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Lunsford-Avery JR, Carskadon MA, Kollins SH, Krystal AD. Sleep Physiology and Neurocognition Among Adolescents With Attention-Deficit/Hyperactivity Disorder. J Am Acad Child Adolesc Psychiatry 2024:S0890-8567(24)00123-0. [PMID: 38484795 DOI: 10.1016/j.jaac.2024.03.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Revised: 01/26/2024] [Accepted: 03/05/2024] [Indexed: 04/04/2024]
Abstract
OBJECTIVE Few studies have characterized the nature of sleep problems among adolescents with attention-deficit/hyperactivity disorder (ADHD) using polysomnography (PSG). Additionally, although adolescents with ADHD and adolescents with sleep disturbances display similar neurocognitive deficits, the role of sleep in contributing to neurocognitive impairment in adolescent ADHD is unknown. This study investigated differences in PSG-measured sleep among adolescents with ADHD compared with non-psychiatric controls and associations with neurocognition. METHOD Medication-free adolescents aged 13 to 17 (N = 62, n = 31 with ADHD; mean age = 15.3 years; 50% female) completed a diagnostic evaluation, 3 nights of ambulatory PSG, the Cambridge Neuropsychological Test Automated Battery, and subjective reports of sleep and executive functioning. Linear regressions covarying for age, sex, and pubertal status examined group differences in sleep indices, and partial Pearson correlations assessed relations between sleep and neurocognition. RESULTS Although adolescents with ADHD did not exhibit differences in PSG-measured sleep duration, awakenings, or latency (ps > .05) compared with non-psychiatric controls, they displayed lower slow wave sleep percentage (β = -.40) and non-rapid eye movement (NREM) electroencephalogram (EEG) delta power (β = -.29). They also exhibited greater stage 2 percentage (β = .41), NREM EEG sigma power (β = .41), and elevated self-reported sleep disturbances (ps < .05). Lower NREM EEG delta power, increased high-frequency power, and slower decline in NREM EEG delta power overnight were associated with poorer neurocognition among adolescents with ADHD. CONCLUSIONS Adolescents with ADHD reported more sleep disturbances than non-psychiatric controls and exhibited differences in sleep stage distribution and NREM sleep EEG frequency. Sleep-EEG spectral indices were associated with impaired neurocognition, suggesting that physiological sleep processes may underlie neurocognitive deficits in ADHD. Future studies may clarify whether sleep plays a causal role in neurocognitive impairments in adolescent ADHD and whether interventions normalizing sleep improve neurocognition. CLINICAL TRIAL REGISTRATION INFORMATION Sleep Dysfunction and Neurocognitive Outcomes in Adolescent ADHD; https://clinicaltrials.gov/; NCT02897362. DIVERSITY & INCLUSION STATEMENT We worked to ensure sex and gender balance in the recruitment of human participants. We worked to ensure race, ethnic, and/or other types of diversity in the recruitment of human participants. We worked to ensure that the study questionnaires were prepared in an inclusive way. One or more of the authors of this paper self-identifies as a member of one or more historically underrepresented sexual and/or gender groups in science. We actively worked to promote sex and gender balance in our author group. While citing references scientifically relevant for this work, we also actively worked to promote sex and gender balance in our reference list.
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Affiliation(s)
| | - Mary A Carskadon
- Warren Alpert Medical School of Brown University, Providence, Rhode Island
| | | | - Andrew D Krystal
- Weill Institute for Neurosciences at University of California San Francisco, San Francisco, California
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Zhang H, Sun H, Li J, Yang J, Fan Y, Jülich ST, Lei X. Response inhibition impairment related to altered frontal-striatal functional connectivity in insomnia disorder: A pilot and non-clinical study. J Psychiatr Res 2024; 170:138-146. [PMID: 38134723 DOI: 10.1016/j.jpsychires.2023.12.023] [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] [Received: 08/10/2023] [Revised: 12/06/2023] [Accepted: 12/12/2023] [Indexed: 12/24/2023]
Abstract
BACKGROUND It is not clear whether and how insomnia disorder (ID) impairs response inhibition ability. Fronto-striatal functional connectivity (FC) plays a critical role in response inhibition and is found be abnormal in patients with ID. In this study, we examined whether insomnia symptoms impair response inhibition in a large non-clinical sample and whether impaired response inhibition is related to abnormal fronto-striatal FC. METHODS One hundred and fifteen young ID patients and 160 age and sex-matched healthy controls (HC) underwent resting-state functional magnetic response imaging scans and performed the stop-signal task (SST). Performance of SST, Gray Matter Volumes (GMVs), and connections of brain regions related to fronto-striatal circuits was compared between groups. Further examined the association between response inhibition impairment and fronto-striatal FC. RESULTS The behavioral results showed that patients with ID had significantly longer stop-signal reaction time (SSRT) compared with the HC, reflecting the impaired response inhibition among IDs. Brain imaging results showed IDs had decreased GMVs of the Right Superior Frontal (SFG) and left Supplementary Motor area (SMA). Seed-based FC results showed that compared to HC, the ID showed decreased FC between left SMA and left Paracentral lobule, left SMA and right SMA, and right SFG and right Orbital Middle Frontal gyrus, and increased FC between right SFG and right putamen. Meanwhile, the FC between right SFG and putamen was positively correlated with SSRT in IDs. CONCLUSIONS The current study found significantly impaired response inhibition among ID and this impairment may be related to abnormal fronto-striatal FC in ID.
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Affiliation(s)
- Haobo Zhang
- Sleep and NeuroImaging Center, Faculty of Psychology, Southwest University, Chongqing, 400715, China; Key Laboratory of Cognition and Personality (Southwest University), Ministry of Education, Chongqing, 400715, China
| | - Haonan Sun
- Sleep and NeuroImaging Center, Faculty of Psychology, Southwest University, Chongqing, 400715, China; Key Laboratory of Cognition and Personality (Southwest University), Ministry of Education, Chongqing, 400715, China
| | - Jiatao Li
- Sleep and NeuroImaging Center, Faculty of Psychology, Southwest University, Chongqing, 400715, China; Key Laboratory of Cognition and Personality (Southwest University), Ministry of Education, Chongqing, 400715, China
| | - Jingqi Yang
- Sleep and NeuroImaging Center, Faculty of Psychology, Southwest University, Chongqing, 400715, China; Key Laboratory of Cognition and Personality (Southwest University), Ministry of Education, Chongqing, 400715, China
| | - Yuhan Fan
- Sleep and NeuroImaging Center, Faculty of Psychology, Southwest University, Chongqing, 400715, China; Key Laboratory of Cognition and Personality (Southwest University), Ministry of Education, Chongqing, 400715, China
| | - Simon Theodor Jülich
- Sleep and NeuroImaging Center, Faculty of Psychology, Southwest University, Chongqing, 400715, China; Key Laboratory of Cognition and Personality (Southwest University), Ministry of Education, Chongqing, 400715, China
| | - Xu Lei
- Sleep and NeuroImaging Center, Faculty of Psychology, Southwest University, Chongqing, 400715, China; Key Laboratory of Cognition and Personality (Southwest University), Ministry of Education, Chongqing, 400715, China.
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Hildebrand L, Huskey A, Dailey N, Jankowski S, Henderson-Arredondo K, Trapani C, Patel SI, Chen AYC, Chou YH, Killgore WDS. Transcranial Magnetic Stimulation of the Default Mode Network to Improve Sleep in Individuals With Insomnia Symptoms: Protocol for a Double-Blind Randomized Controlled Trial. JMIR Res Protoc 2024; 13:e51212. [PMID: 38277210 PMCID: PMC10858423 DOI: 10.2196/51212] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2023] [Revised: 12/24/2023] [Accepted: 12/26/2023] [Indexed: 01/27/2024] Open
Abstract
BACKGROUND Cortical hyperarousal and ruminative thinking are common aspects of insomnia that have been linked with greater connectivity in the default mode network (DMN). Therefore, disrupting network activity within the DMN may reduce cortical and cognitive hyperarousal and facilitate better sleep. OBJECTIVE This trial aims to establish a novel, noninvasive method for treating insomnia through disruption of the DMN with repetitive transcranial magnetic stimulation, specifically with continuous theta burst stimulation (cTBS). This double-blind, pilot randomized controlled trial will assess the efficacy of repetitive transcranial magnetic stimulation as a novel, nonpharmacological approach to improve sleep through disruption of the DMN prior to sleep onset for individuals with insomnia. Primary outcome measures will include assessing changes in DMN functional connectivity before and after stimulation. METHODS A total of 20 participants between the ages of 18 to 50 years with reported sleep disturbances will be recruited as a part of the study. Participants will then conduct an in-person screening and follow-on enrollment visit. Eligible participants then conduct at-home actigraphic collection until their first in-residence overnight study visit. In a double-blind, counterbalanced, crossover study design, participants will receive a 40-second stimulation to the left inferior parietal lobule of the DMN during 2 separate overnight in-residence visits. Participants are randomized to the order in which they receive the active stimulation and sham stimulation. Study participants will undergo a prestimulation functional magnetic resonance imaging scan and a poststimulation functional magnetic resonance imaging scan prior to sleep for each overnight study visit. Sleep outcomes will be measured using clinical polysomnography. After their first in-residence study visit, participants conduct another at-home actigraphic collection before returning for their second in-residence overnight study visit. RESULTS Our study was funded in September 2020 by the Department of Defense (W81XWH2010173). We completed the enrollment of our target study population in the October 2022 and are currently working on neuroimaging processing and analysis. We aim to publish the results of our study by 2024. Primary neuroimaging outcome measures will be tested using independent components analysis, seed-to-voxel analyses, and region of interest to region of interest analyses. A repeated measures analysis of covariance (ANCOVA) will be used to assess the effects of active and sham stimulation on sleep variables. Additionally, we will correlate changes in functional connectivity to polysomnography-graded sleep. CONCLUSIONS The presently proposed cTBS protocol is aimed at establishing the initial research outcomes of the effects of a single burst of cTBS on disrupting the network connectivity of the DMN to improve sleep. If effective, future work could determine the most effective stimulation sites and administration schedules to optimize this potential intervention for sleep problems. TRIAL REGISTRATION ClinicalTrials.gov NCT04953559; https://clinicaltrials.gov/ct2/show/NCT04953559. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/51212.
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Affiliation(s)
- Lindsey Hildebrand
- Department of Psychiatry, University of Arizona, Tucson, AZ, United States
| | - Alisa Huskey
- Department of Psychiatry, University of Arizona, Tucson, AZ, United States
| | - Natalie Dailey
- Department of Psychiatry, University of Arizona, Tucson, AZ, United States
| | - Samantha Jankowski
- Department of Psychiatry, University of Arizona, Tucson, AZ, United States
| | | | | | - Salma Imran Patel
- Division of Pulmonary, Allergy, Critical Care and Sleep Medicine, University of Arizona, Tucson, AZ, United States
| | | | - Ying-Hui Chou
- Department of Psychology, University of Arizona, Tucson, AZ, United States
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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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Xu H, Dou Z, Luo Y, Yang L, Xiao X, Zhao G, Lin W, Xia Z, Zhang Q, Zeng F, Yu S. Neuroimaging profiles of the negative affective network predict anxiety severity in patients with chronic insomnia disorder: A machine learning study. J Affect Disord 2023; 340:542-550. [PMID: 37562562 DOI: 10.1016/j.jad.2023.08.016] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Revised: 05/05/2023] [Accepted: 08/03/2023] [Indexed: 08/12/2023]
Abstract
BACKGROUND Sleep is instrumental in safeguarding emotional well-being. While the susceptibility to both insomnia and anxiety has been demonstrated to involve intricate brain systems, the neuroimaging profile of chronic insomnia disorder with comorbid anxiety symptoms (CID-A) remains unexplored. Employing machine learning methodologies, this study aims to elucidate the distinct neural substrates underlying CID-A and to investigate whether these cerebral markers can prognosticate anxiety symptoms in patients with insomnia. METHODS Functional magnetic resonance imaging (fMRI) data were procured from a relatively large cohort (dataset 1) comprised of 47 CID-A patients, 49 CID patients without anxiety (CID-NA), and 48 good sleeper controls (GSC). Aberrant cerebral functional alterations were assessed through functional connectivity strength (FCS) and resting-state functional connectivity (rsFC). Subsequently, Support Vector Regression (SVR) models were constructed to predict anxiety symptoms in CID patients based on neuroimaging features, which were validated utilizing an external cohort (dataset 2). RESULTS In comparison to CID-NA and GSC subjects, CID-A patients exhibited heightened FCS in the right dorsomedial prefrontal cortex (DMPFC), a central hub within the negative affective network. Moreover, the SVR models revealed that DMPFC-related rsFC/FCS features could be employed to predict anxiety symptoms in two independent cohorts of CID patients. LIMITATION Modifications in brain functionality might vary across insomnia subtypes. CONCLUSION The present findings suggest a potential negative affective network model for the neuropathophysiology of CID accompanied by anxiety. Importantly, the negative affective network pattern may serve as a predictor for anxiety symptoms in CID patients.
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Affiliation(s)
- Hao Xu
- School of Acupuncture and Tuina, Chengdu University of Traditional Chinese Medicine, Chengdu, China; Center of Interventional Medicine, Affiliated Hospital of North Sichuan Medical College, Department of Interventional Radiology, School of Medical Imaging, North Sichuan Medical College, Nanchong, China
| | - Zeyang Dou
- School of Acupuncture and Tuina, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Yucai Luo
- School of Acupuncture and Tuina, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Lu Yang
- School of Acupuncture and Tuina, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Xiangwen Xiao
- School of Acupuncture and Tuina, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Guangli Zhao
- School of Rehabilitation and Health Preservation, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Wenting Lin
- School of Rehabilitation and Health Preservation, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Zihao Xia
- School of Acupuncture and Tuina, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Qi Zhang
- Chongqing Hospital of Traditional Chinese Medicine, Chongqing, China.
| | - Fang Zeng
- School of Acupuncture and Tuina, Chengdu University of Traditional Chinese Medicine, Chengdu, China; Acupuncture and Brain Science Research Center, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Siyi Yu
- School of Acupuncture and Tuina, Chengdu University of Traditional Chinese Medicine, Chengdu, China; Acupuncture and Brain Science Research Center, Chengdu University of Traditional Chinese Medicine, Chengdu, China.
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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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Aljudibi RA, Albeladi AA, Alsulami S, Alamoudi W. Hippocampal Malrotation Presenting With Treatment-Resistant Insomnia: A Case Report. Cureus 2023; 15:e46051. [PMID: 37900455 PMCID: PMC10604413 DOI: 10.7759/cureus.46051] [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] [Accepted: 09/26/2023] [Indexed: 10/31/2023] Open
Abstract
A frequent complaint in medical settings is insomnia. Chronic insomnia is defined as the occurrence of sleep disturbance symptoms for a period of three months, three times per week, and in conjunction with at least one daytime symptom. In the case study, a young man with a documented seizure disorder underwent a thorough evaluation for chronic sleeplessness. Electroencephalograms, sleep investigations, and drug reviews were unsuccessful in determining the cause. Nonetheless, it was found that there was bilateral hippocampal malrotation. This link is distinct and hasn't been mentioned as a possible cause before.
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Affiliation(s)
- Razan A Aljudibi
- College of Medicine, King Abdulaziz University Hospital, King Abdulaziz University, Jeddah, SAU
| | - Asala A Albeladi
- College of Medicine, King Abdulaziz University Hospital, King Abdulaziz University, Jeddah, SAU
| | - Salhah Alsulami
- Faculty of Medicine, King Abdulaziz University Hospital, King Abdulaziz University, Jeddah, SAU
| | - Wail Alamoudi
- Internal Medicine, King Abdulaziz University Hospital, King Abdulaziz University, Jeddah, SAU
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Zhang H, Sun H, Li J, Fan Y, Jülich ST, Lei X. Subtypes of insomnia revealed by the heterogeneity of neuroanatomical patterns: a structural MRI study. Biol Psychol 2023; 180:108591. [PMID: 37230291 DOI: 10.1016/j.biopsycho.2023.108591] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2023] [Revised: 05/17/2023] [Accepted: 05/22/2023] [Indexed: 05/27/2023]
Abstract
The current conflicting neuroimaging findings of insomnia disorder (ID) may be attributed to heterogeneity in ID. The present study aims to clarify the high heterogeneity in ID and examine the objective neurobiological subtypes of ID by using a novel machine learning method based on gray matter volumes (GMVs). We recruited 56 patients with ID and 73 healthy controls (HCs). The T1-weighted anatomical images were obtained for each participant. We investigated whether the ID has higher interindividual heterogeneity in GMVs. Then, we used a heterogeneous machine learning algorithm by discriminative analysis (HYDRA) to identify subtypes of ID with features of brain regional GMVs. We found that patients with ID have higher interindividual variability than HCs. HYDRA identified two distinct and reliable neuroanatomical subtypes of ID. Two subtypes showed significantly different aberrance in GMVs compared with HCs. Specifically, subtype 1 exhibited widespread decreased GMVs in some brain regions, including the right inferior temporal gyrus, left superior temporal gyrus, left precuneus, right middle cingulate, and right supplementary motor area. Subtype 2 only demonstrated increased GMVs in the right superior temporal gyrus. Additionally, the GMVs of altered brain regions in subtype 1 were significantly correlated with daytime functioning, but in subtype 2, they were significantly correlated with sleep disturbance. These results explain conflicting neuroimaging findings and propose a potential objective neurobiological classification contributing to ID's precise clinical diagnosis and treatment. DATA AND CODE AVAILABILITY: The source and means of obtaining the data used in the study have been described fully in the Methods and Materials section. The codes and data in this study are available upon a reasonable request to the corresponding author.
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Affiliation(s)
- Haobo Zhang
- Sleep and NeuroImaging Center, Faculty of Psychology, Southwest University, Chongqing, 400715, China; Key Laboratory of Cognition and Personality (Southwest University), Ministry of Education, Chongqing, 400715, China
| | - Haonan Sun
- Sleep and NeuroImaging Center, Faculty of Psychology, Southwest University, Chongqing, 400715, China; Key Laboratory of Cognition and Personality (Southwest University), Ministry of Education, Chongqing, 400715, China
| | - Jiaqi Li
- Sleep and NeuroImaging Center, Faculty of Psychology, Southwest University, Chongqing, 400715, China; Key Laboratory of Cognition and Personality (Southwest University), Ministry of Education, Chongqing, 400715, China
| | - Yuhan Fan
- Sleep and NeuroImaging Center, Faculty of Psychology, Southwest University, Chongqing, 400715, China; Key Laboratory of Cognition and Personality (Southwest University), Ministry of Education, Chongqing, 400715, China
| | - Simon Theodor Jülich
- Sleep and NeuroImaging Center, Faculty of Psychology, Southwest University, Chongqing, 400715, China; Key Laboratory of Cognition and Personality (Southwest University), Ministry of Education, Chongqing, 400715, China
| | - Xu Lei
- Sleep and NeuroImaging Center, Faculty of Psychology, Southwest University, Chongqing, 400715, China; Key Laboratory of Cognition and Personality (Southwest University), Ministry of Education, Chongqing, 400715, China.
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Xu H, Wang Y, Wang YM, Cao Y, Li P, Hu Y, Xia G. Insomniacs show greater prefrontal activation during verbal fluency task compared to non-insomniacs: a functional near-infrared spectroscopy investigation of depression in patients. BMC Psychiatry 2023; 23:217. [PMID: 36997897 PMCID: PMC10064712 DOI: 10.1186/s12888-023-04694-z] [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: 11/18/2022] [Accepted: 03/17/2023] [Indexed: 04/01/2023] Open
Abstract
BACKGROUND Previous studies have shown that insomnia affects human prefrontal function and that there are specific patterns of brain activation to counteract sleep and improve cognition. However, the effects of insomnia on the prefrontal cortex of MDD (major depressive disorder) patients and the patterns of activation to counteract sleep in MDD patients remain unclear. The aim of this study is to examine this using fNIRS (functional near-infrared spectroscopy). METHODS Eighty depressed patients and 44 healthy controls were recruited for this study. fNIRS was used to assess changes in the concentration of oxygenated hemoglobin ([oxy-Hb]) in the prefrontal cortex of all participants during the VFT (verbal fluency test) and to record the number of words created to assess cognitive ability. The Pittsburgh Sleep Quality Index was used to assess sleep quality, and the Hamilton Rating Scale for Depression (24-item) and Hamilton Rating Scale for Anxiety (14-item) were used to assess the severity of depression and anxiety. RESULTS When comparing patients, the healthy control group had significantly higher [oxy-Hb] values in the bilateral prefrontal cortex during VFT than the MDD group. In the MDD group, the [oxy-Hb] values in all brain regions except the right DLPFC were significantly higher in the group with insomnia than in the group without insomnia, but their VFT performance was significantly lower than in the group without insomnia and the healthy group. PSQI scores were positively correlated with [oxy-Hb] values in some left-brain regions, whereas HAMD and HAMA scores were not correlated with [oxy-Hb] values. CONCLUSION The PFC was significantly less active during VFT in those with MDD than in healthy controls. All brain regions, except the right DLPFC, were significantly more active in MDD patients with insomnia than in those without insomnia, suggesting that sleep quality needs to be an important indicator in fNIRS screening. In addition, there was a positive correlation between the severity of insomnia in the left VLPFC and the level of activation, suggesting a role for the left brain region in the neurophysiology of overcoming sleepiness in MDD patients. these findings may provide new ideas for the treatment of MDD patients in the future. TRIAL REGISTRATION Our experiment was registered in the China Clinical Trial Registry (registration number ChiCTR2200065622) on November 10.( The first patient was recruited in 10/11/2022.).
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Affiliation(s)
- HuaSen Xu
- Department of psychiatry, Affliated Hospital to Guizhou Medical University, Guizhou, China
| | - YuXing Wang
- Department of psychiatry, Affliated Hospital to Guizhou Medical University, Guizhou, China
| | - Yi Ming Wang
- Department of psychiatry, Affliated Hospital to Guizhou Medical University, Guizhou, China.
| | - YaQi Cao
- Department of psychiatry, Affliated Hospital to Guizhou Medical University, Guizhou, China
| | - PeiFan Li
- Department of psychiatry, Affliated Hospital to Guizhou Medical University, Guizhou, China
| | - YongXue Hu
- Department of psychiatry, Affliated Hospital to Guizhou Medical University, Guizhou, China
| | - GuangYuan Xia
- Department of psychiatry, Affliated Hospital to Guizhou Medical University, Guizhou, China
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Wang T, Ye Y, Li S, Jiang G. Altered functional connectivity of anterior cingulate cortex in chronic insomnia: A resting-state fMRI study. Sleep Med 2023; 102:46-51. [PMID: 36599195 DOI: 10.1016/j.sleep.2022.11.036] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/24/2022] [Revised: 11/28/2022] [Accepted: 11/30/2022] [Indexed: 12/12/2022]
Abstract
The aim of our present study was to explore the connectivity pattern change between the anterior cingulate cortex (ACC) and the voxels from the whole brain in chronic insomnia (CI). With region of interest (ROI)-based functional connectivity, a two-sample t-test was performed on individual FC correlation maps from two groups based on the resting-state fMRI data acquired from 57 CI patients and 46 healthy controls (GRF correction, voxel-level P < 0.001 and cluster-level P < 0.001). A correlation analysis was performed to evaluate the relationship between the clinical features and the abnormal FC. Compared to the healthy controls, the CI patients show increased connectivity between the ACC and the right middle frontal gyrus, with decreased connectivity between the ACC and the bilateral precuneus gyrus. Correlation analysis indicated that the decreased connectivity showed positive correlations with Self-Rating Anxiety Scale (SAS) scores. Our study shows the alterations of CI patients in the level of functional integration and may indicate the dysfunction of communication within brain regions of the default mode network (DMN). These changes and their correlation with negative emotions may provide additional evidence to understand the possible neural mechanisms of CI.
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Affiliation(s)
- Tianyue Wang
- Guangdong Second Provincial General Hospital, China
| | - Yongyi Ye
- Guangdong Medical University, China; Guangdong Second Provincial General Hospital, China
| | - Shumei Li
- Guangdong Second Provincial General Hospital, China
| | - Guihua Jiang
- Guangdong Medical University, China; Guangdong Second Provincial General Hospital, China.
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11
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Tegeler CL, Munger Clary H, Shaltout HA, Simpson SL, Gerdes L, Tegeler CH. Cereset Research Standard Operating Procedures for Insomnia: A Randomized, Controlled Clinical Trial. GLOBAL ADVANCES IN INTEGRATIVE MEDICINE AND HEALTH 2023; 12:27536130221147475. [PMID: 36816469 PMCID: PMC9933987 DOI: 10.1177/27536130221147475] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/13/2022] [Revised: 11/29/2022] [Accepted: 12/06/2022] [Indexed: 01/19/2023]
Abstract
Background Interventions for insomnia that also address autonomic dysfunction are needed. Objective We evaluate Cereset Research™ Standard Operating Procedures (CR-SOP) in a pilot randomized, controlled trial. CR-SOP is a less operator-dependent, more generalizable innovation of HIRREM®, a noninvasive, closed-loop, allostatic, acoustic stimulation neurotechnology demonstrated to improve insomnia and autonomic function. Methods Adults with Insomnia Severity Index (ISI) scores of ≥8 were randomized to receive ten sessions of CR-SOP, with tones linked to brainwaves (LB, intervention), or a sham condition of random tones not linked to brainwaves (NL, control). Measures were collected at enrollment and 0-14 days and 4-6 weeks post-allocated intervention. The primary outcome was differential change in ISI from baseline to 4-6 weeks post-intervention. Secondary self-report measures assessed sleep quality65 and behavioral outcomes. Ten-minute recordings of heart rate and blood pressure were collected to analyze autonomic function (heart rate variability [HRV] and baroreflex sensitivity). Results Of 22 randomized, 20 participants completed the allocated condition. Intention to treat analysis of change from baseline to the 4-6 week outcome demonstrated mean ISI score reduction of 4.69 points among controls (SE 1.40). In the intervention group, there was an additional 2.58 point reduction in ISI score (SE 2.13; total reduction of 7.27, P = .24). Sleep quality and some measures of autonomic function improved significantly among the intervention group compared to control. Conclusions This pilot study compared use of a standardized, allostatic, acoustic neurotechnology intervention with a sham, active control condition. The magnitude of change in insomnia severity was clinically relevant and similar to the findings in a prior, fully powered trial, but the differential improvement observed was not statistically significant. Significant improvements were demonstrated in sleep quality and some autonomic function measures.
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Affiliation(s)
- Catherine L. Tegeler
- Department of Neurology, Wake Forest School of Medicine (WFSM), Winston-Salem, NC, USA
| | - Heidi Munger Clary
- Department of Neurology, Wake Forest School of Medicine (WFSM), Winston-Salem, NC, USA
| | | | - Sean L. Simpson
- Department of Biostatistics and Data Sciences, WFSM, Winston-Salem, NC, USA
| | - Lee Gerdes
- Brain State Technologies, LLC, Scottsdale, AZ, USA
| | - Charles H. Tegeler
- Department of Neurology, Wake Forest School of Medicine (WFSM), Winston-Salem, NC, USA,Charles H. Tegeler, MD, Department of Neurology, Wake Forest School of Medicine, Medical Center Boulevard, Winston-Salem, NC 27157-1078, USA.
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12
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Fang Z, Liu X, Wang C, Cao J, Peng Y, Lv Y. Insomnia attenuates response inhibition: Evidence from Go/NoGo research. Sleep Med 2022; 100:518-533. [PMID: 36306630 DOI: 10.1016/j.sleep.2022.09.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Revised: 09/03/2022] [Accepted: 09/09/2022] [Indexed: 11/09/2022]
Abstract
OBJECTIVE Varied cognitive dysfunctions including memory, attention, inputs, processing and filtration have been found in insomnia. Meanwhile, evidence from functional neuroimaging have revealed that the abnormal metabolism in prefrontal cortex was associated with probable deficit of executive function. And in our study, we have detected the response inhibition in insomnia patients by Go/NoGo,an Event-related potentials (ERPs) study, in order to explore the impaired executive function, because response inhibition is a hallmark of executive function. METHODS We used polysomnography (PSG) to record such objective PSG parameters. Go/NoGo was performed in sequence, different ERP components have been analyzed such as latency or amplitude between insomnia group and control group. And we used Person correlation coefficient R to make analysis between different ERP components and gender, duration, education, BMI and sleep characteristics. RESULTS On the behavioral level, we found a little poor performance insomnia participants. On the electrophysiological level, under Go condition, insomnia participants have prolonged latency and smaller amplitude of N2 or P3. While, under NoGo condition, insomnia participants also have longer latency, but higher amplitude of N2 or P3. another major finding was that different correlation was found between gender,anxiety-depression,duration, education,BMI,sleep characteristics and N2 or P3. DISCUSSION Our study has revealed that sleep loss may influence the response inhibition ability in insomnia, not only on behavior level, but also on the electrophysiological level. Abnormal changes in inhibition process or inhibition supervision can be represented as N2/P3 components under Go/No-go condition. Additionally, correlation analysis has been found between gender, anxiety-depression, BMI, education, and sleep structure. Thus, sleep loss attenuates response inhibition and impairs executive function in insomnia participants.
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Affiliation(s)
- Zibing Fang
- Department of Neurology, Department of Neurology and Neuroscience Center, The First Hospital of Jilin University, 71-XinminStreet, ChangChun, PR China.
| | - Xinrui Liu
- Department of Neurology, Department of Neurology and Neuroscience Center, The First Hospital of Jilin University, 71-XinminStreet, ChangChun, PR China.
| | - Changming Wang
- Department of Neurosurgery, Xuanwu Hospital, Capital Medical University, Beijing, China.
| | - Jie Cao
- Department of Neurology, Department of Neurology and Neuroscience Center, The First Hospital of Jilin University, 71-XinminStreet, ChangChun, PR China.
| | - Yanhui Peng
- Department of Neurology, The Sixth Affiliated Hospital of Xinjiang Medical University, Wulumiqi, China.
| | - Yudan Lv
- Department of Neurology, Department of Neurology and Neuroscience Center, The First Hospital of Jilin University, 71-XinminStreet, ChangChun, PR China.
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13
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Observation on the Clinical Efficacy of Traditional Chinese Medicine Non-Drug Therapy in the Treatment of Insomnia: A Systematic Review and Meta-Analysis Based on Computer Artificial Intelligence System. COMPUTATIONAL INTELLIGENCE AND NEUROSCIENCE 2022; 2022:1081713. [PMID: 36268156 PMCID: PMC9578844 DOI: 10.1155/2022/1081713] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/08/2022] [Accepted: 09/24/2022] [Indexed: 11/17/2022]
Abstract
Objective. Insomnia is a common and frequently occurring disease affecting the health of the population, which can seriously affect the work and life of patients. Drug treatment of insomnia has a rapid onset of action but has a large adverse reaction incidence rate. Traditional external treatment of traditional Chinese medicine (TCM) belongs to a type of non-drug therapy, the treatment of insomnia has a long history, but the methods of non-drug treatment of TCM are diverse, and the efficacy is also different. This study investigated the efficacy of TCM non-drug therapy in the treatment of insomnia by means of literature search and meta-analysis. Methods. We searched Embase, Pubmed, OVid, WOS, CNKI, and CBM for randomized controlled trials (RCTs) on the use of TCM as a non-drug treatment for primary insomnia. After doing a literature search according to the inclusion and exclusion criteria, we used Cochrane rob v2.0 to assess the potential for bias in the studies that were included, and we did a combined analysis and assessment of the effectiveness of the therapy. Results. 16 articles were included in this study for quantitative analysis, and a total of 1285 patients participated in the study, including 643 patients in the intervention group and 642 patients in the control group. Meta-analysis showed that non-drug therapy of TCM could improve the treatment response rate of insomnia patients [OR = 6.88, 95%CI (4.40,10.74), Z = 8.48,
], reduce post-treatment PSQI total score [MD = −3.42, 95%CI (−4.62, −2.22), Z = −5.60,
], and improved patient anxiety [SMD = −1.25, 95%CI (−2.13, −0.37), Z = −2.78,
] and degree of depression [SMD = −1.53, 95%CI (−2.84, −0.21), Z = −2.28,
]. The heterogeneity survey showed that treatment time was one of the sources of heterogeneity. Meta-regression analysis revealed that publication year, patient age, sample size, and intervention characteristics were not specific factors affecting the combined results. Discussion. TCM non-drug therapy (acupuncture, moxibustion, massage, and auricular point pressing beans) can significantly improve the PSQI score of patients after treatment and improve the degree of anxiety and depression of patients, with significant effect, which is worthy of clinical promotion.
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14
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Abnormalities of the Default Mode Network Functional Connectivity in Patients with Insomnia Disorder. CONTRAST MEDIA & MOLECULAR IMAGING 2022; 2022:9197858. [PMID: 36101797 PMCID: PMC9440808 DOI: 10.1155/2022/9197858] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/07/2022] [Revised: 07/14/2022] [Accepted: 08/01/2022] [Indexed: 11/24/2022]
Abstract
Objective This paper aimed to probe changes in the default mode network (DMN) functional connectivity (DMNFC) of the brain of patients with insomnia disorder (ID) under the resting state. Methods A total of 67 patients with ID and 67 graphically matched healthy controls were selected. Then, their general information was collected, followed by a psychological scale valuation. Resting state functional magnetic resonance imaging (rs-fMRI) scanning was conducted. Subsequently, collected statistics were processed, bilateral precuneus and medial superior frontal gyrus were defined as regions of interest (ROI), and the difference in intensity between these two groups was compared. Results Compared with the healthy control group, the patients in the ID group were observed with abnormalities of DMNFC. Specifically, a significant increase in the functional connectivity (FC) could be observed between the left medial superior frontal gyrus and left central anterior gyrus, the left medial superior frontal gyrus and anterior cingulate gyrus, the right medial superior frontal gyrus and left central anterior gyrus, the left anterior cuneiform and left central anterior/posterior gyrus, the left anterior cuneiform and left superior occipital gyrus, as well as the right anterior cuneiform and left central posterior gyrus. However, the FC between the left anterior cuneiform and the right middle frontal gyrus was weakened, as well as between the left anterior cuneiform and the right angle gyrus and between the right precuneus and the left inferior temporal gyrus. Conclusion ID patients may suffer changes in FC. The decline of FC in DMN may be one of the underlying causes of ID; the enhancement of FC between DMN and the visual-spatial attention network may play a key role in the mechanisms of impaired brain functional networks of ID.
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15
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Guan C, Cheng Z, Xie F, Wang R, Zhang J, Yao F, Fang M. Efficacy of abdomen-rubbing qigong exercise for chronic insomnia: study protocol for a randomized controlled trial. Trials 2021; 22:774. [PMID: 34742345 PMCID: PMC8571850 DOI: 10.1186/s13063-021-05528-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2020] [Accepted: 08/09/2021] [Indexed: 12/29/2022] Open
Abstract
Background Insomnia is a common sleeping disorder which affects the quality of life which can bring harms to physical and mental health of human beings and even economic development. Traditional Chinese medicine (TCM) plays an outstanding role in treating chronic diseases and alleviating their symptoms. Therefore, the purpose of this study is to assess the treatment efficacy in patients with insomnia treated with abdomen-rubbing qigong exercise (ARQE). In addition, the brain function changes of patients will be explored by resting state functional magnetic resonance imaging (rs-fMRI). Method/design This trial is a randomized, single-blind, controlled study planned to transpire between July 1, 2020, and July 31, 2021. A sample size of 114 participants (57 per group) with chronic insomnia will be randomly assigned to receive ARQE or CBTI for 8 weeks. The study duration will be 13 weeks, including a 1-week screening period, 8 weeks of intervention, and another 4 weeks of follow-up. The primary outcome is the Pittsburgh sleep quality index scores. Secondary outcomes include insomnia severity index, gastrointestinal symptom rating scale, the Hamilton Depression Scale, and rs-fMRI scan. The adverse events will be in control. Discussion The results of this study will help to clarify the efficacy of ARQE in the treatment of insomnia and try to use rs-fMRI technology to explore the brain function changes of ARQE in improving sleep quality in patients with insomnia disorder. If the results are as expected, this study will provide high-quality evidence for the treatment of insomnia with ARQE. Trial registration China Clinical Registration Agency ChiCTR1900028009. Registered on 19 December 2019.
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Affiliation(s)
- Chong Guan
- Shanghai University of Traditional Chinese Medicine, Shanghai, 201203, China
| | - Ziji Cheng
- Shanghai University of Traditional Chinese Medicine, Shanghai, 201203, China
| | - Fangfang Xie
- Shanghai University of Traditional Chinese Medicine, Shanghai, 201203, China
| | - Ruiping Wang
- Shanghai Skin Disease Hospital, Shanghai, 200050, China
| | - Jing Zhang
- Shanghai University of Traditional Chinese Medicine, Shanghai, 201203, China
| | - Fei Yao
- Shanghai University of Traditional Chinese Medicine, Shanghai, 201203, China.
| | - Min Fang
- Shanghai University of Traditional Chinese Medicine, Shanghai, 201203, China. .,Institute of Tuina, Shanghai Institute of Traditional Chinese Medicine, Shanghai, 200437, China.
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16
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Shao Y, Zou G, Tabarak S, Chen J, Gao X, Yao P, Liu J, Li Y, Xiong N, Pan W, Ma M, Zhou S, Xu J, Ma Y, Deng J, Sun Q, Bao Y, Sun W, Shi J, Zou Q, Gao JH, Sun H. Spindle-related brain activation in patients with insomnia disorder: An EEG-fMRI study. Brain Imaging Behav 2021; 16:659-670. [PMID: 34499294 DOI: 10.1007/s11682-021-00544-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/14/2021] [Indexed: 10/20/2022]
Abstract
Sleep spindles have been implicated in sleep protection, depression and anxiety. However, spindle-related brain imaging mechanism underpinning the deficient sleep protection and emotional regulation in insomnia disorder (ID) remains elusive. The aim of the current study is to investigate the relationship between spindle-related brain activations and sleep quality, symptoms of depression and anxiety in patients with ID. Participants (n = 46, 28 females, 18-60 years) were recruited through advertisements including 16 with ID, according to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, and 30 matched controls. Group differences in spindle-related brain activations were analyzed using multimodality data acquired with simultaneous electroencephalography and functional magnetic resonance imaging during sleep. Compared with controls, patients with ID showed significantly decreased bilateral spindle-related brain activations in the cingulate gyrus (familywise error corrected p ˂ 0.05, cluster size 4401 mm3). Activations in the cingulate gyrus were negatively correlated with Pittsburgh Sleep Quality Index scores (r = -0.404, p = 0.005) and Self-Rating Anxiety Scale scores (r = -0.364, p = 0.013), in the pooled sample. These findings underscore the key role of spindle-related brain activations in the cingulate gyrus in subjective sleep quality and emotional regulation in ID.
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Affiliation(s)
- 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
| | - 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
| | - Serik Tabarak
- Peking-Tsinghua Center for Life Sciences, PKU-IDG/McGovern Institute for Brain Research, Peking University, Beijing, China
| | - Jie Chen
- 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
| | - Xuejiao Gao
- 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
| | - 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
| | - 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
| | - Nana Xiong
- 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
| | - Wen Pan
- Sleep Medicine Center, Suzhou Guangji Hospital, The Affiliated Guangji Hospital of Soochow University, Suzhou, China
| | - Mengying Ma
- 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
| | - 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
| | - Yundong Ma
- 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
| | - Jiahui Deng
- 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
| | - Qiqing 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
| | - Yanping Bao
- National Institute On Drug Dependence and Beijing Key Laboratory of Drug Dependence, Peking University, Beijing, China
| | - Wei 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
| | - Jie Shi
- National Institute On Drug Dependence and Beijing Key Laboratory of Drug Dependence, Peking University, Beijing, China
| | - Qihong Zou
- 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. .,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.
| | - 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.
| | - 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.
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17
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Ramos AR, Alperin N, Lee S, Gonzalez KA, Tarraf W, Hernandez-Cardenache R. Cognitive and Neuroimaging Correlates of the Insomnia Severity Index in Obstructive Sleep Apnea: A Pilot-Study. APPLIED SCIENCES-BASEL 2021; 11. [PMID: 34221490 PMCID: PMC8253601 DOI: 10.3390/app11125314] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
We aim to determine the sleep correlates of age-related brain loss in a sample of middle-aged to older males with obstructive sleep apnea (OSA). We recruited consecutive treatment naïve male patients with moderate to severe OSA from January to November of 2019. We excluded participants if they had dementia, stroke or heart disease. We collected demographic variables and vascular risk factors. We also obtained the insomnia severity index, the Epworth sleepiness scale and the Pittsburgh sleep quality index. We also obtained computerized neurocognitive testing with the go-no-go response inhibition test, Stroop interference test, catch game test, staged information processing speed test, verbal memory test and non-verbal memory test. We derived age and education adjusted domain-specific Z-scores for global cognition, memory, attention, processing speed and executive function. We used brain MRI T1-weighted images to derive total hippocampal and gray matter volumes. Partial correlations evaluated associations between variables from sleep questionnaires (e.g., insomnia severity index score), and polysomnographic variables (the apnea-hypopnea index, average oxygen levels during sleep) with cognitive domains and brain volumes. We examined 16 participants with an age range of 40–76 years, 73% Hispanic/Latino. The mean apnea-hypopnea index was 48.9 ± 25.5 and average oxygen saturation during sleep was 91.4% ± 6.9%. Hypertension was seen in 66% and diabetes mellitus in 27%. We found that the insomnia severity index score and average oxygen levels during sleep had the strongest correlations with brain volumes and cognition. These preliminary findings may aid in developing future strategies to improve age-related brain loss in patients with OSA.
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Affiliation(s)
- Alberto R. Ramos
- Department of Neurology, Miller School of Medicine, University of Miami, Miami, FL 33136, USA
- Correspondence:
| | - Noam Alperin
- Department of Radiology, Miller School of Medicine, University of Miami, Miami, FL 33136, USA
| | - Sang Lee
- Department of Radiology, Miller School of Medicine, University of Miami, Miami, FL 33136, USA
| | - Kevin A. Gonzalez
- Department of Neuroscience, University of California, San Diego, CA 92093, USA
| | - Wassim Tarraf
- Department of Health Care Sciences, Institute of Gerontology, Wayne State University, Detroit, MI 48202, USA
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18
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Decreased modulation of segregated SEEKING and selective attention systems in chronic insomnia. Brain Imaging Behav 2021; 15:430-443. [PMID: 32367486 DOI: 10.1007/s11682-020-00271-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Sleep-related attentional bias and instinctual craving-sleep status may be associated with value-driven selective attention network and SEEKING system. We hypothesized that the two networks might be important components and underlie etiology of inability to initiate or/and maintain sleep in patients with chronic insomnia (PIs). Our aim is to investigate whether frequency-frequency couplings(temporal and spatial coupling, and differences of a set of imaging parameters) could elevate the sensibility to characterize the two insomnia-related networks in studying their relationships with sleep parameters and post-insomnia emotions. Forty-eight PIs and 48 status-matched good sleepers were requested to complete sleep and emotion-related questionnaires. Receiver operating characteristic curve was used to calculate the discriminatory power of a set of parameters. Granger causality and mediating causality analysis were used to address the causal relationships between the two networks and sleep/emotion-related parameters. Frequency-frequency couplings could characterize the two networks with high discriminatory power (AUC, 0.951; sensitivity, 87.5%; specificity, 95.8%), which suggested that the frequency-frequency couplings could be served as a useful biomarker to address the insomnia-related brain networks. Functional deficits of the SEEKING system played decreased mediator acting in post-insomnia negative emotions (decreased frequency-frequency coupling). Functional hyperarousal of the value-driven attention network played decreased mediator acting in sleep regulation (increased frequency-frequency coupling). Granger causality analysis showed decreased causal effect connectivity between and within the two networks. The between-network causal effect connectivity segregation played decreased mediator acting in sleep regulation (decreased connectivity). These findings suggest that the functional deficits and segregation of the two systems may underlie etiology of PIs.
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19
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Gong L, Yu S, Xu R, Liu D, Dai X, Wang Z, Hu Y, Yan B, Kui Y, Zhang B, Feng F. The abnormal reward network associated with insomnia severity and depression in chronic insomnia disorder. Brain Imaging Behav 2021; 15:1033-1042. [PMID: 32710331 DOI: 10.1007/s11682-020-00310-w] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Previous research has shown that acute sleep deprivation can influence the reward networks. However, it is unclear whether and how the intrinsic reward network is altered in chronic insomnia disorder (CID). In the present study, we aimed to investigate whether the reward network is altered in patients with CID using resting-state functional magnetic resonance imaging (fMRI) data. Forty-two patients with CID and 33 healthy controls (HCs) were enrolled and underwent resting-state fMRI. Nucleus accumbens (NAc) - based functional connectivity (NAFC) was evaluated to explore the differences in the reward network between the CID and HC groups. Pearson correlation analysis was used to evaluate the clinical significance of altered NAFC networks. Compared to those in the HC group, increased NAFC was found in the salience and limbic networks, while decreased NAFC was found in the default mode network (DMN) and within the reward circuit in patients with CID. In addition, decreased FC between the NAc and DMN was associated with insomnia severity, while NAFC within the reward network was associated with depression symptoms in patients with CID. These findings showed that the reward network is dysfunctional and associated with depression symptom in patients with CID. Future studies of CID should consider both insomnia and depression symptoms to disentangle the role of insomnia and depression in the relationship under study.
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Affiliation(s)
- Liang Gong
- Department of Neurology, Chengdu Second People's Hospital, Chengdu, 610017, Sichuan, China
| | - Siyi Yu
- Department of Acupuncture & Tuina, Chengdu University of Traditional Chinese Medicine, Chengdu, 610075, Sichuan, China
| | - Ronghua Xu
- Department of Neurology, Chengdu Second People's Hospital, Chengdu, 610017, Sichuan, China
| | - Duan Liu
- Department of Neurology, Chengdu Second People's Hospital, Chengdu, 610017, Sichuan, China
| | - Xijian Dai
- Department of Medical Imaging, Jinling Hospital, Medical School of Nanjing University, Nanjing, 210002, Jiangsu, China
| | - Zhengyan Wang
- Department of Pain Management, Sichuan Integrative Medicine, Sichuan, 610041, Chengdu, China
| | - Youping Hu
- Department of Acupuncture & Tuina, Chengdu University of Traditional Chinese Medicine, Chengdu, 610075, Sichuan, China
| | - Bohua Yan
- Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, 610072, Sichuan, China
| | - Yu Kui
- The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, 510120, Guangdong, China
| | - Bei Zhang
- Department of Neurology, Chengdu Second People's Hospital, Chengdu, 610017, Sichuan, China
| | - Fen Feng
- Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, 610072, Sichuan, China.
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20
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Ding S, Gao L, Kukun H, Ai K, Zhao W, Xie C, Wang Y. Novel Neuroimaging Biomarker for Sleep Quality in Insomnia Disorder: A Hypothalamus Resting State Study. Front Neurosci 2021; 15:634984. [PMID: 33716655 PMCID: PMC7953135 DOI: 10.3389/fnins.2021.634984] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2020] [Accepted: 01/21/2021] [Indexed: 11/15/2022] Open
Abstract
Despite striking progress in the understanding of the neurobiology of insomnia disorder (ID), about 40% of ID patients do not reach sustained remission with the primary treatments. It is necessary to reveal novel neuroimaging biomarkers for sleep quality in ID. The hypothalamus has a central role in sleep-wake regulation by communicating with different brain regions. However, the functional implications of hypothalamus circuitry with other brain areas remains largely unknown in ID. It may be speculated that dysfunctional circuitry in the hypothalamus is involved in the pathogenesis of ID. Thus, we investigated the different network organizations of the bilateral hypothalamus during the resting-state between 26 ID patients and 28 healthy controls (HC). Correlation analysis has been carried out to link the neuroimaging findings and Pittsburgh sleep quality index (PSQI) scores. Group comparisons reveal that the resting-state functional connectivity (RSFC) between the left hypothalamic region and a few other brain regions, including the medial prefrontal cortex (mPFC) and pallidum, are significantly higher in ID compared with HC. The right inferior temporal cortex showed reduced RSFC with the left hypothalamus. No significantly different RSFC between ID and HC was detected for the right hypothalamus. Positive correlations with PSQI scores were observed for RSFC strength between the left hypothalamus and bilateral mPFC (left: r = 0.2985, p = 0.0393; right: r = 0.3723, p = 0.0056). Similarly, the RSFC strength between the right hypothalamus and bilateral mPFC (left: r = 0.3980, p = 0.0029; right: r = 0.2972, p = 0.0291) also showed significant positive correlations with PSQI scores. In conclusion, we reveal a novel neuroimaging biomarker for sleep quality, i.e., the RSFC strength of the hypothalamus-mPFC pathway. Consistent with the hyperarousal model of ID, our results shed new insights into the implications of the hyper-connection within hypothalamus circuits in the pathology of the ID.
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Affiliation(s)
- Shuang Ding
- Department of Radiology, The First Affiliated Hospital, Xinjiang Medical University, Ürümqi, China
| | - Lijuan Gao
- Department of Radiology, The First Affiliated Hospital, Xinjiang Medical University, Ürümqi, China
| | - Hanjiaerbieke Kukun
- Department of Radiology, The First Affiliated Hospital, Xinjiang Medical University, Ürümqi, China
| | - Kai Ai
- Philips Healthcare, Xi'an, China
| | - Wei Zhao
- Department of Radiology, The First Affiliated Hospital, Xinjiang Medical University, Ürümqi, China
| | - Chao Xie
- Department of Radiology, The Seventh Affiliated Hospital, Xinjiang Medical University, Ürümqi, China
| | - Yunling Wang
- Department of Radiology, The First Affiliated Hospital, Xinjiang Medical University, Ürümqi, China
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21
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Lapidaire W, Urrila AS, Artiges E, Miranda R, Vulser H, Bézivin-Frere P, Lemaître H, Penttilä J, Banaschewski T, Bokde ALW, Bromberg U, Büchel C, Conrod PJ, Desrivières S, Frouin V, Gallinat J, Garavan H, Gowland P, Heinz A, Ittermann B, Papadopoulos-Orfanos D, Paus T, Smolka MN, Schumann G, Martinot MLP, Martinot JL. Irregular sleep habits, regional grey matter volumes, and psychological functioning in adolescents. PLoS One 2021; 16:e0243720. [PMID: 33566829 PMCID: PMC7875363 DOI: 10.1371/journal.pone.0243720] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2019] [Accepted: 11/28/2020] [Indexed: 01/10/2023] Open
Abstract
Changing sleep rhythms in adolescents often lead to sleep deficits and a delay in sleep timing between weekdays and weekends. The adolescent brain, and in particular the rapidly developing structures involved in emotional control, are vulnerable to external and internal factors. In our previous study in adolescents at age 14, we observed a strong relationship between weekend sleep schedules and regional medial prefrontal cortex grey matter volumes. Here, we aimed to assess whether this relationship remained in this group of adolescents of the general population at the age of 16 (n = 101; mean age 16.8 years; 55% girls). We further examined grey matter volumes in the hippocampi and the amygdalae, calculated with voxel-based morphometry. In addition, we investigated the relationships between sleep habits, assessed with self-reports, and regional grey matter volumes, and psychological functioning, assessed with the Strengths and Difficulties Questionnaire and tests on working memory and impulsivity. Later weekend wake-up times were associated with smaller grey matter volumes in the medial prefrontal cortex and the amygdalae, and greater weekend delays in wake-up time were associated with smaller grey matter volumes in the right hippocampus and amygdala. The medial prefrontal cortex region mediated the correlation between weekend wake up time and externalising symptoms. Paying attention to regular sleep habits during adolescence could act as a protective factor against the emergence of psychopathology via enabling favourable brain development.
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Affiliation(s)
- Winok Lapidaire
- National Institute of Health and Medical Research, INSERM U A10 "Trajectoires développementales & psychiatrie", University Paris-Saclay, Ecole Normale Supérieure Paris-Saclay, CNRS, Centre Borelli, Gif-sur-Yvette, France
| | - Anna S. Urrila
- National Institute of Health and Medical Research, INSERM U A10 "Trajectoires développementales & psychiatrie", University Paris-Saclay, Ecole Normale Supérieure Paris-Saclay, CNRS, Centre Borelli, Gif-sur-Yvette, France
- Department of Health, Unit of Mental Health, National Institute for Health and Welfare, Helsinki, Finland
- Department of Psychiatry / Adolescent Psychiatry, University of Helsinki and Helsinki University Central Hospital, Helsinki, Finland
| | - Eric Artiges
- National Institute of Health and Medical Research, INSERM U A10 "Trajectoires développementales & psychiatrie", University Paris-Saclay, Ecole Normale Supérieure Paris-Saclay, CNRS, Centre Borelli, Gif-sur-Yvette, France
- Psychiatry Department, EPS Barthelemy Durand, Etampes, France
| | - Ruben Miranda
- National Institute of Health and Medical Research, INSERM U A10 "Trajectoires développementales & psychiatrie", University Paris-Saclay, Ecole Normale Supérieure Paris-Saclay, CNRS, Centre Borelli, Gif-sur-Yvette, France
| | - Hélène Vulser
- National Institute of Health and Medical Research, INSERM U A10 "Trajectoires développementales & psychiatrie", University Paris-Saclay, Ecole Normale Supérieure Paris-Saclay, CNRS, Centre Borelli, Gif-sur-Yvette, France
| | - Pauline Bézivin-Frere
- National Institute of Health and Medical Research, INSERM U A10 "Trajectoires développementales & psychiatrie", University Paris-Saclay, Ecole Normale Supérieure Paris-Saclay, CNRS, Centre Borelli, Gif-sur-Yvette, France
| | - Hervé Lemaître
- National Institute of Health and Medical Research, INSERM U A10 "Trajectoires développementales & psychiatrie", University Paris-Saclay, Ecole Normale Supérieure Paris-Saclay, CNRS, Centre Borelli, Gif-sur-Yvette, France
| | - Jani Penttilä
- National Institute of Health and Medical Research, INSERM U A10 "Trajectoires développementales & psychiatrie", University Paris-Saclay, Ecole Normale Supérieure Paris-Saclay, CNRS, Centre Borelli, Gif-sur-Yvette, France
- Adolescent Psychiatry Department, Medical School, Tampere University, Tampere, Finland
| | - Tobias Banaschewski
- Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Arun L. W. Bokde
- Institute of Neuroscience, Trinity College Dublin, Dublin, Ireland
| | - Uli Bromberg
- University Hospital Hamburg Eppendorf, Hamburg, Germany
| | | | - Patricia J. Conrod
- Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, United Kingdom
- Department of Psychiatry, University of Montreal, CHU Ste Justine Hospital, Montréal, Canada
| | - Sylvane Desrivières
- Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, United Kingdom
- MRC Social, Genetic and Developmental Psychiatry (SGDP) Centre, London, United Kingdom
| | - Vincent Frouin
- Neurospin, Commission for Atomic and Alternative Energy, Saclay, France
| | - Jürgen Gallinat
- Department of Psychiatry and Psychotherapy, Campus Charité Mitte, Charité – University Medical Centre Berlin, Berlin, Germany
| | - Hugh Garavan
- Institute of Neuroscience, Trinity College Dublin, Dublin, Ireland
- Departments of Psychiatry and Psychology, 6436 UHC, University of Vermont, Burlington, Vermont, United States of America
| | - Penny Gowland
- Sir Peter Mansfield Magnetic Resonance Centre, University of Nottingham, Nottingham, United Kingdom
| | - Andreas Heinz
- Department of Psychiatry and Psychotherapy, Campus Charité Mitte, Charité – University Medical Centre Berlin, Berlin, Germany
| | - Bernd Ittermann
- Department of Psychiatry and Psychotherapy, Campus Charité Mitte, Charité – University Medical Centre Berlin, Berlin, Germany
| | | | - Tomáš Paus
- Holland Bloorview Kids Rehabilitation Hospital and Departments of Psychology and Psychiatry, Bloorview Research Institute, University of Toronto, Toronto, Canada
| | - Michael N. Smolka
- Department of Psychiatry and Psychotherapy, Technical University Dresden, Dresden, Germany
| | - Gunter Schumann
- Institute of Neuroscience, Trinity College Dublin, Dublin, Ireland
- MRC Social, Genetic and Developmental Psychiatry (SGDP) Centre, London, United Kingdom
| | - Marie-Laure Paillère Martinot
- National Institute of Health and Medical Research, INSERM U A10 "Trajectoires développementales & psychiatrie", University Paris-Saclay, Ecole Normale Supérieure Paris-Saclay, CNRS, Centre Borelli, Gif-sur-Yvette, France
- Department of Child and Adolescent Psychiatry, AP-HP. Sorbonne Université, Pitié-Salpêtrière Hospital, Paris, France
| | - Jean-Luc Martinot
- National Institute of Health and Medical Research, INSERM U A10 "Trajectoires développementales & psychiatrie", University Paris-Saclay, Ecole Normale Supérieure Paris-Saclay, CNRS, Centre Borelli, Gif-sur-Yvette, France
- Centre of Neuroimaging Research, CENIR at ICM Institute, Paris Cedex, France
- * E-mail:
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Zeng B, Zhou J, Li Z, Zhang H, Li Z, Yu P. Altered Percent Amplitude of Fluctuation in Healthy Subjects After 36 h Sleep Deprivation. Front Neurol 2021; 11:565025. [PMID: 33519662 PMCID: PMC7843545 DOI: 10.3389/fneur.2020.565025] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2020] [Accepted: 08/26/2020] [Indexed: 12/16/2022] Open
Abstract
Objective: To investigate regional brain activity alteration in healthy subjects in a sleep deprivation (SD) status relative to a rested wakefulness status using a percent amplitude of fluctuation (PerAF) method. Methods: A total of 20 healthy participants (12 males, 8 females; age, 22.25 ± 1.12 years) were recruited. All participants underwent attention tests and resting-state functional MRI scans during rested wakefulness before SD and after 36 h SD, respectively. The PerAF method was applied to identify SD-related regional brain activity alteration. A ROC curve was conducted to evaluate the ability of the PerAF method in distinguishing different sleep statuses. The relationships between SD-induced brain alterations and attention deficits were determined by Pearson correlation analysis. Results: SD resulted in a 2.23% decrease in accuracy rate and an 8.82% increase in reaction time. SD was associated with increased PerAF differences in the bilateral visual cortex and bilateral sensorimotor cortex, and was associated with decreased PerAF differences in bilateral dorsolateral prefrontal cortex and bilateral cerebellum posterior lobe. These SD-induced brain alterations exhibited a high discriminatory power of extremely high AUC values (0.993-1) in distinguishing the two statuses. The accuracy rate positively correlated with the bilateral cerebellum posterior lobe, and bilateral dorsolateral prefrontal cortex, and negatively correlated with the bilateral sensorimotor cortex. Conclusions: Acute SD could lead to an ~8% attention deficit, which was associated with regional brain activity deficits. The PerAF method might work as a potential sensitivity biomarker for identifying different sleep statuses.
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Affiliation(s)
- Bingliang Zeng
- Department of Radiology, Jiangxi Provincial People's Hospital Affiliated to Nanchang University, Nanchang, China
| | - Jian Zhou
- Department of Radiology, Jiangxi Provincial People's Hospital Affiliated to Nanchang University, Nanchang, China
| | - Zicong Li
- Department of Radiology, Jiangxi Provincial People's Hospital Affiliated to Nanchang University, Nanchang, China
| | - Hua Zhang
- Department of Imaging, The Third Affiliated Hospital of Nanchang University, Nanchang, China
- Department of Imaging, The First Hospital of Nanchang, Nanchang, China
| | - Zongliang Li
- Department of Radiology, Nanfeng County People's Hospital, Fuzhou, China
| | - Peng Yu
- Radiology Department, Jinxian County People's Hospital, Nanchang, China
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23
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Zhao FY, Fu QQ, Spencer SJ, Kennedy GA, Conduit R, Zhang WJ, Zheng Z. Acupuncture: A Promising Approach for Comorbid Depression and Insomnia in Perimenopause. Nat Sci Sleep 2021; 13:1823-1863. [PMID: 34675729 PMCID: PMC8520448 DOI: 10.2147/nss.s332474] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2021] [Accepted: 09/24/2021] [Indexed: 12/12/2022] Open
Abstract
Comorbid depression and insomnia are ubiquitous mental complaints among women going through the perimenopausal stage of life and can result in major decline in quality of life. Antidepressive agents combined with/without hypnotics, and/or hormone therapy are currently the most common treatment for perimenopausal depression (PMD) and insomnia (PMI). Balancing the benefits of these pharmacotherapies against the risk of adverse events (AEs) is a difficult task for both clinicians and women. There has been a growing body of research regarding the utilization of acupuncture for treatment of PMD or PMI, whereas no studies of acupuncture for comorbid PMD and PMI have appeared. In this review, we summarize the clinical and preclinical evidence of acupuncture as a treatment for PMD or PMI, and then discuss the potential mechanisms involved and the role of acupuncture in helping women during this transition. Most clinical trials indicate that acupuncture ameliorates not only PMD/PMI but also climacteric symptoms with minimal AEs. It also regulates serum hormone levels. The reliability of trials is however limited due to methodological flaws in most studies. Rodent studies suggest that acupuncture prolongs total sleep time and reduces depression-like behavior in PMI and PMD models, respectively. These effects are possibly mediated through multiple mechanisms of action, including modulating sex hormones, neurotransmitters, hypothalamic-pituitary-adrenal axis/hypothalamic-pituitary-ovary axis, oxidative stress, signaling pathways, and other cellular events. In conclusion, acupuncture is a promising therapeutic strategy for comorbid depression and insomnia during perimenopause. Neuroendocrine modulation is likely to play a major role in mediating those effects. High-quality trials are required to further validate acupuncture's effectiveness.
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Affiliation(s)
- Fei-Yi Zhao
- School of Health and Biomedical Sciences, RMIT University, Bundoora, Victoria, 3083, Australia.,Shanghai Municipal Hospital of Traditional Chinese Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, 200071, People's Republic of China.,Department of Nursing, School of International Medical Technology, Shanghai Sanda University, Shanghai, 201209, People's Republic of China
| | - Qiang-Qiang Fu
- Yangpu Hospital, School of Medicine, Tongji University, Shanghai, 200090, People's Republic of China
| | - Sarah J Spencer
- School of Health and Biomedical Sciences, RMIT University, Bundoora, Victoria, 3083, Australia.,ARC Centre of Excellence for Nanoscale Biophotonics, RMIT University, Bundoora, Victoria, 3083, Australia
| | - Gerard A Kennedy
- School of Health and Biomedical Sciences, RMIT University, Bundoora, Victoria, 3083, Australia.,School of Science, Psychology and Sport, Federation University, Mount Helen, Victoria, Australia.,Institute for Breathing and Sleep, Austin Health, Heidelberg, Victoria, 3084, Australia
| | - Russell Conduit
- School of Health and Biomedical Sciences, RMIT University, Bundoora, Victoria, 3083, Australia
| | - Wen-Jing Zhang
- Shanghai Municipal Hospital of Traditional Chinese Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, 200071, People's Republic of China
| | - Zhen Zheng
- School of Health and Biomedical Sciences, RMIT University, Bundoora, Victoria, 3083, Australia
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24
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Tegeler CL, Shaltout HA, Lee SW, Simpson SL, Gerdes L, Tegeler CH. High-resolution, relational, resonance-based, electroencephalic mirroring (HIRREM) improves symptoms and autonomic function for insomnia: A randomized, placebo-controlled clinical trial. Brain Behav 2020; 10:e01826. [PMID: 32940419 PMCID: PMC7667311 DOI: 10.1002/brb3.1826] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2019] [Revised: 08/10/2020] [Accepted: 08/11/2020] [Indexed: 01/31/2023] Open
Abstract
INTRODUCTION Effective insomnia interventions that also address autonomic dysregulation are lacking. We evaluate high-resolution, relational, resonance-based, electroencephalic mirroring (HIRREM® ), in a randomized, controlled clinical trial. HIRREM is a noninvasive, closed-loop, allostatic, acoustic stimulation neurotechnology, to support self-optimization of brain rhythms. METHODS One hundred and seven adults (mean age 45.7, SD ± 5.6, 73 women), with Insomnia Severity Index (ISI) scores of ≥15, received ten, 90-min sessions of HIRREM, with tones linked to brainwaves (LB, 56), or random tones not linked to brainwaves (NL, 51), as an active, sham placebo. Outcomes were obtained at enrollment (V1), 1-7 days (V2), 8-10 weeks (V3), and 16-18 weeks (V4) after intervention. Primary outcome was differential change in ISI from V1 to V3. Secondary measures assessed depression (BDI), anxiety (BAI), quality of life (EQ-5D), and a sleep diary. Ten minute recordings of HR and BP allowed analysis of heart rate variability (HRV) and baroreflex sensitivity (BRS). RESULTS Of 107 randomized, 101 completed the intervention. Intention-to-treat analysis (107) of change from V1 to V3 revealed a mean reduction of ISI in NL of -4.93 (SE ± 0.76) points, with additional, significant reduction of -2.05 points (0.74) in LB (total reduction of -6.98, p = .045). Additional reduction of -2.30 points (0.76) was still present in the LB at V4 (p = .058). Total ISI reduction from V1 to V4 was -5.90 points for NL and -7.93 points in LB. There were group differences (p < .05) for multiple HRV and BRS measures (rMSSD, SDNN, HF alpha, and Seq ALL), as well as total sleep time, sleep onset latency, and sleep efficiency. There were no serious adverse events. CONCLUSIONS Results of this controlled clinical trial showed clinically relevant reduction of insomnia symptoms with HIRREM, over, and above an active, sham control, with associated, durable improvement in autonomic cardiovascular regulation.
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Affiliation(s)
| | | | - Sung W. Lee
- University of Arizona School of MedicinePhoenixAZUSA
| | - Sean L. Simpson
- Department of Biostatistics and Data SciencesWFSMWinston‐SalemNCUSA
| | - Lee Gerdes
- Brain State Technologies, LLCScottsdaleAZUSA
| | - Charles H. Tegeler
- Department of NeurologyWake Forest School of Medicine (WFSM)Winston‐SalemNCUSA
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25
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Zhou F, Zhu Y, Zhu Y, Huang M, Jiang J, He L, Huang S, Zeng X, Gong H. Altered long- and short-range functional connectivity density associated with poor sleep quality in patients with chronic insomnia disorder: A resting-state fMRI study. Brain Behav 2020; 10:e01844. [PMID: 32935924 PMCID: PMC7667361 DOI: 10.1002/brb3.1844] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/05/2020] [Revised: 06/22/2020] [Accepted: 08/30/2020] [Indexed: 12/21/2022] Open
Abstract
INTRODUCTION Previous neuroimaging studies have suggested that brain functional impairment and hyperarousal occur during the daytime among patients with chronic insomnia disorder (CID); however, alterations to the brain's intrinsic functional architecture and their association with sleep quality have not yet been documented. METHODS In this study, our aim was to investigate the insomnia-related alterations to the intrinsic connectome in patients with CID (n = 27) at resting state, with a data-driven approach based on graph theory assessment and functional connectivity density (FCD), which can be interpreted as short-range (intraregional) or long-range (interregional) mapping. RESULTS Compared with healthy controls with good sleep, CID patients showed significantly decreased long-range FCD in the dorsolateral prefrontal cortices and the putamen. These patients also showed decreased short-range FCD in their multimodal-processing regions, executive control network, and supplementary motor-related areas. Furthermore, several regions showed increased short-range FCD in patients with CID, implying hyper-homogeneity of local activity. CONCLUSIONS Together, these findings suggest that insufficient sleep during chronic insomnia widely affects cortical functional activities, including disrupted FCD and increased short-range FCD, which is associated with poor sleep quality.
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Affiliation(s)
- Fuqing Zhou
- Department of RadiologyThe First Affiliated HospitalNanchang UniversityNanchangChina
- Neuroimaging LaboratoryJiangxi Province Medical Imaging Research InstituteNanchangChina
| | - Yanyan Zhu
- Department of RadiologyThe First Affiliated HospitalNanchang UniversityNanchangChina
- Neuroimaging LaboratoryJiangxi Province Medical Imaging Research InstituteNanchangChina
| | - Yujun Zhu
- Department of RespiratoryThe People’s Hospital of Yichun CityYichunChina
| | - Muhua Huang
- Department of RadiologyThe First Affiliated HospitalNanchang UniversityNanchangChina
- Neuroimaging LaboratoryJiangxi Province Medical Imaging Research InstituteNanchangChina
| | - Jian Jiang
- Department of RadiologyThe First Affiliated HospitalNanchang UniversityNanchangChina
- Neuroimaging LaboratoryJiangxi Province Medical Imaging Research InstituteNanchangChina
| | - Laichang He
- Department of RadiologyThe First Affiliated HospitalNanchang UniversityNanchangChina
- Neuroimaging LaboratoryJiangxi Province Medical Imaging Research InstituteNanchangChina
| | - Suhua Huang
- Department of RadiologyJiangxi Province Children's HospitalNanchangChina
| | - Xianjun Zeng
- Department of RadiologyThe First Affiliated HospitalNanchang UniversityNanchangChina
- Neuroimaging LaboratoryJiangxi Province Medical Imaging Research InstituteNanchangChina
| | - Honghan Gong
- Department of RadiologyThe First Affiliated HospitalNanchang UniversityNanchangChina
- Neuroimaging LaboratoryJiangxi Province Medical Imaging Research InstituteNanchangChina
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Functional connectome fingerprint of sleep quality in insomnia patients: Individualized out-of-sample prediction using machine learning. NEUROIMAGE-CLINICAL 2020; 28:102439. [PMID: 32980600 PMCID: PMC7522804 DOI: 10.1016/j.nicl.2020.102439] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/30/2020] [Revised: 08/13/2020] [Accepted: 09/15/2020] [Indexed: 11/22/2022]
Abstract
Short-term and chronic insomnia are two subtypes of insomnia. Functional connectome predicts individual sleep quality for both two subtypes. Shared and distinct neural basis underlying poor sleep quality between two subtypes.
Objectives Insomnia disorder has been reclassified into short-term/acute and chronic subtypes based on recent etiological advances. However, understanding the similarities and differences in the neural mechanisms underlying the two subtypes and accurately predicting the sleep quality remain challenging. Methods Using 29 short-term/acute insomnia participants and 44 chronic insomnia participants, we used whole-brain regional functional connectivity strength to predict unseen individuals’ Pittsburgh sleep quality index (PSQI), applying the multivariate relevance vector regression method. Evaluated using both leave-one-out and 10-fold cross-validation, the pattern of whole-brain regional functional connectivity strength significantly predicted an unseen individual’s PSQI in both datasets. Results There were both similarities and differences in the regions that contributed the most to PSQI prediction between the two groups. Further functional connectivity analysis suggested that between-network connectivity was re-organized between short-term/acute insomnia and chronic insomnia. Conclusions The present study may have clinical value by informing the prediction of sleep quality and providing novel insights into the neural basis underlying the heterogeneity of insomnia.
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27
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Meng X, Zheng J, Liu Y, Yin Y, Hua K, Fu S, Wu Y, Jiang G. Increased Dynamic Amplitude of Low Frequency Fluctuation in Primary Insomnia. Front Neurol 2020; 11:609. [PMID: 32714271 PMCID: PMC7344192 DOI: 10.3389/fneur.2020.00609] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2020] [Accepted: 05/25/2020] [Indexed: 01/05/2023] Open
Abstract
The physiological mechanism underlying primary insomnia (PI) is poorly understood. Resting-state functional magnetic resonance imaging (fMRI) has emerged as a powerful tool to explore PI. However, previous studies ignore the dynamics of the brain activity. In the current study, we aimed to explore altered dynamic intrinsic brain activity in PI. Fifty-nine patients with PI and 47 matched healthy controls (HCs) were recruited and underwent resting-state fMRI. The variance of dynamic amplitude of low frequency fluctuation (dALFF) maps across time was calculated to measure the temporal variability of intrinsic brain activity and then compared between patients with PI and HCs. As a result, patients with PI presented increased variance of dALFF in the bilateral hippocampus extending to the parahippocampus, the right putamen and the right anterior insula cortex. In addition, the variance of dALFF in the right putamen was positively correlated with Self-rating Anxiety Scale (SAS) score in PI. Our results revealed increased instability of intrinsic activity in PI.
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Affiliation(s)
- Xianyun Meng
- Hwa Mei Hospital, University of Chinese Academy of Sciences, Ningbo, China
- Ningbo Institute of Life and Health Industry, University of Chinese Academy of Sciences, Ningbo, China
| | - Jianjun Zheng
- Hwa Mei Hospital, University of Chinese Academy of Sciences, Ningbo, China
- Ningbo Institute of Life and Health Industry, University of Chinese Academy of Sciences, Ningbo, China
| | - Yingpeng Liu
- Hwa Mei Hospital, University of Chinese Academy of Sciences, Ningbo, China
- Ningbo Institute of Life and Health Industry, University of Chinese Academy of Sciences, Ningbo, China
| | - Yi Yin
- Department of Medical Imaging, Guangdong Second Provincial General Hospital, Guangzhou, China
| | - Kelei Hua
- Department of Medical Imaging, Guangdong Second Provincial General Hospital, Guangzhou, China
| | - Shishun Fu
- Department of Medical Imaging, Guangdong Second Provincial General Hospital, Guangzhou, China
| | - Yunfan Wu
- Department of Medical Imaging, Guangdong Second Provincial General Hospital, Guangzhou, China
| | - Guihua Jiang
- Department of Medical Imaging, Guangdong Second Provincial General Hospital, Guangzhou, China
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28
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Jiang F. Sleep and Early Brain Development. ANNALS OF NUTRITION AND METABOLISM 2020; 75 Suppl 1:44-54. [DOI: 10.1159/000508055] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/28/2020] [Accepted: 04/07/2020] [Indexed: 11/19/2022]
Abstract
The early years of life are characterized by dramatic developmental changes. Within this important time period lies the transition from newborn to childhood. Sleep is one of the primary activities of the brain during early development and plays an important role in healthy cognitive and psychosocial development in early life. This paper will first review the normal sleep characteristics and their development in neonates and children, including architecture of sleep, development of a healthy sleep rhythm in early childhood, sleep recommendations and cultural disparity, as well as important factors for establishing a healthy sleep pattern during the first years of life, such as regular and consistent bedtime routine, safe and comfortable sleep environment, and appropriate sleep onset associations. This paper then provides recent updates of evidence of the effects of sleep on early brain development, particularly on learning and memory, emotional regulation, and general cognitive development through behavioral and neurophysiological studies. As regards the mechanism, many experimental sleep deprivation studies in animals and adults have attempted to explain the underlying mechanisms of sleep on cognition and the emotional brain. Future studies are expected to delineate the effects of sleep on brain structural and functional networks in the developing brain with the marked development of image acquisition approaches and the novel analysis tools for infants and young children in recent years.
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29
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Gong L, Xu R, Liu D, Zhang C, Huang Q, Zhang B, Xi C. Abnormal functional connectivity density in patients with major depressive disorder with comorbid insomnia. J Affect Disord 2020; 266:417-423. [PMID: 32056908 DOI: 10.1016/j.jad.2020.01.088] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2019] [Revised: 01/17/2020] [Accepted: 01/20/2020] [Indexed: 02/01/2023]
Abstract
BACKGROUND Insomnia is a common comorbidity symptom in patients with major depressive disorder (MDD). However, the brain functional alteration in MDD with higher level insomnia (MDD-HI) and lower level insomnia (MDD-LI) remains unclear. Here, we investigated the association of insomnia with global functional connectivity density (gFCD) in patients with MDD. METHODS A total of 148 participants were recruited and underwent resting-state functional magnetic resonance imaging. A voxel-wise analysis of covariance was employed to explore group differences in gFCD among the MDD-HI, MDD-LI and healthy control (HC) groups. RESULTS The gFCD in the bilateral parahippocampal/hippocampal gyri (PHG/HIP) was higher in the two MDD than in the HC group, and it was higher in the MDD-LI than in the MDD-HI group; the gFCD in the left fusiform area was lower in the MDD than in the HC group. The gFCD in the left inferior temporal gyrus (ITG) was higher in the MDD-HI than in the MDD-LI and HC groups. The gFCD in the left ITG and posterior PHG/HIP was associated with insomnia, while the gFCD in the left anterior PHG/HIP was correlated with non-insomnia depressive symptoms in the MDD group. LIMITATIONS The cross-sectional design and the use of brief/subjective insomnia assessments. CONCLUSIONS The present study showed that the abnormal brain features of MDD with different insomnia symptom. Importantly, the posterior and anterior parts of the hippocampus may play different roles in the presence or absence of insomnia in patients with MDD.
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Affiliation(s)
- Liang Gong
- Department of Neurology, Chengdu Second People's Hospital, Chengdu, Sichuan, 610017, China.
| | - Ronghua Xu
- Department of Neurology, Chengdu Second People's Hospital, Chengdu, Sichuan, 610017, China
| | - Duan Liu
- Department of Neurology, Chengdu Second People's Hospital, Chengdu, Sichuan, 610017, China
| | - Chuantao Zhang
- Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, 610072, China
| | - Qun Huang
- Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, 610072, China
| | - Bei Zhang
- Department of Neurology, Chengdu Second People's Hospital, Chengdu, Sichuan, 610017, China
| | - Chunhua Xi
- Department of Neurology, The Third Affiliated Hospital of Anhui Medical University, Heifei, Anhui, 230061, China.
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Liang C, Cheng S, Cheng B, Ma M, Zhang L, Qi X, Liu L, Kafle OP, Li P, Wen Y, Zhang F. A large-scale genetic correlation scan identified the plasma proteins associated with brain function related traits. Brain Res Bull 2020; 158:84-89. [PMID: 32119964 DOI: 10.1016/j.brainresbull.2020.02.017] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2019] [Revised: 02/25/2020] [Accepted: 02/27/2020] [Indexed: 12/18/2022]
Abstract
AIMS Insomnia, intelligence and neuroticism are three typical traits and dysfunctions mainly regulated by human brain. Our research aimed to explore the potential genetic relationships between brain function related traits and more than 3000 human plasma proteins. MATERIALS AND METHODS We conducted a large-scale genetic correlation scan of human plasma proteins and three brain function related traits, including insomnia, intelligence and neuroticism. Linkage disequilibrium score regression (LDSC) analysis was performed to estimate the genetic correlations between each of the blood proteins and insomnia, intelligence and neuroticism via utilizing the genome-wide association study summary statistics of plasma proteins and those three traits. RESULTS LDSC analysis identified 18 specific plasma proteins shown suggestive genetic correlations with insomnia such as Periostin (coefficient=-0.3910, P value = 0.0070). Twenty-one plasma proteins exhibited genetic correlations with intelligence such as Ecto-ADP-ribosyltransferase 3 (coefficient = 0.3066, P value = 0.0013). Six specific plasma proteins shown suggestive genetic correlations with neuroticism, such as CD70 antigen (coefficient = 0.2979, P value = 0.0134). After further comparing the suggestive proteins between insomnia, intelligence and neuroticism, we detected 3 common plasma proteins shared by insomnia and intelligence such as Periostin (coefficient insomnia =-0.3910, Pinsomnia value = 0.0070; coefficient intelligence =0.2673, Pintelligence value = 0.0159) and Neurexin-1 (coefficient insomnia =-0.2913, Pinsomnia value = 0.0197; coefficient intelligence = 0.2399, Pintelligence value = 0.0035). We also detected 2 common plasma proteins shared by intelligence and neuroticism, including CD70 antigen (coefficient intelligence =-0.2092, Pintelligence value = 0.0337; coefficient neuroticism = 0.2979, Pneuroticism value = 0.0134). CONCLUSION Our results provide novel clues for unveiling the functional relevance of plasma proteins and brain function related traits.
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Affiliation(s)
- Chujun Liang
- Key Laboratory of Trace Elements and Endemic Diseases of National Health and Family Planning Commission, School of Public Health, Health Science Center, Xi'an Jiaotong University, Xi'an, PR China
| | - Shiqiang Cheng
- Key Laboratory of Trace Elements and Endemic Diseases of National Health and Family Planning Commission, School of Public Health, Health Science Center, Xi'an Jiaotong University, Xi'an, PR China
| | - Bolun Cheng
- Key Laboratory of Trace Elements and Endemic Diseases of National Health and Family Planning Commission, School of Public Health, Health Science Center, Xi'an Jiaotong University, Xi'an, PR China
| | - Mei Ma
- Key Laboratory of Trace Elements and Endemic Diseases of National Health and Family Planning Commission, School of Public Health, Health Science Center, Xi'an Jiaotong University, Xi'an, PR China
| | - Lu Zhang
- Key Laboratory of Trace Elements and Endemic Diseases of National Health and Family Planning Commission, School of Public Health, Health Science Center, Xi'an Jiaotong University, Xi'an, PR China
| | - Xin Qi
- Key Laboratory of Trace Elements and Endemic Diseases of National Health and Family Planning Commission, School of Public Health, Health Science Center, Xi'an Jiaotong University, Xi'an, PR China
| | - Li Liu
- Key Laboratory of Trace Elements and Endemic Diseases of National Health and Family Planning Commission, School of Public Health, Health Science Center, Xi'an Jiaotong University, Xi'an, PR China
| | - Om Prakash Kafle
- Key Laboratory of Trace Elements and Endemic Diseases of National Health and Family Planning Commission, School of Public Health, Health Science Center, Xi'an Jiaotong University, Xi'an, PR China
| | - Ping Li
- Key Laboratory of Trace Elements and Endemic Diseases of National Health and Family Planning Commission, School of Public Health, Health Science Center, Xi'an Jiaotong University, Xi'an, PR China
| | - Yan Wen
- Key Laboratory of Trace Elements and Endemic Diseases of National Health and Family Planning Commission, School of Public Health, Health Science Center, Xi'an Jiaotong University, Xi'an, PR China
| | - Feng Zhang
- Key Laboratory of Trace Elements and Endemic Diseases of National Health and Family Planning Commission, School of Public Health, Health Science Center, Xi'an Jiaotong University, Xi'an, PR China.
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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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Amygdala Changes in Chronic Insomnia and Their Association with Sleep and Anxiety Symptoms: Insight from Shape Analysis. Neural Plast 2019; 2019:8549237. [PMID: 31885536 PMCID: PMC6914992 DOI: 10.1155/2019/8549237] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2019] [Revised: 10/12/2019] [Accepted: 10/26/2019] [Indexed: 01/17/2023] Open
Abstract
Affective disorders, such as anxiety and depression, are common comorbidities associated with chronic insomnia disorder (CID). However, the underlying neural mechanisms of these comorbidities are still not clear. The present study is aimed at investigating structural changes in the amygdala of CID patients using surface-based shape analysis. A total of 65 medication-naive patients with CID and 55 healthy controls (HCs) matched for age, sex, and years of education were enrolled in this study and were subjected to structural magnetic resonance imaging (MRI). The Oxford Centre for Functional MRI of the Brain (FMRIB) created an Integrated Registration and Segmentation Tool (FIRST) that was employed in this study to assess the volumetric and surface alterations in patients with CID. Shape correlations between the amygdala and clinical features were also analyzed. Atrophic changes in the amygdala were observed at the local level, not for the entire amygdala volume. The left atrophic changes in the amygdala were in the superficial and basolateral nuclei while right atrophic changes were in the basolateral nuclei in CID patients. Insomnia severity was associated with the centromedial right amygdala while anxiety was linked with the basolateral nuclei. These findings indicate localized amygdala atrophy in CID. Separate amygdala regions are associated with insomnia and anxiety in CID. This evidence helps elucidate the neural mechanisms underlying the bidirectional relationship between insomnia and anxiety.
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Liu J, Cai W, Zhao M, Cai W, Sui F, Hou W, Wang H, Yu D, Yuan K. Reduced resting-state functional connectivity and sleep impairment in abstinent male alcohol-dependent patients. Hum Brain Mapp 2019; 40:4941-4951. [PMID: 31379038 PMCID: PMC6865575 DOI: 10.1002/hbm.24749] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2019] [Revised: 07/21/2019] [Accepted: 07/24/2019] [Indexed: 01/17/2023] Open
Abstract
Alcohol dependence is associated with poor sleep quality, which has both been implicated with thalamocortical circuits function. To identify the possible roles of these circuits in the alcohol-sleep association, we investigated the volume of both left and right thalamus and corresponding resting-state functional connectivity (RSFC) differences between 15 alcohol-dependent patients (AD) and 15 healthy controls (HC) male participants. The neuroimaging findings were then correlated with clinical variables, that is, Alcohol Use Disorders Identification Test (AUDIT) and Pittsburgh Sleep Quality Index (PSQI). Additionally, mediation analysis was carried out to test whether the thalamocortical RSFC mediates the relationship between drinking behavior and sleep impairments in AD when applicable. We observed a significant positive correlation between AUDIT score and PSQI score in AD. Compared with HC, AD showed reduced RSFC between the left thalamus and medial prefrontal cortex (mPFC), orbitofrontal cortex, anterior cingulate cortex (ACC), and right caudate. We also observed a negative correlation between RSFC of the left thalamus-mPFC and PSQI score in AD. More importantly, the left thalamus-mPFC RSFC strength mediated the relationship between AUDIT score and PSQI score in AD. No significant difference was detected in the normalized volume of both left and right thalamus, and volumes were not significantly correlated with clinical variables. Our results demonstrate that AD show abnormal interactions within thalamocortical circuits in association with drinking behaviors and sleep impairments. It is hoped that our study focusing on thalamocortical circuits could provide new information on potential novel therapeutic targets for treatment of sleep impairment in alcohol-dependent patients.
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Affiliation(s)
- Jingjing Liu
- School of Life Science and Technology, Xidian University, Xi'an, Shaanxi, People's Republic of China.,Engineering Research Center of Molecular and Neuro Imaging Ministry of Education, Xi'an, People's Republic of China
| | - Wanye Cai
- School of Life Science and Technology, Xidian University, Xi'an, Shaanxi, People's Republic of China.,Engineering Research Center of Molecular and Neuro Imaging Ministry of Education, Xi'an, People's Republic of China
| | - Meng Zhao
- School of Life Science and Technology, Xidian University, Xi'an, Shaanxi, People's Republic of China.,Engineering Research Center of Molecular and Neuro Imaging Ministry of Education, Xi'an, People's Republic of China
| | - Wenlong Cai
- Xilinguole Meng Mongolian General Hospital, Xilinhaote, Inner Mongolian, People's Republic of China
| | - Feng Sui
- Xilinguole Meng Mongolian General Hospital, Xilinhaote, Inner Mongolian, People's Republic of China
| | - Wenbao Hou
- Xilinguole Meng Mongolian General Hospital, Xilinhaote, Inner Mongolian, People's Republic of China
| | - Hongde Wang
- Xilinguole Meng Mongolian General Hospital, Xilinhaote, Inner Mongolian, People's Republic of China
| | - Dahua Yu
- Inner Mongolia Key Laboratory of Pattern Recognition and Intelligent Image Processing, School of Information Engineering, Inner Mongolia University of Science and Technology, Baotou, Inner Mongolia, People's Republic of China
| | - Kai Yuan
- School of Life Science and Technology, Xidian University, Xi'an, Shaanxi, People's Republic of China.,Engineering Research Center of Molecular and Neuro Imaging Ministry of Education, Xi'an, People's Republic of China.,Inner Mongolia Key Laboratory of Pattern Recognition and Intelligent Image Processing, School of Information Engineering, Inner Mongolia University of Science and Technology, Baotou, Inner Mongolia, People's Republic of China.,Guangxi Key Laboratory of Multi-Source Information Mining and Security, Guangxi Normal University, Guilin, People's Republic of China
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Dai XJ, Liu BX, Ai S, Nie X, Xu Q, Hu J, Zhang Q, Xu Y, Zhang Z, Lu G. Altered inter-hemispheric communication of default-mode and visual networks underlie etiology of primary insomnia. Brain Imaging Behav 2019; 14:1430-1444. [DOI: 10.1007/s11682-019-00064-0] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
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35
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Joo EY. Chronic insomnia disorder: perspectives from structural neuroimaging. PRECISION AND FUTURE MEDICINE 2019. [DOI: 10.23838/pfm.2018.00156] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
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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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Yu S, Shen Z, Lai R, Feng F, Guo B, Wang Z, Yang J, Hu Y, Gong L. The Orbitofrontal Cortex Gray Matter Is Associated With the Interaction Between Insomnia and Depression. Front Psychiatry 2018; 9:651. [PMID: 30564152 PMCID: PMC6288475 DOI: 10.3389/fpsyt.2018.00651] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/02/2018] [Accepted: 11/16/2018] [Indexed: 01/18/2023] Open
Abstract
Insomnia and depression are highly comorbid symptoms in both primary insomnia (PI) and major depressive disorder (MDD). In the current study, we aimed at exploring both the homogeneous and heterogeneous brain structure alteration in PI and MDD patients. Sixty-five MDD patients and 67 matched PI patients were recruited and underwent a structural MRI scan. The subjects were sub-divided into four groups, namely MDD patients with higher or lower insomnia, and PI patients with higher or lower severe depression. A general linear model was employed to explore the changes in cortical thickness and volume as a result of depression or insomnia, and their interaction. In addition, partial correlation analysis was conducted to detect the clinical significance of the altered brain structural regions. A main effect of depression on cortical thickness was seen in the superior parietal lobe, middle cingulate cortex, and parahippocampal gyrus, while a main effect of insomnia on cortical thickness was found in the posterior cingulate cortex. Importantly, the interaction between depression and insomnia was associated with decreased gray matter volume in the right orbitofrontal cortex, i.e., patients with co-occurring depression and insomnia showed smaller brain volume in the right orbitofrontal cortex when compared to patients with lower insomnia/depression. These findings highlighted the role of the orbitofrontal cortex in the neuropathology of the comorbidity of insomnia and depression. Our findings provide new insights into the understanding of the brain mechanism underlying comorbidity of insomnia and depression.
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Affiliation(s)
- Siyi Yu
- Department of Acupuncture & Tuina, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Zhifu Shen
- Department of Acupuncture & Tuina, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Rui Lai
- Department of Anesthesiology, People's Hospital of Deyang, Deyang, China
| | - Fen Feng
- Affiliated Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Baojun Guo
- Department of Acupuncture & Tuina, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Zhengyan Wang
- Department of Pain Management, Sichuan Integrative Medicine Hospital, Chengdu, China
| | - Jie Yang
- Department of Acupuncture & Tuina, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Youping Hu
- Department of Acupuncture & Tuina, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Liang Gong
- Department of Neurology, Chengdu Second People's Hospital, Chengdu, China
- Department of Neurology, Affiliated ZhongDa Hospital, School of Medicine, Southeast University, Nanjing, China
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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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Zhao W, Gao D, Yue F, Wang Y, Mao D, Chen X, Lei X. Response Inhibition Deficits in Insomnia Disorder: An Event-Related Potential Study With the Stop-Signal Task. Front Neurol 2018; 9:610. [PMID: 30131753 PMCID: PMC6090996 DOI: 10.3389/fneur.2018.00610] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2018] [Accepted: 07/09/2018] [Indexed: 12/20/2022] Open
Abstract
Background: Response inhibition is a hallmark of executive function, which was detected impaired in various psychiatric disorders. However, whether insomnia disorder (ID) impairs response inhibition has caused great controversy. Methods: Using the auditory stop-signal paradigm coupled with event-related potentials (ERPs), we carried out this study to examine whether individuals with ID presented response inhibition deficits and further investigated the neural mechanism correlated to these deficits. Twelve individuals with ID and 13 matched good sleepers (GSs) had participated in this study, and then they performed an auditory stop-signal task (SST) in the laboratory setting with high density EEG recordings. Results: The behavioral results revealed that compared to GSs, patients with ID presented significantly longer stop-signal reaction time (SSRT), suggesting the impairment of motor inhibition among insomniacs. Their reaction time in go trials, however, showed no significant between-group difference. Considering the electrophysiological correlate underlying the longer SSRT, we found reduced P3 amplitude in patients with insomnia in the successful stop trials, which might reflect their poor efficiency of response inhibition. Finally, when we performed exploratory analyses in the failed stop and go trials, patients with ID presented reduced Pe and N1 amplitude in the failed sop trials and go trials respectively. Discussion: Taken together, these findings indicate that individuals with ID would present response inhibition deficits. Moreover, the electrophysiological correlate underlying these deficits mainly revolves around the successful stop P3 component. The present study is the first to investigate the electrophysiological correlate underlying the impaired response inhibition among insomniacs.
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Affiliation(s)
- Wenrui Zhao
- Sleep and Neuroimaging Center, Faculty of Psychology, Southwest University, Chongqing, China.,Key Laboratory of Cognition and Personality of Ministry of Education, Chongqing, China
| | - Dong Gao
- Sleep Psychology Center, Daping Hospital, Army Medical University, Chongqing, China
| | - Faguo Yue
- Sleep Psychology Center, Daping Hospital, Army Medical University, Chongqing, China
| | - Yanting Wang
- Sleep Psychology Center, Daping Hospital, Army Medical University, Chongqing, China
| | - Dandan Mao
- Sleep Psychology Center, Daping Hospital, Army Medical University, Chongqing, China
| | - Xinyuan Chen
- Sleep and Neuroimaging Center, Faculty of Psychology, Southwest University, Chongqing, China.,Key Laboratory of Cognition and Personality of Ministry of Education, Chongqing, China
| | - Xu Lei
- Sleep and Neuroimaging Center, Faculty of Psychology, Southwest University, Chongqing, China.,Key Laboratory of Cognition and Personality of Ministry of Education, Chongqing, China
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Chen L, Qi X, Zheng J. Altered Regional Cortical Brain Activity in Healthy Subjects After Sleep Deprivation: A Functional Magnetic Resonance Imaging Study. Front Neurol 2018; 9:588. [PMID: 30116216 PMCID: PMC6082940 DOI: 10.3389/fneur.2018.00588] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2018] [Accepted: 06/29/2018] [Indexed: 12/18/2022] Open
Abstract
Objective: To investigate acute sleep deprivation (SD)-related regional brain activity changes and their relationships with behavioral performances. Methods: Twenty-two female subjects underwent an MRI scan and an attention network test at rested wakefulness (RW) status and after 24 h SD. The amplitude of low-frequency fluctuations (ALFF) was used to investigate SD-related regional brain activity changes. We used the receiver operating characteristic (ROC) curve to evaluate the ability of the ALFF differences in regional brain areas to distinguish the SD status from the RW status. We used Pearson correlations to evaluate the relationships between the ALFF differences in brain areas and the behavioral performances during the SD status. Results: Subjects at the SD status exhibited a lower accuracy rate and a longer reaction time relative to the RW status. Compared with RW, SD showed significant lower ALFF values in the right cerebellum anterior lobe, and higher ALFF areas in the bilateral inferior occipital gyrus, left thalamus, left insula, and bilateral postcentral gyrus. The area under the curve values of the specific ALFF differences in brain areas were (mean ± std, 0.851 ± 0.045; 0.805–0.93). Further, the ROC curve analysis demonstrated that the ALFF differences in those regional brain areas alone discriminated the SD status from the RW status with high degrees of sensitivities (82.16 ± 7.61%; 75–93.8%) and specificities (81.23 ± 11.39%; 62.5–93.7%). The accuracy rate showed negative correlations with the left inferior occipital gyrus, left thalamus, and left postcentral gyrus, and showed a positive correlation with the right cerebellum. Conclusions: The ALFF analysis is a potential indicator for detecting the excitation–inhibition imbalance of regional cortical activations disturbed by acute SD with high performances.
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Affiliation(s)
- Lingling Chen
- Department of Pediatric Internal Medicine, Linyi Central Hospital, Yishui, China
| | - Xueliang Qi
- Department of Pediatric Internal Medicine, Linyi Central Hospital, Yishui, China
| | - Jiyong Zheng
- Department of Medical Imaging, The Affiliated Huaian No. 1 People's Hospital of Nanjing Medical University, Huaian, China
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42
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Yan CQ, Liu CZ, Wang X, Huo JW, Zhou P, Zhang S, Fu QN, Zhang J, Wang ZY, Liu QQ. Abnormal Functional Connectivity of Anterior Cingulate Cortex in Patients With Primary Insomnia: A Resting-State Functional Magnetic Resonance Imaging Study. Front Aging Neurosci 2018; 10:167. [PMID: 29922151 PMCID: PMC5996039 DOI: 10.3389/fnagi.2018.00167] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2018] [Accepted: 05/16/2018] [Indexed: 12/21/2022] Open
Abstract
Background: Recently, there have been many reports about abnormalities regarding structural and functional brain connectivity of the patients with primary insomnia. However, the alterations in functional interaction between the left and right cerebral hemispheres have not been well understood. The resting-state fMRI approach, which reveals spontaneous neural fluctuations in blood-oxygen-level-dependent signals, offers a method to quantify functional interactions between the hemispheres directly. Methods: We compared interhemispheric functional connectivity (FC) between 26 patients with primary insomnia (48.85 ± 12.02 years) and 28 healthy controls (49.07 ± 11.81 years) using a voxel-mirrored homotopic connectivity (VMHC) method. The patients with primary insomnia and healthy controls were matched for age, gender, and education. Brain regions, which had significant differences in VMHC maps between the primary insomnia and healthy control groups, were defined as seed region of interests. A seed-based approach was further used to reveal significant differences of FC between the seeds and the whole contralateral hemisphere. Results: The patients with primary insomnia showed higher VMHC than healthy controls in the anterior cingulate cortex (ACC) bilaterally. The seed-based analyses demonstrated increased FC between the left ACC and right thalamus (and the right ACC and left orbitofrontal cortex) in patients with primary insomnia, revealing abnormal connectivity between the two cerebral hemispheres. The VMHC values in the ACC were positively correlated with the time to fall asleep and Self-Rating Depression Scale scores (SDS). Conclusions: The results demonstrate that there is abnormal interhemispheric resting-state FC in the brain regions of patients with primary insomnia, especially in the ACC. Our finding demonstrates valid evidence that the ACC is an area of interest in the neurobiology of primary insomnia.
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Affiliation(s)
- Chao-Qun Yan
- Department of Acupuncture and Moxibustion, Beijing Hospital of Traditional Chinese Medicine Affiliated to Capital Medical University, Beijing, China
| | - Cun-Zhi Liu
- Department of Acupuncture, Dongfang Hospital, Beijing University of Chinese Medicine, Beijing, China
| | - Xu Wang
- School of Life Sciences, Beijing University of Chinese Medicine, Beijing, China
| | - Jian-Wei Huo
- Department of Radiology, Beijing Hospital of Traditional Chinese Medicine Affiliated to Capital Medical University, Beijing, China
| | - Ping Zhou
- Department of Acupuncture and Moxibustion, Beijing Hospital of Traditional Chinese Medicine Affiliated to Capital Medical University, Beijing, China
| | - Shuai Zhang
- Department of Acupuncture and Moxibustion, Beijing Hospital of Traditional Chinese Medicine Affiliated to Capital Medical University, Beijing, China
| | - Qing-Nan Fu
- Department of Acupuncture and Moxibustion, Beijing Hospital of Traditional Chinese Medicine Affiliated to Capital Medical University, Beijing, China
| | - Jie Zhang
- Department of Acupuncture and Moxibustion, Beijing Hospital of Traditional Chinese Medicine Affiliated to Capital Medical University, Beijing, China
| | - Zhong-Yan Wang
- Department of Radiology, Beijing Hospital of Traditional Chinese Medicine Affiliated to Capital Medical University, Beijing, China
| | - Qing-Quan Liu
- Beijing Key Laboratory of Basic Study on Traditional Chinese Medicine Infectious Diseases, Beijing Hospital of Traditional Chinese Medicine Affiliated to Capital Medical University, Beijing, China
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Liu X, Zheng J, Liu BX, Dai XJ. Altered connection properties of important network hubs may be neural risk factors for individuals with primary insomnia. Sci Rep 2018; 8:5891. [PMID: 29651014 PMCID: PMC5897381 DOI: 10.1038/s41598-018-23699-3] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2017] [Accepted: 03/14/2018] [Indexed: 12/18/2022] Open
Abstract
Primary insomnia (PIs) is highly prevalent and can lead to adverse socioeconomic impacts, but the underlying mechanism of its complex brain network impairment remains largely unknown. Functional studies are too few and diverse in methodology, which makes it difficult to glean general conclusions. To answer this question, we first used graph theory-based network analyse, together with seed-based functional connectivity approach, to characterize the topology architecture of whole-brain functional networks associated with PIs. Forty-eight subjects with PIs and 48 age/sex/education-matched good sleepers were recruited. We found PIs is associated with altered connection properties of intra-networks within the executive control network, default mode network and salience network, and inter-network between auditory language comprehension center and executive control network. These complex networks were correlated with negative emotions and insomnia severity in the PIs group. Altered connection properties of these network hubs appeared to be neural risk factors for neuropsychological changes of PIs, and might be used as potential neuroimaging markers to distinguish the PIs from the good sleepers. These findings highlight the role of functional connectivity in the pathophysiology of PIs, and may underlie the neural mechanisms of etiology of PIs.
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Affiliation(s)
- Xuming Liu
- Department of Radiology, The Third Clinical Institute Affiliated to Wenzhou Medical University, Wenzhou, 325000, Zhejiang, People's Republic of China
| | - Jiyong Zheng
- Department of Medical Imaging, The affiliated Huaian No. 1 People's Hospital of Nanjing Medical University, Huai'an, 223300, Jiangsu, People's Republic of China
| | - Bi-Xia Liu
- Department of Respiration, the First Hospital Affiliated to Soochow University, Suzhou, 215006, People's Republic of China.,Department of ICU, Jiangxi Provincial Cancer Hospital, Nanchang, 330029, Jiangxi, People's Republic of China
| | - Xi-Jian Dai
- Department of Medical Imaging, Jinling Hospital, Medical School of Nanjing University, Nanjing, 210002, Jiangsu, People's Republic of China. .,Department of Radiology, The First Affiliated Hospital of Nanchang University, Nanchang, 330006, Jiangxi, People's Republic of China.
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44
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Zhang P, Tan CW, Chen GH, Ge YJ, Xu J, Xia L, Wang F, Li XY, Kong XY. Patients with chronic insomnia disorder have increased serum levels of neurofilaments, neuron-specific enolase and S100B: does organic brain damage exist? Sleep Med 2018; 48:163-171. [PMID: 29957487 DOI: 10.1016/j.sleep.2017.12.012] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/16/2017] [Accepted: 12/30/2017] [Indexed: 01/29/2023]
Abstract
OBJECTIVES The aims of this study were to investigate whether serum levels of neurofilaments heavy chain (NfH) and light chain (NfL), neuron-specific enolase (NSE) and S100 calcium binding protein B (S100B): (1) change, (2) alleviate in post-therapy and (3) are associated with sleep quality and cognitive dysfunction, in patients with chronic insomnia disorder (CID). METHODS Forty CID outpatients constituted free-therapy group (ft-CID), in which twenty-four patients completed follow-up after six-month treatment to form re-visiting group (rv-CID), and twenty healthy good sleepers constituted control group (HC). All subjects completed questionnaires, polysomnography, Chinese-Beijing Version of Montreal Cognitive Assessment (MoCA-C) and Nine Box Maze Test (NBMT) to assess sleep and neuropsychological function. The serum levels of NfH, NfL, NSE and S100B were detected using enzyme-linked immunosorbent assay. RESULTS The ft-CID had higher levels of NfH, NfL, NSE and S100B than the HC. Of note, the levels of NfH, NfL and NSE were significantly reduced in the rv-CID compared to the ft-CID, but not the level of S100B. Principal components analysis revealed that in these serum biomarkers, NfL and S100B had a substantial correlation with subjective and objective sleep parameters. CONCLUSIONS The CID patients had elevated serum levels of NfH, NfL, NSE and S100B, indicating existence of damaged brain microstructure, including neurons, astrocytes and neuronal terminals, which were associated with the insomniac severity or/and cognitive dysfunction and could significantly reduce after effective therapy apart from the S100B.
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Affiliation(s)
- Ping Zhang
- Department of Sleep Disorders or Psychiatry or Neurology, The Affiliated Chaohu Hospital of Anhui Medical University, Chaohu, Hefei, 238000, China
| | - Cheng-Wen Tan
- Department of Sleep Disorders or Psychiatry or Neurology, The Affiliated Chaohu Hospital of Anhui Medical University, Chaohu, Hefei, 238000, China
| | - Gui-Hai Chen
- Department of Sleep Disorders or Psychiatry or Neurology, The Affiliated Chaohu Hospital of Anhui Medical University, Chaohu, Hefei, 238000, China; Department of Neurology, The First Affiliated Hospital of Anhui Medical University, Hefei, 230022, China.
| | - Yi-Jun Ge
- Department of Sleep Disorders or Psychiatry or Neurology, The Affiliated Chaohu Hospital of Anhui Medical University, Chaohu, Hefei, 238000, China
| | - Jing Xu
- Department of Sleep Disorders or Psychiatry or Neurology, The Affiliated Chaohu Hospital of Anhui Medical University, Chaohu, Hefei, 238000, China
| | - Lan Xia
- Department of Neurology, The Second Affiliated Hospital of Anhui Medical University, Hefei, 230601, China
| | - Fang Wang
- Department of Neurology, The First Affiliated Hospital of Anhui Medical University, Hefei, 230022, China
| | - Xue-Yan Li
- Department of Sleep Disorders or Psychiatry or Neurology, The Affiliated Chaohu Hospital of Anhui Medical University, Chaohu, Hefei, 238000, China
| | - Xiao-Yi Kong
- Department of Sleep Disorders or Psychiatry or Neurology, The Affiliated Chaohu Hospital of Anhui Medical University, Chaohu, Hefei, 238000, China
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Zhou F, Zhao Y, Huang M, Zeng X, Wang B, Gong H. Disrupted interhemispheric functional connectivity in chronic insomnia disorder: a resting-state fMRI study. Neuropsychiatr Dis Treat 2018; 14:1229-1240. [PMID: 29795981 PMCID: PMC5957476 DOI: 10.2147/ndt.s162325] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Abnormalities in both cerebral structure and intrinsic activity have been increasingly reported in patients with chronic insomnia disorder (CID). However, the inter-hemispheric integration function in CID is still not well understood. Functional homotopy reflects an essential aspect of the intrinsic functional architecture involved in interhemispheric coordination. METHODS In this study, voxel-mirrored homotopic connectivity (VMHC) was used to analyze the patterns of interhemispheric intrinsic functional connectivity in patients with CID (n=29). RESULTS Reduced homotopic connectivity was observed in the middle occipital/posterior middle temporal gyrus in CID patients relative to control subjects. Further analyses demonstrated different insomnia-related heterotopic connectivity patterns in the right and left middle occipital/posterior middle temporal gyrus. Furthermore, within the CID group, the connectivity coefficient within the connectivity network of the middle occipital/posterior middle temporal gyrus was associated with anxiety measures. CONCLUSION Negative significant findings of group differences were found in terms of both the local gray matter density and fractional anisotropy of the white matter skeletal measures in this study; this structural finding, together with the results of VMHC, suggested that disruptions in the intrinsic functional architecture of interhemispheric communication associated with CID can be observed in the absence of detectable microstructural or local morphometric changes in white and gray matter.
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Affiliation(s)
- Fuqing Zhou
- Department of Radiology, The First Affiliated Hospital, Nanchang University, Nanchang, China.,Neuroradiology Lab, Jiangxi Province Medical Imaging Research Institute, Nanchang, China
| | - Yanlin Zhao
- Department of Radiology, The First Affiliated Hospital, Nanchang University, Nanchang, China.,Neuroradiology Lab, Jiangxi Province Medical Imaging Research Institute, Nanchang, China
| | - Muhua Huang
- Department of Radiology, The First Affiliated Hospital, Nanchang University, Nanchang, China.,Neuroradiology Lab, Jiangxi Province Medical Imaging Research Institute, Nanchang, China
| | - Xianjun Zeng
- Department of Radiology, The First Affiliated Hospital, Nanchang University, Nanchang, China.,Neuroradiology Lab, Jiangxi Province Medical Imaging Research Institute, Nanchang, China
| | - Bo Wang
- Department of Radiology, The First Affiliated Hospital, Nanchang University, Nanchang, China.,Neuroradiology Lab, Jiangxi Province Medical Imaging Research Institute, Nanchang, China
| | - Honghan Gong
- Department of Radiology, The First Affiliated Hospital, Nanchang University, Nanchang, China.,Neuroradiology Lab, Jiangxi Province Medical Imaging Research Institute, Nanchang, China
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Dai XJ, Jiang J, Zhang Z, Nie X, Liu BX, Pei L, Gong H, Hu J, Lu G, Zhan Y. Plasticity and Susceptibility of Brain Morphometry Alterations to Insufficient Sleep. Front Psychiatry 2018; 9:266. [PMID: 29997530 PMCID: PMC6030367 DOI: 10.3389/fpsyt.2018.00266] [Citation(s) in RCA: 41] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2018] [Accepted: 05/31/2018] [Indexed: 12/20/2022] Open
Abstract
UNLABELLED Background: Insufficient sleep is common in daily life and can lead to cognitive impairment. Sleep disturbance also exists in neuropsychiatric diseases. However, whether and how acute and chronic sleep loss affect brain morphology remain largely unknown. Methods: We used voxel-based morphology method to study the brain structural changes during sleep deprivation (SD) at six time points of rested wakefulness, 20, 24, 32, 36 h SD, and after one night sleep in 22 healthy subjects, and in 39 patients with chronic primary insomnia relative to 39 status-matched good sleepers. Attention network and spatial memory tests were performed at each SD time point in the SD Procedure. The longitudinal data were analyzed using one-way repeated measures ANOVA, and post-hoc analysis was used to determine the between-group differences. Results: Acute SD is associated with widespread gray matter volume (GMV) changes in the thalamus, cerebellum, insula and parietal cortex. Insomnia is associated with increased GMV in temporal cortex, insula and cerebellum. Acute SD is associated with brain atrophy and as SD hours prolong more areas show reduced GMV, and after one night sleep the brain atrophy is restored and replaced by increased GMV in brain areas. SD has accumulative negative effects on attention and working memory. Conclusions: Acute SD and insomnia exhibit distinct morphological changes of GMV. SD has accumulative negative effects on brain morphology and advanced cognitive function. The altered GMV may provide neurobiological basis for attention and memory impairments following sleep loss. STATEMENT OF SIGNIFICANCE Sleep is less frequently studied using imaging techniques than neurological and psychiatric disorders. Whether and how acute and chronic sleep loss affect brain morphology remain largely unknown. We used voxel-based morphology method to study brain structural changes in healthy subjects over multiple time points during sleep deprivation (SD) status and in patients with chronic insomnia. We found that prolonged acute SD together with one night sleep recovery exhibits accumulative atrophic effect and recovering plasticity on brain morphology, in line with behavioral changes on attentional tasks. Furthermore, acute SD and chronic insomnia exhibit distinct morphological changes of gray matter volume (GMV) but they also share overlapping GMV changes. The altered GMV may provide structural basis for attention and memory impairments following sleep loss.
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Affiliation(s)
- Xi-Jian Dai
- Department of Medical Imaging, Medical School of Nanjing University, Jinling Hospital, Nanjing, China.,Department of Radiology, The First Affiliated Hospital of Nanchang University, Nangchang, China
| | - Jian Jiang
- Department of Radiology, The First Affiliated Hospital of Nanchang University, Nangchang, China
| | - Zhiqiang Zhang
- Department of Medical Imaging, Medical School of Nanjing University, Jinling Hospital, Nanjing, China
| | - Xiao Nie
- Department of Radiology, The First Affiliated Hospital of Nanchang University, Nangchang, China.,Department of Radiology, Yiyang Central Hospital, Yiyang, China
| | - Bi-Xia Liu
- Department of ICU, Jiangxi Cancer Hospital, Nanchang, China
| | - Li Pei
- Department of Radiology, The First Affiliated Hospital of Nanchang University, Nangchang, China
| | - Honghan Gong
- Department of Radiology, The First Affiliated Hospital of Nanchang University, Nangchang, China
| | - Jianping Hu
- Department of Medical Imaging, Medical School of Nanjing University, Jinling Hospital, Nanjing, China
| | - Guangming Lu
- Department of Medical Imaging, Medical School of Nanjing University, Jinling Hospital, Nanjing, China
| | - Yang Zhan
- Brain Cognition and Brain Disease Institute, Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen, China
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47
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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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48
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Dai XJ, Nie X, Liu X, Pei L, Jiang J, Peng DC, Gong HH, Zeng XJ, Wáng YXJ, Zhan Y. Gender Differences in Regional Brain Activity in Patients with Chronic Primary Insomnia: Evidence from a Resting-State fMRI Study. J Clin Sleep Med 2017; 12:363-74. [PMID: 26715399 DOI: 10.5664/jcsm.5586] [Citation(s) in RCA: 70] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2015] [Accepted: 11/23/2015] [Indexed: 12/15/2022]
Abstract
STUDY OBJECTIVES To explore the regional brain activities in patients with chronic primary insomnia (PCPIs) and their sex differences. METHODS Forty-two PCPIs (27 females, 15 males) and 42 good sleepers (GSs; 24 females, 18 males) were recruited. Six PCPIs (3 males, 3 females) were scanned twice by MRI to examine the test-retest reliability. Amplitude of low frequency fluctuation (ALFF) method was used to assess the local brain features. The mean signal values of the different ALFF areas were analyzed with a receiver operating characteristic (ROC) curve. Simple linear regression analysis was performed to investigate the relationships between clinical features and different brain areas. RESULTS Both female and male PCPIs showed higher ALFF in the temporal lobe and occipital lobe, especially in female PCPIs. Female PCPIs had lower ALFF in the bilateral cerebellum posterior lobe, left dorsolateral prefrontal cortex, and bilateral limbic lobe; however, male PCPIs showed lower ALFF in the left occipital gyrus. The mean signal value of the cerebellum in female PCPIs showed negative correlations with negative emotions. Compared with male PCPIs, female PCPIs showed higher ALFF in the bilateral middle temporal gyrus and lower ALFF in the left limbic lobe. The different areas showed high test-retest stability (Clusters of contiguous volumes ≥ 1080 mm(3) with an intraclass correlation coefficient ≥ 0.80) and high degree of sensitivity and specificity. CONCLUSIONS Female PCPIs showed more regional brain differences with higher and lower ALFF responses than male PCPIs. However, they shared analogous excessive hyperarousal mechanism and wide variations in aberrant brain areas.
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Affiliation(s)
- Xi-Jian Dai
- Department of Radiology, The First Affiliated Hospital of Nanchang University, Jiangxi, China.,Brain Cognition and Brain Disease Institute, Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen, China
| | - Xiao Nie
- Department of Radiology, The First Affiliated Hospital of Nanchang University, Jiangxi, China
| | - Xuming Liu
- Department of Radiology, The Third Clinical Institute Affiliated To Wenzhou Medical University, Zhejiang, China
| | - Li Pei
- Department of Radiology, The First Affiliated Hospital of Nanchang University, Jiangxi, China
| | - Jian Jiang
- Department of Radiology, The First Affiliated Hospital of Nanchang University, Jiangxi, China
| | - De-chang Peng
- Department of Radiology, The First Affiliated Hospital of Nanchang University, Jiangxi, China
| | - Hong-Han Gong
- Department of Radiology, The First Affiliated Hospital of Nanchang University, Jiangxi, China
| | - Xian-Jun Zeng
- Department of Radiology, The First Affiliated Hospital of Nanchang University, Jiangxi, China
| | - Yì-Xiáng J Wáng
- Department of Imaging and Interventional Radiology, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong
| | - Yang Zhan
- Brain Cognition and Brain Disease Institute, Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen, China
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49
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Huang S, Zhou F, Jiang J, Huang M, Zeng X, Ding S, Gong H. Regional impairment of intrinsic functional connectivity strength in patients with chronic primary insomnia. Neuropsychiatr Dis Treat 2017; 13:1449-1462. [PMID: 28652745 PMCID: PMC5473502 DOI: 10.2147/ndt.s137292] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
Several neuroimaging studies have suggested that brain impairment and plasticity occur in patients with chronic primary insomnia (CPI); however, the effects of insomnia on the intrinsic organization of the brain remain largely unknown. In this study, a voxel-based functional connectivity strength (FCS) assessment, a data-driven method based on a theoretical approach, was applied to investigate the effects of insomnia on the intrinsic organization of the whole brain in 27 treatment-naïve CPI patients and 26 well-matched healthy controls (HCs). Compared with HCs, CPI patients exhibited decreased FCS primarily in the right dorsolateral prefrontal cortex, the right medial prefrontal cortex (MPFC), the left basal ganglia/insula, and the right cerebellum anterior lobe (CAL) due to decreased functional connectivity patterns. These results suggest that poor sleep quality could impair FCS within the brain, including the MPFC and the CAL, which are important for cognitive control and modulating motor and limbic functions. Additionally, a receiver operator characteristic analysis revealed that altered FCS has moderate sensitivity (76.9%-88.5%) and specificity (59.3%-70.4%) as a reference indicator to discriminate CPI patients from HCs. Taken together, these findings provide evidence for abnormal intrinsic brain activity in CPI patients and might improve our understanding of the pathophysiological processes that occur in insomnia patients.
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Affiliation(s)
- Suhua Huang
- Department of Radiology, Jiangxi Province Children's Hospital
| | - Fuqing Zhou
- Department of Radiology, The First Affiliated Hospital, Nanchang University.,Jiangxi Province Medical Imaging Research Institute, Nanchang, People's Republic of China
| | - Jian Jiang
- Department of Radiology, The First Affiliated Hospital, Nanchang University.,Jiangxi Province Medical Imaging Research Institute, Nanchang, People's Republic of China
| | - Muhua Huang
- Department of Radiology, The First Affiliated Hospital, Nanchang University.,Jiangxi Province Medical Imaging Research Institute, Nanchang, People's Republic of China
| | - Xianjun Zeng
- Department of Radiology, The First Affiliated Hospital, Nanchang University.,Jiangxi Province Medical Imaging Research Institute, Nanchang, People's Republic of China
| | - Shan Ding
- Department of Radiology, Jiangxi Province Children's Hospital
| | - Honghan Gong
- Department of Radiology, The First Affiliated Hospital, Nanchang University.,Jiangxi Province Medical Imaging Research Institute, Nanchang, People's Republic of China
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50
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Radcliff Z, Baylor A, Rybarczyk B. Adopted youth and sleep difficulties. PEDIATRIC HEALTH MEDICINE AND THERAPEUTICS 2016; 7:165-175. [PMID: 29388635 PMCID: PMC5683292 DOI: 10.2147/phmt.s119958] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Sleep is a critical component of healthy development for youth, with cascading effects on youth’s biological growth, psychological well-being, and overall functioning. Increased sleep difficulties are one of many disruptions that adopted youth may face throughout the adoption process. Sleep difficulties have been frequently cited as a major concern by adoptive parents and hypothesized in the literature as a problem that may affect multiple areas of development and functioning in adopted youth. However, there is limited research exploring this relationship. Using a biopsychosocial framework, this paper reviews the extant literature to explore the development, maintenance, and impact of sleep difficulties in adopted youth. Finally, implications for future research and clinical interventions are outlined.
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Affiliation(s)
- Zach Radcliff
- Department of Psychology, Virginia Commonwealth University, Richmond, VA, USA
| | - Allison Baylor
- Department of Psychology, Virginia Commonwealth University, Richmond, VA, USA
| | - Bruce Rybarczyk
- Department of Psychology, Virginia Commonwealth University, Richmond, VA, USA
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