simon D Kyle
- Nuffield Department of Clinical Neurosciences, Sleep and Circadian Neuroscience Institute (SCNi), University of Oxford, Oxford, UK
| | - Dieter Riemann
- Department of Psychiatry and Psychotherapy, Faculty of Medicine, Medical Center - University of Freiburg, University of Freiburg, Freiburg, Germany
| | - Jürgen Biermann
- Department of Cardiology and Angiology, Cardiac Electrophysiology, St. Franziskus-Hospital Münster, Münster, Germany.,Department of Cardiology and Angiology I, Faculty of Medicine, Heart Center - University of Freiburg, University of Freiburg, Freiburg, Germany
| | - Kai Spiegelhalder
- Department of Psychiatry and Psychotherapy, Faculty of Medicine, Medical Center - University of Freiburg, University of Freiburg, Freiburg, Germany
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Kyle SD, Hurry MED, Emsley R, Marsden A, Omlin X, Juss A, Spiegelhalder K, Bisdounis L, Luik AI, Espie CA, Sexton CE. The effects of digital cognitive behavioral therapy for insomnia on cognitive function: a randomized controlled trial. Sleep 2020; 43:5777024. [DOI: 10.1093/sleep/zsaa034] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2019] [Revised: 02/07/2020] [Indexed: 11/14/2022] Open
Abstract
AbstractStudy ObjectivesWe sought to examine the impact of digital cognitive behavioral therapy (dCBT) for insomnia on both self-reported cognitive impairment and objective cognitive performance.MethodsThe Defining the Impact of Sleep improvement on Cognitive Outcomes (DISCO) trial was an online, two-arm, single-blind, randomized clinical trial of dCBT versus wait-list control. Participants were aged 25 years and older, met DSM-5 diagnostic criteria for insomnia disorder, and reported difficulties with concentration or memory. Assessments were carried out online at baseline, and 10 and 24 weeks post-randomization. The primary outcome measure was self-reported cognitive impairment, assessed with the British Columbia Cognitive Complaints Inventory (BC-CCI). Secondary outcomes included tests of cognitive performance, insomnia symptoms, cognitive failures, fatigue, sleepiness, depression, and anxiety.ResultsFour hundred and ten participants with insomnia were recruited and assigned to dCBT (N = 205) or wait-list control (N = 205). At 10 weeks post-randomization the estimated adjusted mean difference for the BC-CCI was −3.03 (95% CI: −3.60, −2.47; p < 0.0001, d = −0.86), indicating that participants in the dCBT group reported less cognitive impairment than the control group. These effects were maintained at 24 weeks (d = −0.96) and were mediated, in part, via reductions in insomnia severity and increased sleep efficiency. Treatment effects in favor of dCBT, at both 10 and 24 weeks, were found for insomnia severity, sleep efficiency, cognitive failures, fatigue, sleepiness, depression, and anxiety. We found no between-group differences in objective tests of cognitive performance.ConclusionsOur study shows that dCBT robustly decreases self-reported cognitive impairment at post-treatment and these effects are maintained at 6 months.
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Affiliation(s)
- Simon D Kyle
- Sleep and Circadian Neuroscience Institute, Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK
| | - Madeleine E D Hurry
- Division of Neuroscience and Experimental Psychology, University of Manchester, Manchester, UK
| | - Richard Emsley
- Department of Biostatistics and Health Informatics, Institute of Psychiatry, Psychology and Neuroscience, Kings College London, London, UK
| | - Antonia Marsden
- Division of Population Health, Health Services Research & Primary Care, University of Manchester, Manchester, UK
| | - Ximena Omlin
- Sleep and Circadian Neuroscience Institute, Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK
| | - Amender Juss
- Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK
| | - Kai Spiegelhalder
- Department of Psychiatry and Psychotherapy, Faculty of Medicine, Medical Center – University of Freiburg, Freiburg, Germany
| | - Lampros Bisdounis
- Sleep and Circadian Neuroscience Institute, Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK
| | - Annemarie I Luik
- Sleep and Circadian Neuroscience Institute, Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK
- Department of Epidemiology, Erasmus MC University Medical Center, Rotterdam, The Netherlands
| | - Colin A Espie
- Sleep and Circadian Neuroscience Institute, Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK
- Big Health Ltd, London, UK
| | - Claire E Sexton
- Oxford Centre for Human Brain Activity, Wellcome Centre for Integrative Neuroimaging, Department of Psychiatry, University of Oxford, Oxford, UK
- Global Brain Health Institute, Memory and Aging Center, Department of Neurology, University of California, San Francisco, CA
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33
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Effect-size seed-based d mapping of resting-state fMRI for persistent insomnia disorder. Sleep Breath 2019; 24:653-659. [DOI: 10.1007/s11325-019-02001-3] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2019] [Revised: 12/05/2019] [Accepted: 12/16/2019] [Indexed: 12/11/2022]
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Bagherzadeh-Azbari S, Khazaie H, Zarei M, Spiegelhalder K, Walter M, Leerssen J, Van Someren EJW, Sepehry AA, Tahmasian M. Neuroimaging insights into the link between depression and Insomnia: A systematic review. J Affect Disord 2019; 258:133-143. [PMID: 31401541 DOI: 10.1016/j.jad.2019.07.089] [Citation(s) in RCA: 35] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/02/2018] [Revised: 07/06/2019] [Accepted: 07/30/2019] [Indexed: 12/12/2022]
Abstract
BACKGROUND Insomnia is a common symptom of Major Depressive Disorder (MDD) and genome-wide association studies pointed to their strong genetic association. Although the prevalence of insomnia symptoms in MDD is noticeable and evidence supports their strong bidirectional association, the number of available neuroimaging findings on patients of MDD with insomnia symptoms is limited. However, such neuroimaging studies could verily improve our understanding of their shared pathophysiology and advance corresponding theories. METHODS Based on the preferred reporting items for systematic reviews and meta-analysis (PRISMA) guideline, we have conducted a literature search using PubMed, EMBASE, and Scopus databases and systematically explored 640 studies using various neuroimaging modalities in MDD patients with different degrees of insomnia symptoms. RESULTS Despite inconsistencies, current findings from eight studies suggested structural and functional disturbances in several brain regions including the amygdala, prefrontal cortex and anterior cingulate cortex and insula. The aberrant functional connectivity within and between the main hubs of the salience and default mode networks could potentially yield new insights into the link between MDD and insomnia, which needs further assessment. LIMITATIONS The number of studies reviewed herein is limited. The applied methods for assessing structural and functional neural mechanisms of insomnia and depression were variable. CONCLUSION Neuroimaging methods demonstrated the overlapping underlying neural mechanisms between MDD and insomnia. Future studies may facilitate better understanding of their pathophysiology to allow development of specific treatment.
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Affiliation(s)
- Shadi Bagherzadeh-Azbari
- Institute of Medical Sciences and Technology, Shahid Beheshti University, Tehran, Iran; Department of Psychology, Humboldt-Universität zu Berlin, Berlin, Germany
| | - Habibolah Khazaie
- Sleep Disorders Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Mojtaba Zarei
- Institute of Medical Sciences and Technology, Shahid Beheshti University, Tehran, Iran
| | - Kai Spiegelhalder
- Department of Psychiatry and Psychotherapy, Medical Centre - University of Freiburg, Faculty of Medicine, University of Freiburg, Germany
| | - Martin Walter
- Department of Psychiatry, University of Tübingen, Tübingen, Germany; Clinical Affective Neuroimaging Laboratory, Leibniz Institute for Neurobiology, Otto-von-Guericke University, Magdeburg, Germany
| | - Jeanne Leerssen
- Department of Sleep and Cognition, Netherlands Institute for Neuroscience, an institute of the Royal Netherlands Academy of Arts and Sciences, 1105 BA, Amsterdam, Netherlands; Departments of Psychiatry and Integrative Neurophysiology, Center for Neurogenomics and Cognitive Research (CNCR), Amsterdam Neuroscience, Vrije Universtiteit Amsterdam, Amsterdam UMC, De Boelelaan 1085, 1081 HV Amsterdam, the Netherlands
| | - Eus J W Van Someren
- Department of Sleep and Cognition, Netherlands Institute for Neuroscience, an institute of the Royal Netherlands Academy of Arts and Sciences, 1105 BA, Amsterdam, Netherlands; Departments of Psychiatry and Integrative Neurophysiology, Center for Neurogenomics and Cognitive Research (CNCR), Amsterdam Neuroscience, Vrije Universtiteit Amsterdam, Amsterdam UMC, De Boelelaan 1085, 1081 HV Amsterdam, the Netherlands
| | - Amir A Sepehry
- Clinical and Counselling Psychology Program, Adler University, Vancouver, BC, Canada
| | - Masoud Tahmasian
- Institute of Medical Sciences and Technology, Shahid Beheshti University, Tehran, Iran.
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Jespersen KV, Stevner A, Fernandes H, Sørensen SD, Van Someren E, Kringelbach M, Vuust P. Reduced structural connectivity in Insomnia Disorder. J Sleep Res 2019; 29:e12901. [DOI: 10.1111/jsr.12901] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2019] [Revised: 06/28/2019] [Accepted: 07/08/2019] [Indexed: 11/28/2022]
Affiliation(s)
- Kira V. Jespersen
- Department of Clinical Medicine Center for Music in the Brain Aarhus University & the Royal Academy of Music Aarhus/Aalborg Aarhus Denmark
| | - Angus Stevner
- Department of Clinical Medicine Center for Music in the Brain Aarhus University & the Royal Academy of Music Aarhus/Aalborg Aarhus Denmark
- Department of Psychiatry University of Oxford Oxford UK
| | - Henrique Fernandes
- Department of Clinical Medicine Center for Music in the Brain Aarhus University & the Royal Academy of Music Aarhus/Aalborg Aarhus Denmark
- Department of Psychiatry University of Oxford Oxford UK
| | - Stine D. Sørensen
- Department of Clinical Medicine Center for Music in the Brain Aarhus University & the Royal Academy of Music Aarhus/Aalborg Aarhus Denmark
| | - Eus Van Someren
- Department of Sleep and Cognition Netherlands Institute for Neuroscience Institute of the Royal Netherlands Academy of Arts and Sciences Amsterdam The Netherlands
- Department of Integrative Neurophysiology Center for Neurogenomics and Cognitive Research Amsterdam Neuroscience VU University Amsterdam Amsterdam The Netherlands
- Department of Psychiatry Amsterdam UMC Amsterdam Neuroscience VU University Amsterdam Amsterdam The Netherlands
| | - Morten Kringelbach
- Department of Clinical Medicine Center for Music in the Brain Aarhus University & the Royal Academy of Music Aarhus/Aalborg Aarhus Denmark
- Department of Psychiatry University of Oxford Oxford UK
| | - Peter Vuust
- Department of Clinical Medicine Center for Music in the Brain Aarhus University & the Royal Academy of Music Aarhus/Aalborg Aarhus Denmark
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Aribisala BS, Riha RL, Valdes Hernandez M, Muñoz Maniega S, Cox S, Radakovic R, Taylor A, Pattie A, Corley J, Redmond P, Bastin ME, Starr J, Deary I, Wardlaw JM. Sleep and brain morphological changes in the eighth decade of life. Sleep Med 2019; 65:152-158. [PMID: 31706897 DOI: 10.1016/j.sleep.2019.07.015] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/14/2019] [Revised: 07/03/2019] [Accepted: 07/09/2019] [Indexed: 12/13/2022]
Abstract
OBJECTIVE Sleep is important for brain health. We analysed associations between usual sleep habits and magnetic resonance imaging (MRI) markers of neurodegeneration (brain atrophy), vascular damage (white matter hyperintensities, WMH) and waste clearance (perivascular spaces, PVS) in older community-dwelling adults. METHOD We collected self-reported usual sleep duration, quality and medical histories from the Lothian Birth Cohort 1936 (LBC1936) age 76 years and performed brain MRI. We calculated sleep efficiency, measured WMH and brain volumes, quantified PVS, and assessed associations between sleep measures and brain markers in multivariate models adjusted for demographic and medical history variables. RESULTS In 457 subjects (53% males, mean age 76 ± 0.65 years), we found: brain and white matter loss with increased weekend daytime sleep (β = -0.114, P = 0.03; β = -0.122, P = 0.007 respectively), white matter loss with less efficient sleep (β = 0.132, P = 0.011) and PVS increased with interrupted sleep (OR 1.84 95% CI, P = 0.025). CONCLUSION Cross-sectional associations of sleep parameters with brain atrophy and more PVS suggest adverse relationships between usual sleep habits and brain health in older people that should be evaluated longitudinally.
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Affiliation(s)
- Benjamin S Aribisala
- Brain Research Imaging Centre, Division of Neuroimaging Sciences, University of Edinburgh, Edinburgh, UK; Centre for Cognitive Ageing and Cognitive Epidemiology, University of Edinburgh, Edinburgh, UK; Scottish Imaging Network, A Platform for Scientific Excellence (SINAPSE), UK; Department of Computer Science, Lagos State University, Lagos, Nigeria
| | - Renata L Riha
- Centre for Cognitive Ageing and Cognitive Epidemiology, University of Edinburgh, Edinburgh, UK; Department of Sleep Medicine, Royal Infirmary of Edinburgh, NHS Lothian, UK
| | - Maria Valdes Hernandez
- Brain Research Imaging Centre, Division of Neuroimaging Sciences, University of Edinburgh, Edinburgh, UK; Centre for Cognitive Ageing and Cognitive Epidemiology, University of Edinburgh, Edinburgh, UK; Scottish Imaging Network, A Platform for Scientific Excellence (SINAPSE), UK
| | - Susana Muñoz Maniega
- Brain Research Imaging Centre, Division of Neuroimaging Sciences, University of Edinburgh, Edinburgh, UK; Centre for Cognitive Ageing and Cognitive Epidemiology, University of Edinburgh, Edinburgh, UK; Scottish Imaging Network, A Platform for Scientific Excellence (SINAPSE), UK
| | - Simon Cox
- Centre for Cognitive Ageing and Cognitive Epidemiology, University of Edinburgh, Edinburgh, UK; Department of Psychology, University of Edinburgh, Edinburgh, UK
| | - Ratko Radakovic
- Centre for Cognitive Ageing and Cognitive Epidemiology, University of Edinburgh, Edinburgh, UK; Department of Psychology, University of Edinburgh, Edinburgh, UK; Faculty of Health and Medical Sciences, University of East Anglia, Norwich, UK; Alzheimer Scotland Dementia Research Centre, University of Edinburgh, Edinburgh, UK
| | - Adele Taylor
- Department of Psychology, University of Edinburgh, Edinburgh, UK
| | - Alison Pattie
- Centre for Cognitive Ageing and Cognitive Epidemiology, University of Edinburgh, Edinburgh, UK; Department of Psychology, University of Edinburgh, Edinburgh, UK
| | - Janie Corley
- Centre for Cognitive Ageing and Cognitive Epidemiology, University of Edinburgh, Edinburgh, UK; Department of Psychology, University of Edinburgh, Edinburgh, UK
| | - Paul Redmond
- Centre for Cognitive Ageing and Cognitive Epidemiology, University of Edinburgh, Edinburgh, UK; Department of Psychology, University of Edinburgh, Edinburgh, UK
| | - Mark E Bastin
- Brain Research Imaging Centre, Division of Neuroimaging Sciences, University of Edinburgh, Edinburgh, UK; Centre for Cognitive Ageing and Cognitive Epidemiology, University of Edinburgh, Edinburgh, UK; Scottish Imaging Network, A Platform for Scientific Excellence (SINAPSE), UK
| | - John Starr
- Centre for Cognitive Ageing and Cognitive Epidemiology, University of Edinburgh, Edinburgh, UK; Alzheimer Scotland Dementia Research Centre, University of Edinburgh, Edinburgh, UK
| | - Ian Deary
- Centre for Cognitive Ageing and Cognitive Epidemiology, University of Edinburgh, Edinburgh, UK; Department of Psychology, University of Edinburgh, Edinburgh, UK; Alzheimer Scotland Dementia Research Centre, University of Edinburgh, Edinburgh, UK
| | - Joanna M Wardlaw
- Brain Research Imaging Centre, Division of Neuroimaging Sciences, University of Edinburgh, Edinburgh, UK; Centre for Cognitive Ageing and Cognitive Epidemiology, University of Edinburgh, Edinburgh, UK; Scottish Imaging Network, A Platform for Scientific Excellence (SINAPSE), UK; UK Dementia Research Institute, University of Edinburgh, UK.
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Feng F, Yu S, Wang Z, Wang J, Park J, Wilson G, Deng M, Hu Y, Yan B, Kong J. Non-pharmacological and pharmacological interventions relieve insomnia symptoms by modulating a shared network: A controlled longitudinal study. Neuroimage Clin 2019; 22:101745. [PMID: 30878612 PMCID: PMC6423470 DOI: 10.1016/j.nicl.2019.101745] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2018] [Revised: 02/10/2019] [Accepted: 03/02/2019] [Indexed: 12/30/2022]
Abstract
BACKGROUND Primary insomnia (PI) is one of the most common complaints among the general population. Both non-pharmacological and pharmacological therapies have proven effective in treating primary insomnia. However, the underlying mechanism of treatment remains unclear, and no studies have compared the underlying mechanisms of different treatments. METHODS In this study, we investigated gray matter volume (GMV) and resting-state functional connectivity (rsFC) changes following both pharmacological and non-pharmacological treatments in patients with PI. A total of 67 PI patients were randomized into benzodiazepine treatment, cupping treatment, or a wait-list control group for 4 weeks. The Pittsburgh Sleep Quality Index (PSQI), gray matter volume (GMV), and resting-state functional connectivity (rsFC) of the hippocampus were measured at the beginning and end of the experiment. RESULTS We found 1) significantly decreased PSQI scores in the cupping and benzodiazepine treatment groups compared to the control group with no significant differences between the two treatment groups; 2) significant GMV increases in the cupping group compared to the control group at the right hippocampus after 4 weeks of treatment; 3) significantly increased rsFC between the right hippocampus and left rostral anterior cingulate cortex/medial prefrontal cortex (rACC/mPFC) in the two treatment groups, which was significantly associated with PSQI score decreases. DISCUSSION Our findings suggest that benzodiazepine and cupping may share a common mechanism to relieve the symptoms of patients with PI.
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Affiliation(s)
- Fen Feng
- Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu 610075, China
| | - Siyi Yu
- Department of Acupuncture & Tuina, Chengdu University of Traditional Chinese Medicine, Chengdu 610075, China; Department of Psychiatry, Massachusetts General Hospital, Charlestown 02129, MA, USA
| | - Zhengyan Wang
- Sichuan Integrative Medicine Hospital, Chengdu 610041, China
| | - Jialin Wang
- College of nursing, Chengdu University of Traditional Chinese Medicine, Chengdu 610075, China
| | - Joel Park
- Department of Psychiatry, Massachusetts General Hospital, Charlestown 02129, MA, USA
| | - Georgia Wilson
- Department of Psychiatry, Massachusetts General Hospital, Charlestown 02129, MA, USA
| | - Mou Deng
- Department of mathematics and statistics, Sichuan Institute of Industrial Technology, Deyang 618005, Sichuan, China
| | - Youping Hu
- Department of Acupuncture & Tuina, Chengdu University of Traditional Chinese Medicine, Chengdu 610075, China
| | - Bohua Yan
- Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu 610075, China.
| | - Jian Kong
- Department of Psychiatry, Massachusetts General Hospital, Charlestown 02129, MA, USA.
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Tahmasian M, Noori K, Samea F, Zarei M, Spiegelhalder K, Eickhoff SB, Van Someren E, Khazaie H, Eickhoff CR. A lack of consistent brain alterations in insomnia disorder: An activation likelihood estimation meta-analysis. Sleep Med Rev 2018; 42:111-118. [PMID: 30093361 PMCID: PMC7965842 DOI: 10.1016/j.smrv.2018.07.004] [Citation(s) in RCA: 77] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2018] [Revised: 07/02/2018] [Accepted: 07/06/2018] [Indexed: 10/28/2022]
Abstract
Insomnia disorder is a prevalent sleep disorder, which affects about 10% of general population. However, its neural mechanisms are poorly understood. Recently, several structural and functional neuroimaging studies have been conducted in patients with insomnia disorder, but these studies have yielded diverse findings. Here, we aimed to identify consistent patterns of abnormal brain alterations in insomnia disorder by performing a quantitative coordinate-based meta-analysis. Following the preferred reporting for systematic reviews and meta-analyses statement, we searched PubMed database and used reference tracking and finally retrieved 19 eligible studies (six task-based functional magnetic resonance imaging, eight resting-state functional magnetic resonance imaging, three voxel-based morphometry, and two positron emission tomography). We extracted peak coordinates from these studies and tested for convergence using the activation likelihood estimation method. Using this method, we found no significant convergent evidence for combination of structural atrophy and functional disturbances across previous studies (p = 0.914). Inconsistencies across these studies might be related to heterogonous clinical populations, the explorative nature of these studies in combination with small sample sizes, different experimental designs, and various preprocessing and statistical approaches. Future neuroimaging studies on insomnia disorder should include larger well-characterized samples, as well as standard imaging and analysis protocols.
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Affiliation(s)
- Masoud Tahmasian
- Institute of Medical Science and Technology, Shahid Beheshti University, Tehran, Iran
| | - Khadijeh Noori
- Sleep Disorders Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Fateme Samea
- Institute for Cognitive and Brain Sciences, Shahid Beheshti University, Tehran, Iran
| | - Mojtaba Zarei
- Institute of Medical Science and Technology, Shahid Beheshti University, Tehran, Iran
| | - Kai Spiegelhalder
- Department of Psychiatry and Psychotherapy, Medical Centre - University of Freiburg, Faculty of Medicine, University of Freiburg, Germany
| | - Simon B Eickhoff
- Institute of Systems Neuroscience, Medical Faculty, Heinrich-Heine University Düsseldorf, Germany; Institute of Neuroscience and Medicine (INM-1; INM-7), Research Center Jülich, Jülich, Germany
| | - Eus Van Someren
- Department of Sleep and Cognition, Netherlands Institute for Neuroscience, Meibergdreef 47, 1105 Amsterdam BA, The Netherlands; Department of Psychiatry and Integrative Neurophysiology, Center for Neurogenomics and Cognitive Research (CNCR), Neuroscience Campus Amsterdam, VU University and Medical Center, De Boelelaan 1187, 1081 Amsterdam HV, The Netherlands
| | - Habibolah Khazaie
- Sleep Disorders Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran.
| | - Claudia R Eickhoff
- Institute of Neuroscience and Medicine (INM-1; INM-7), Research Center Jülich, Jülich, Germany; Institute of Clinical Neuroscience and Medical Psychology, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
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Herbert V, Kyle SD, Pratt D. Does cognitive behavioural therapy for insomnia improve cognitive performance? A systematic review and narrative synthesis. Sleep Med Rev 2018; 39:37-51. [DOI: 10.1016/j.smrv.2017.07.001] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2016] [Revised: 07/04/2017] [Accepted: 07/04/2017] [Indexed: 01/04/2023]
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Increased hippocampal-prefrontal functional connectivity in insomnia. Neurobiol Learn Mem 2018; 160:144-150. [PMID: 29448003 DOI: 10.1016/j.nlm.2018.02.006] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2017] [Revised: 01/18/2018] [Accepted: 02/07/2018] [Indexed: 12/20/2022]
Abstract
Insomnia Disorder (ID) is the second-most common mental disorder and has a far-reaching impact on daytime functioning. A meta-analysis indicates that, of all cognitive domains, declarative memory involving the hippocampus is most affected in insomnia. Hippocampal functioning has consistently been shown to be sensitive to experimental sleep deprivation. Insomnia however differs from sleep deprivation in many aspects, and findings on hippocampal structure and function have been equivocal. The present study used both structural and resting-state functional Magnetic Resonance Imaging in a larger sample than previously reported to evaluate hippocampal volume and functional connectivity in ID. Included were 65 ID patients (mean age = 48.3 y ± 14.0, 17 males) and 65 good sleepers (mean age = 44.1 y ± 15.2, 23 males). Insomnia severity was assessed with the Insomnia Severity Index (ISI), subjective sleep with the Consensus Sleep Diary (CSD) and objective sleep by two nights of polysomnography (PSG). Seed-based analysis showed a significantly stronger connectivity of the bilateral hippocampus with the left middle frontal gyrus in ID than in controls (p = .035, cluster based correction for multiple comparisons). Further analyses across all participants moreover showed that individual differences in the strength of this connectivity were associated with insomnia severity (ISI, r = 0.371, p = 9.3e-5) and with subjective sleep quality (CSD sleep efficiency, r = -0.307, p = .009) (all p FDR-corrected). Hippocampal volume did not differ between ID and controls. The findings indicate more severe insomnia and worse sleep quality in people with a stronger functional connectivity between the bilateral hippocampus and the left middle frontal gyrus, part of a circuit that characteristically activates with maladaptive rumination and deactivates with sleep.
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Liu CH, Liu CZ, Zhu XQ, Fang JL, Lu SL, Tang LR, Wang CY, Liu QQ. Increased Posterior Insula-Sensorimotor Connectivity Is Associated with Cognitive Function in Healthy Participants with Sleep Complaints. Front Hum Neurosci 2018; 12:35. [PMID: 29467636 PMCID: PMC5808346 DOI: 10.3389/fnhum.2018.00035] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2017] [Accepted: 01/22/2018] [Indexed: 11/13/2022] Open
Abstract
Insomnia is characterized by sensory hypersensitivity and cognitive impairments. Recent work has identified the insula as a central brain region involved in both bottom-up gating of sensory information and top-down cognitive control. However, the specific relationships between insular subregion connectivity and emotional and cognitive functions remain unclear. In this study, resting-state functional magnetic resonance imaging data were obtained from 25 healthy participants with sleep complaints (HPS) and 25 age-, gender- and educational level-matched healthy participants without insomnia complaints (HP). We performed insular subregion (ventral anterior, dorsal anterior and posterior) functional connectivity (FC) analyses, and cognitive function was measured with several validated test procedures (e.g., the Wisconsin Card Sorting Test [WCST], Continuous Performance Test [CPT] and Trail making Test [TMT]). There were no significant differences between the two groups for WCST, CPT and TMT scores. The HPS group showed enhanced connectivity from the right posterior insula (R-PI) to the left postcentral gyrus (L-postCG) compared to HP group. WCST random errors (RE), sleep disturbance scores and HAMA scores correlated with this connectivity measurement in both HP and HPS groups. Our results provide direct evidence that the posterior insula (PI) synchronizes with sensorimotor areas to detect homeostatic changes and suggest that alteration of the latter is related to executive dysfunction in subjects with insomnia.
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Affiliation(s)
- Chun-Hong Liu
- Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Beijing Institute of Traditional Chinese Medicine, Beijing, China.,Department of Radiology and Psychiatry, Beijing Anding Hospital, Capital Medical University, Beijing, China
| | - Cun-Zhi Liu
- The department of Acupuncture and Moxibustion, Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Beijing Key Laboratory of Acupuncture Neuromodulation, Beijing, China
| | - Xue-Qi Zhu
- Department of Psychosomatic Medicine/Administration of Medical Institution Conducting Clinical Trials for Human Used Drug, Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Beijing, China
| | - Ji-Liang Fang
- Functional Brain Imaging Lab, Department of Radiology, Guang An Men Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Shun-Li Lu
- Department of Radiology and Psychiatry, Beijing Anding Hospital, Capital Medical University, Beijing, China
| | - Li-Rong Tang
- Department of Radiology and Psychiatry, Beijing Anding Hospital, Capital Medical University, Beijing, China
| | - Chuan-Yue Wang
- Department of Radiology and Psychiatry, Beijing Anding Hospital, Capital Medical University, Beijing, China
| | - Qing-Quan Liu
- Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Beijing Institute of Traditional Chinese Medicine, Beijing, China
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43
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Li Z, Chen R, Guan M, Wang E, Qian T, Zhao C, Zou Z, Beck T, Shi D, Wang M, Zhang H, Li Y. Disrupted brain network topology in chronic insomnia disorder: A resting-state fMRI study. NEUROIMAGE-CLINICAL 2018; 18:178-185. [PMID: 29387533 PMCID: PMC5789127 DOI: 10.1016/j.nicl.2018.01.012] [Citation(s) in RCA: 42] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/04/2017] [Revised: 12/26/2017] [Accepted: 01/15/2018] [Indexed: 01/01/2023]
Abstract
This study investigated the topological characteristics of brain functional networks in chronic insomnia disorder (CID) patients. The resting-state functional magnetic resonance imaging and graph theory analysis method were applied to investigate the brain functional connectome patterns among 45 CID patients and 32 healthy controls. The brain functional connectome was constructed by thresholding partial correlation matrices of 90 brain regions from an automated anatomical labeling atlas. The topologic properties of brain functional connectomes at both global and nodal levels were tested. The CID patients had decreased number of module (p = .014) and hierarchy (p = .038), and increased assortativity (p = .035). Furthermore, some brain regions located in the default mode network, dorsal attention network, and sensory-motor network in these patients showed altered nodal centralities. Within these areas, the node betweenness of right central paracentral lobule had positive correlation with the Pittsburgh Sleep Quality Index score (R = 0.319, p = .039). The results imply that functional disruptions of CID patients may be related to disruptions in global and regional topological organization of the brain functional connectome, and provide new and important insights to understand the pathophysiological mechanisms of CID. Chronic insomnia disorder (CID) patients had disrupted global topological properties. Many brain regions of CID patients showed altered nodal centralities involving three different resting networks. Functional disruption of right central paracentral lobule may be a target for therapeutic intervention in pediatric CID. The disruption of topological organization might be explain the mechanism/reason of functional disruptions of CID.
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Affiliation(s)
- Zhonglin Li
- People's Hospital of Zhengzhou University, Department of Radiology, China; Henan Key Laboratory for Medical Imaging of Neurological Diseases, Department of Functional Imaging, China
| | - Rui Chen
- People's Hospital of Zhengzhou University, Department of Radiology, China; Henan Key Laboratory for Medical Imaging of Neurological Diseases, Department of Functional Imaging, China
| | - Min Guan
- People's Hospital of Zhengzhou University, Department of Radiology, China; Henan Key Laboratory for Medical Imaging of Neurological Diseases, Department of Functional Imaging, China
| | - Enfeng Wang
- People's Hospital of Zhengzhou University, Department of Radiology, China; Henan Key Laboratory for Medical Imaging of Neurological Diseases, Department of Functional Imaging, China
| | - Tianyi Qian
- Siemens Healthcare, MR Collaboration, NEA, Beijing, China
| | - Cuihua Zhao
- People's Hospital of Zhengzhou University, Department of Radiology, China; Henan Key Laboratory for Medical Imaging of Neurological Diseases, Department of Functional Imaging, China
| | - Zhi Zou
- People's Hospital of Zhengzhou University, Department of Radiology, China; Henan Key Laboratory for Medical Imaging of Neurological Diseases, Department of Functional Imaging, China
| | - Thomas Beck
- Siemens Healthcare, MR Strategy and Innovation, Erlangen, Germany
| | - Dapeng Shi
- People's Hospital of Zhengzhou University, Department of Radiology, China; Henan Key Laboratory for Medical Imaging of Neurological Diseases, Department of Functional Imaging, China
| | - Meiyun Wang
- People's Hospital of Zhengzhou University, Department of Radiology, China; Henan Key Laboratory for Medical Imaging of Neurological Diseases, Department of Functional Imaging, China
| | - Hongju Zhang
- People's Hospital of Zhengzhou University, Department of Neurology, China.
| | - Yongli Li
- People's Hospital of Zhengzhou University, Department of Radiology, China; Henan Key Laboratory for Medical Imaging of Neurological Diseases, Department of Functional Imaging, China.
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44
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Liu CH, Guo J, Lu SL, Tang LR, Fan J, Wang CY, Wang L, Liu QQ, Liu CZ. Increased Salience Network Activity in Patients With Insomnia Complaints in Major Depressive Disorder. Front Psychiatry 2018; 9:93. [PMID: 29615938 PMCID: PMC5869937 DOI: 10.3389/fpsyt.2018.00093] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/03/2017] [Accepted: 03/06/2018] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Insomnia is one of the main symptom correlates of major depressive disorder (MDD), but the neural mechanisms underlying the multifaceted interplay between insomnia and depression are not fully understood. MATERIALS AND METHODS Patients with MDD and high insomnia (MDD-HI, n = 24), patients with MDD and low insomnia (MDD-LI, n = 37), and healthy controls (HCs, n = 51) were recruited to participate in the present study. The amplitude of low-frequency fluctuations (ALFF) during the resting state were compared among the three groups. RESULTS We observed ALFF differences between the three groups in the right inferior frontal gyrus/anterior insula (IFG/AI), right middle temporal gyrus, left calcarine, and bilateral dorsolateral prefrontal cortex (dlPFC). Further region of interest (ROI) comparisons showed that the increases in the right IFG/AI reflected an abnormality specific to insomnia in MDD, while increases in the bilateral dlPFC reflected an abnormality specific to MDD generally. Increased ALFF in the right IFG/AI was also found to be correlated with sleep disturbance scores when regressing out the influence of the severity of anxiety and depression. CONCLUSION Our findings suggest that increased resting state ALLF in IFG/AI may be specifically related to hyperarousal state of insomnia in patients with MDD, independently of the effects of anxiety and depression.
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Affiliation(s)
- Chun-Hong Liu
- Beijing Hospital of Traditional Chinese Medicine, Beijing Institute of Traditional Chinese Medicine, Capital Medical University, Beijing, China.,Beijing Key Laboratory of Mental Disorders, Department of Radiology, Beijing Anding Hospital, Capital Medical University, Beijing, China
| | - Jing Guo
- Acupuncture and Moxibustion Department, Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Beijing, China
| | - Shun-Li Lu
- Beijing Key Laboratory of Mental Disorders, Department of Radiology, Beijing Anding Hospital, Capital Medical University, Beijing, China
| | - Li-Rong Tang
- Beijing Key Laboratory of Mental Disorders, Department of Radiology, Beijing Anding Hospital, Capital Medical University, Beijing, China
| | - Jin Fan
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, United States
| | - Chuan-Yue Wang
- Beijing Key Laboratory of Mental Disorders, Department of Radiology, Beijing Anding Hospital, Capital Medical University, Beijing, China
| | - Lihong Wang
- Department of Psychiatry, University of Connecticut Health Center, Farmington, CT, United States
| | - Qing-Quan Liu
- Beijing Hospital of Traditional Chinese Medicine, Beijing Institute of Traditional Chinese Medicine, Capital Medical University, Beijing, China
| | - Cun-Zhi Liu
- Acupuncture and Moxibustion Department, Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Beijing, China
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45
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Lu FM, Dai J, Couto TA, Liu CH, Chen H, Lu SL, Tang LR, Tie CL, Chen HF, He MX, Xiang YT, Yuan Z. Diffusion Tensor Imaging Tractography Reveals Disrupted White Matter Structural Connectivity Network in Healthy Adults with Insomnia Symptoms. Front Hum Neurosci 2017; 11:583. [PMID: 29249951 PMCID: PMC5715269 DOI: 10.3389/fnhum.2017.00583] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2017] [Accepted: 11/17/2017] [Indexed: 12/17/2022] Open
Abstract
Neuroimaging studies have revealed that insomnia is characterized by aberrant neuronal connectivity in specific brain regions, but the topological disruptions in the white matter (WM) structural connectivity networks remain largely unknown in insomnia. The current study uses diffusion tensor imaging (DTI) tractography to construct the WM structural networks and graph theory analysis to detect alterations of the brain structural networks. The study participants comprised 30 healthy subjects with insomnia symptoms (IS) and 62 healthy subjects without IS. Both the two groups showed small-world properties regarding their WM structural connectivity networks. By contrast, increased local efficiency and decreased global efficiency were identified in the IS group, indicating an insomnia-related shift in topology away from regular networks. In addition, the IS group exhibited disrupted nodal topological characteristics in regions involving the fronto-limbic and the default-mode systems. To our knowledge, this is the first study to explore the topological organization of WM structural network connectivity in insomnia. More importantly, the dysfunctions of large-scale brain systems including the fronto-limbic pathways, salience network and default-mode network in insomnia were identified, which provides new insights into the insomnia connectome. Topology-based brain network analysis thus could be a potential biomarker for IS.
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Affiliation(s)
- Feng-Mei Lu
- Bioimaging Core, Faculty of Health Sciences, University of Macau, Macau, China
| | - Jing Dai
- Chengdu Mental Health Center, Chengdu, China.,The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Lab for Neuroinformation, University of Electronic Science and Technology of China, Chengdu, China
| | - Tania A Couto
- Bioimaging Core, Faculty of Health Sciences, University of Macau, Macau, China
| | - Chun-Hong Liu
- Beijing Institute of Traditional Chinese Medicine, Beijing Hospital of Traditional Chinese Medicine Affiliated to Capital Medical University, Beijing, China.,Department of Radiology, Beijing Anding Hospital, Capital Medical University, Beijing, China
| | - Heng Chen
- Key Laboratory for NeuroInformation of Ministry of Education, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu, China
| | - Shun-Li Lu
- Department of Radiology, Beijing Anding Hospital, Capital Medical University, Beijing, China
| | - Li-Rong Tang
- Department of Radiology, Beijing Anding Hospital, Capital Medical University, Beijing, China
| | - Chang-Le Tie
- Department of Radiology, Beijing Anding Hospital, Capital Medical University, Beijing, China
| | - Hua-Fu Chen
- Key Laboratory for NeuroInformation of Ministry of Education, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu, China
| | - Man-Xi He
- Chengdu Mental Health Center, Chengdu, China.,The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Lab for Neuroinformation, University of Electronic Science and Technology of China, Chengdu, China
| | - Yu-Tao Xiang
- Bioimaging Core, Faculty of Health Sciences, University of Macau, Macau, China
| | - Zhen Yuan
- Bioimaging Core, Faculty of Health Sciences, University of Macau, Macau, China
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46
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Dubrovsky B, Janal MN, Lavigne GJ, Sirois DA, Wigren PE, Nemelivsky L, Krieger AC, Raphael KG. Depressive symptoms account for differences between self-reported versus polysomnographic assessment of sleep quality in women with myofascial TMD. J Oral Rehabil 2017; 44:925-933. [PMID: 28853162 DOI: 10.1111/joor.12552] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/23/2017] [Indexed: 12/13/2022]
Abstract
Patients with temporomandibular disorder (TMD) report poor sleep quality on the Pittsburgh Sleep Quality Index (PSQI). However, polysomnographic (PSG) studies show meagre evidence of sleep disturbance on standard physiological measures. The present aim was to analyse self-reported sleep quality in TMD as a function of myofascial pain, PSG parameters and depressive symptomatology. PSQI scores from 124 women with myofascial TMD and 46 matched controls were hierarchically regressed onto TMD presence, ratings of pain intensity and pain-related disability, in-laboratory PSG variables and depressive symptoms (Symptoms Checklist-90). Relative to controls, TMD cases had higher PSQI scores, representing poorer subjective sleep and more depressive symptoms (both P < 0·001). Higher PSQI scores were strongly predicted by more depressive symptoms (P < 0·001, R2 = 26%). Of 19 PSG variables, two had modest contributions to higher PSQI scores: longer rapid eye movement latency in TMD cases (P = 0·01, R2 = 3%) and more awakenings in all participants (P = 0·03, R2 = 2%). After accounting for these factors, TMD presence and pain ratings were not significantly related to PSQI scores. These results show that reported poor sleep quality in TMD is better explained by depressive symptoms than by PSG-assessed sleep disturbances or myofascial pain. As TMD cases lacked typical PSG features of clinical depression, the results suggest a negative cognitive bias in TMD and caution against interpreting self-report sleep measures as accurate indicators of PSG sleep disturbance. Future investigations should take account of depressive symptomatology when interpreting reports of poor sleep.
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Affiliation(s)
- B Dubrovsky
- Department of Oral and Maxillofacial Pathology, Radiology and Medicine, NYU College of Dentistry, New York, NY, USA.,Center for Sleep Disorders, Division of Pulmonary and Critical Care Medicine, Department of Medicine, New York-Presbyterian Brooklyn Methodist Hospital, Brooklyn, NY, USA
| | - M N Janal
- Department of Epidemiology and Health Promotion, NYU College of Dentistry, New York, NY, USA
| | - G J Lavigne
- Faculté de Médecine Dentaire, Université de Montréal, Montréal, QC, Canada
| | - D A Sirois
- Department of Oral and Maxillofacial Pathology, Radiology and Medicine, NYU College of Dentistry, New York, NY, USA
| | - P E Wigren
- Department of Oral and Maxillofacial Pathology, Radiology and Medicine, NYU College of Dentistry, New York, NY, USA.,Private Practice, Stockholm, Sweden
| | - L Nemelivsky
- Cancer Clinical Trials Office, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - A C Krieger
- Departments of Medicine, Neurology and Genetic Medicine, Weill Cornell Medical College, Cornell University, New York, NY, USA
| | - K G Raphael
- Department of Oral and Maxillofacial Pathology, Radiology and Medicine, NYU College of Dentistry, New York, NY, USA
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47
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Miller CB, Rae CD, Green MA, Yee BJ, Gordon CJ, D’Rozario AL, Kyle SD, Espie CA, Grunstein RR, Bartlett DJ. An Objective Short Sleep Insomnia Disorder Subtype Is Associated With Reduced Brain Metabolite Concentrations In Vivo: A Preliminary Magnetic Resonance Spectroscopy Assessment. Sleep 2017; 40:4093919. [DOI: 10.1093/sleep/zsx148] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
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48
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Li X, Guo S, Wang C, Wang B, Sun H, Zhang X. Increased interhemispheric resting-state functional connectivity in healthy participants with insomnia symptoms: A randomized clinical consort study. Medicine (Baltimore) 2017; 96:e7037. [PMID: 28682863 PMCID: PMC5502136 DOI: 10.1097/md.0000000000007037] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND Abnormalities within the insular cortex of the salience and thalamus of the hyperarousal network have been increasingly reported in healthy participants with insomnia symptoms by recent resting-state functional magnetic resonance imaging (rsfMRI) studies. However, little is known about the changes in functional interaction between the bilateral cerebral hemispheres in healthy participants with insomnia symptoms. METHODS In a randomized trial, 27 healthy participants with insomnia symptoms and 27 age-, gender-, and educational level-matched healthy participants without insomnia symptoms underwent rsfMRI. Voxel-mirrored homotopic connectivity (VMHC) was used to measure functional connectivity between any pair of symmetrical interhemispheric voxels (i.e., functional homotopy). RESULTS The healthy participants with insomnia symptoms displayed significantly increased VMHC compared to healthy participants without insomnia symptoms in the bilateral thalamus/posterior insula (including anterior insula), fusiform, middle cingulate gyrus, inferior parietal lobe, and postcentral gyrus. No regions of decreased VMHC were detected in healthy participants with insomnia symptoms. There were significantly positive correlations between the VMHC values in the anterior cingulate cortex (ACC) and sleep disturbance scores in all healthy participants. CONCLUSIONS Insomnia is associated with substantial impairment of interhemispheric coordination within the default mode (ACC), salience (insula), hyperarousal (thalamus/posterior insula), and visual (fusiform) networks.
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Affiliation(s)
- Xuhua Li
- Department of Neurology, Linyi People's Hospital, Linyi
| | - Shougang Guo
- Department of Neurology, Shandong Provincial Hospital Affiliated to Shandong University, Jinan, China
| | - Chunjuan Wang
- Department of Neurology, Shandong Provincial Hospital Affiliated to Shandong University, Jinan, China
| | - Baojie Wang
- Department of Neurology, Shandong Provincial Hospital Affiliated to Shandong University, Jinan, China
| | - Hao Sun
- Department of Neurology, Shandong Provincial Hospital Affiliated to Shandong University, Jinan, China
| | - Xiaoting Zhang
- Department of Neurology, Shandong Provincial Hospital Affiliated to Shandong University, Jinan, China
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49
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Changes in subcortical shape and cognitive function in patients with chronic insomnia. Sleep Med 2017; 35:23-26. [DOI: 10.1016/j.sleep.2017.04.002] [Citation(s) in RCA: 37] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2017] [Revised: 03/28/2017] [Accepted: 04/04/2017] [Indexed: 12/19/2022]
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50
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Kyle SD, Hurry MED, Emsley R, Luik AI, Omlin X, Spiegelhalder K, Espie CA, Sexton CE. Effects of digital Cognitive Behavioural Therapy for Insomnia on cognitive function: study protocol for a randomised controlled trial. Trials 2017; 18:281. [PMID: 28623947 PMCID: PMC5474001 DOI: 10.1186/s13063-017-2012-6] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2017] [Accepted: 05/23/2017] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND The daytime effects of insomnia pose a significant burden to patients and drive treatment seeking. In addition to subjective deficits, meta-analytic data show that patients experience reliable objective impairments across several cognitive domains. While Cognitive Behavioural Therapy for Insomnia (CBT-I) is an effective and scalable treatment, we know little about its impact upon cognitive function. Trials of CBT-I have typically used proxy measures for cognitive functioning, such as fatigue or work performance scales, and no study has assessed self-reported impairment in cognitive function as a primary outcome. Moreover, only a small number of studies have assessed objective cognitive performance, pre-to-post CBT-I, with mixed results. This study specifically aims to (1) investigate the impact of CBT-I on cognitive functioning, assessed through both self-reported impairment and objective performance measures, and (2) examine whether change in sleep mediates this impact. METHODS/DESIGN We propose a randomised controlled trial of 404 community participants meeting criteria for Insomnia Disorder. In the DISCO trial (D efining the I mpact of improved S leep on CO gnitive function (DISCO)) participants will be randomised to digital automated CBT-I delivered by a web and/or mobile platform (in addition to treatment as usual (TAU)) or to a wait-list control (in addition to TAU). Online assessments will take place at 0 (baseline), 10 (post-treatment), and 24 (follow-up) weeks. At week 25, all participants allocated to the wait-list group will be offered digital CBT-I, at which point the controlled element of the trial will be complete. The primary outcome is self-reported cognitive impairment at post-treatment (10 weeks). Secondary outcomes include objective cognitive performance, insomnia severity, sleepiness, fatigue, and self-reported cognitive failures and emotional distress. All main analyses will be carried out on completion of follow-up assessments and will be based on the intention-to-treat principle. Further analyses will determine to what extent observed changes in self-reported cognitive impairment and objective cognitive performance are mediated by changes in sleep. The trial is supported by the National Institute for Health Research (NIHR) Oxford Biomedical Research Centre (BRC) based at Oxford University Hospitals NHS Trust and University of Oxford, and by the NIHR Oxford Health BRC. DISCUSSION This study will be the first large-scale examination of the impact of digital CBT-I on self-reported cognitive impairment and objective cognitive performance. TRIAL REGISTRATION ISRCTN, ID: ISRCTN89237370 . Registered on 17 October 2016.
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Affiliation(s)
- Simon D. Kyle
- Nuffield Department of Clinical Neurosciences, Sleep and Circadian Neuroscience Institute, University of Oxford, Sir William Dunn School of Pathology, South Parks Road, Oxford, OX1 3RE UK
| | - Madeleine E. D. Hurry
- Nuffield Department of Clinical Neurosciences, Sleep and Circadian Neuroscience Institute, University of Oxford, Sir William Dunn School of Pathology, South Parks Road, Oxford, OX1 3RE UK
- Oxford Nuffield Department of Clinical Neurosciences, Centre for Functional Magnetic Resonance Imaging of the Brain (FMRIB Centre), University of Oxford, Oxford, UK
| | - Richard Emsley
- Centre for Biostatistics, School of Health Sciences, The University of Manchester, Manchester Academic Health Science Centre, Manchester, UK
| | - Annemarie I. Luik
- Nuffield Department of Clinical Neurosciences, Sleep and Circadian Neuroscience Institute, University of Oxford, Sir William Dunn School of Pathology, South Parks Road, Oxford, OX1 3RE UK
- Big Health Ltd., London, UK
| | - Ximena Omlin
- Nuffield Department of Clinical Neurosciences, Sleep and Circadian Neuroscience Institute, University of Oxford, Sir William Dunn School of Pathology, South Parks Road, Oxford, OX1 3RE UK
| | - Kai Spiegelhalder
- Department of Psychiatry and Psychotherapy, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Colin A. Espie
- Nuffield Department of Clinical Neurosciences, Sleep and Circadian Neuroscience Institute, University of Oxford, Sir William Dunn School of Pathology, South Parks Road, Oxford, OX1 3RE UK
- Big Health Ltd., London, UK
| | - Claire E. Sexton
- Oxford Nuffield Department of Clinical Neurosciences, Centre for Functional Magnetic Resonance Imaging of the Brain (FMRIB Centre), University of Oxford, Oxford, UK
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