Altered intrinsic regional brain spontaneous activity and subjective sleep quality in patients with chronic primary insomnia: a resting-state fMRI study

Abstract

Study objectiveTo prospectively explore the underlying regional homogeneity (ReHo) brain-activity deficit in patients with chronic primary insomnia (PCPIs) and its relationship with clinical features.DesignThe ReHo method and Statistical Parametric Mapping 8 software were used to evaluate whether resting-state localized brain activity was modulated between PCPIs and good sleepers (GSs), and correlation analysis between altered regional brain areas and clinical features was calculated.Patients and participantsTwenty-four PCPIs (17 females, seven males) and 24 (12 females, 12 males) age-, sex-, and education-matched GSs.Measurements and resultsPCPIs disturbed subjective sleep quality, split positive mood, and exacerbated negative moods. Compared with GSs, PCPIs showed higher ReHo in left fusiform gyrus, and lower ReHo in bilateral cingulate gyrus and right cerebellum anterior lobe. Compared with female GSs, female PCPIs showed higher ReHo in the left fusiform gyrus and right posterior cingulate, and lower ReHo in the left cerebellum anterior lobe and left superior frontal gyrus. Compared with male GSs, male PCPIs showed higher ReHo in the right temporal lobe and lower ReHo in the bilateral frontal lobe. The fusiform gyrus showed strong positive correlations and the frontal lobe showed negative correlations with the clinical measurements.ConclusionThe ReHo analysis is a useful noninvasive imaging tool for the detection of cerebral changes and the indexing of clinical features. The abnormal spontaneous activity areas provided important information on the neural mechanisms underlying emotion and sleep-quality impairment in PCPIs.

Gender Differences in Regional Brain Activity in Patients with Chronic Primary Insomnia: Evidence from a Resting-State fMRI Study

“…48 Joo et al found that the PCPIs showed significant reduction of gray matter concentrations in the dorsolateral prefrontal cortices compared with the GSs. 7 Our previous study also found the PCPI-Ms showed lower regional homogeneity in the dorsolateral prefrontal cortex compared with the GS-Ms. 23 In support of these findings, in the present study we found that the PCPI-Fs showed lower ALFF in the left dorsolateral prefrontal cortex compared with the GS-Fs. These findings suggest that the attentional and cognitive dysfunction may contribute to the impaired dorsolateral prefrontal cortex.…”

“…7 Altena et al found a smaller gray matter volume in the left orbitofrontal cortex in the PCPIs compared with the GSs. 45 Our previous regional homogeneity study found that both the PCPI-Fs and the PCPI-Ms showed lower regional homogeneity in the VMPFC, 23 and our previous functional connectivity study found that the PCPIs showed significant decreased functional connectivity between the MPFC and the right MTL, and between the left MTL and the left inferior parietal cortices using the seed-based region-to-region functional connectivity method. 12 In support of these findings, in the present study we found that the PCPI-Fs showed higher ALFF in the bilateral MTL and lower ALFF in the bilateral VMPFC and right MTL compared with the GS-Fs.…”

“…The details of the ALFF calculation have been reported in the previous studies. 18,23,29 To reduce the global effects of variability across the participants, the mean ALFF value of each voxel was divided by the global mean ALFF value for each participant.…”

“…36 Our previous sleep deprivation study found that the female sleep deprivation subjects showed hyperarousal re-activation in the bilateral occipital gyrus compared with the GS-Fs, 21 and our previous regional homogeneity study demonstrated the excessive hyperarousal reactivities in the temporal lobe in the PCPIs, PCPI-Ms and PCPI-Fs, and the excessive hyperarousal reactivation in the occipital cortex in the PCPI-Fs. 23 The vision-related regions were not only activated by real vision, but also by visual mental imagery, 37,38 since the visual cortex was relevant to emotional activities, as emotional changes could lead to higher BOLD signal regions in the visual cortex. 39,40 These findings supported our results that both PCPI-Fs and PCPI-Ms had higher ALFF in the occipital gyrus and temporal lobe.…”

“…23 Conformity to the pertinent diagnostic criteria was defined by the International Classification of Sleep Disorders, Second Edition, duration of insomnia > 2 months, Pittsburgh Sleep Quality Index (PSQI) score > 5, sleep diary for > 2 weeks duration, and right-handedness. All GSs met the following criteria: good sleeping habits, good sleep onset and/or maintenance, regular dietary habits, no consumption of any stimulants, medications, caffeine, tea, or coffee during or prior to the study for ≥ 3 months, PSQI score < 5, and Hamilton Depression Rating Scale (HAMD) and Hamilton Anxiety Rating Scale (HAMA) < 7.…”