Brain Gray Matter Deficits in Patients with Chronic Primary Insomnia

Joo, Eun Yeon; Noh, Han-Jin; Kim, Jeong-Sik; Koo, Dae Lim; Kim, Dae-Young; Hwang, Kyoung Jin; Kim, Ji Young; Kim, Sung Tae; Kim, Mi Rim; Hong, Seung Bong

doi:10.5665/sleep.2796

Cited by 190 publications

(208 citation statements)

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“…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.…”

Section: Discussionmentioning

confidence: 99%

“…44 Joo et al found decreased volume of gray matter in the MPFC in the PCPIs compared with the GSs. 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.…”

Section: Discussionmentioning

confidence: 99%

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

Dai

Nie

Liu

et al. 2016

Journal of Clinical Sleep Medicine

115

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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 testretest 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. I NTRO DUCTI O NPatients with chronic primary insomnia (PCPIs), who underwent the subjective experience of chronically disturbed sleep, sleep loss, non-refreshing sleep, and heightened arousal in bed with impaired quality of life, showed a decreased ability to disengage from external information processing at sleep onset.1-3 Occasional episodes of insomnia symptoms are reported in half of all adults, while chronic insomnia is prevalent in 10-15% of the adult population. 4 In spite of a recent increase in neuroimaging research into PCPIs, it has not gleaned a consistent conclusion about its neuropathology after reviewing the neuroimaging studies of primary insomnia, especially with regard to the structural studies of brain alterations. 5 The results of structural studies are either contradictory or required replication. Altena et al. found that PCPIs had a smaller volume of reduced gray matter in the precuneus and left orbitofrontal cortex which strongly correlated with the subjective severity of insomnia, but increased gray matter volume was not found. 6 Joo et al. demonstrated significantly reduced gray matter concentrations in the dorsolateral prefrontal and pericentral cortices, superior temporal gyrus, and cerebellum, and decreased gray matter volumes in the medial frontal lobe and middle temporal lobe in PCPIs compared with good sleepers (GSs), ...

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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

Dai

Nie

Liu

et al. 2016

Journal of Clinical Sleep Medicine

115

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show abstract

“…Several studies have reported associations between selfreport primary insomnia and reduced cortical gray matter volume in several brain regions including the orbitofrontal cortex, 15,16 hippocampus, 17,18 and precuneus. 15 Moreover, in individuals without a clinical diagnosis of insomnia, self-report metrics of poorer sleep quality have been associated with Significance Sleep fragmentation is a common symptom in older adults and is associated with a number of adverse health outcomes.…”

Section: Introductionmentioning

confidence: 99%

Regional neocortical gray matter structure and sleep fragmentation in older adults

et al. 2015

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“…19,20 With respect to OSA, a variety of neuroimaging studies suggest evidence of brain neuronal loss or dysfunction. 21 Gray matter abnormalities also have been observed some, [22][23][24] but not all studies of patients with chronic insomnia. 25 Given the interconnections among TBI, OSA, insomnia, mood disturbances, cognitive decline and neurodegeneration, one can speculate that OSA and insomnia may be additional risk factors or important modifying factors for the development of CTE.…”

mentioning

confidence: 92%

Are Sleep Disturbances a Risk for Chronic Traumatic Encephalopathy? Only the Shadow Knows

Quan

2014

Journal of Clinical Sleep Medicine

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Brain Gray Matter Deficits in Patients with Chronic Primary Insomnia

Abstract: Joo EY; Noh HJ; Kim JS; Koo DL; Kim D; Hwang KJ; Kim JY; Kim ST; Kim MR; Hong SB. Brain gray matter deficits in patients with chronic primary insomnia. 2013;36(7):999-1007.

Cited by 190 publications

References 43 publications

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

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

Regional neocortical gray matter structure and sleep fragmentation in older adults

Are Sleep Disturbances a Risk for Chronic Traumatic Encephalopathy? Only the Shadow Knows

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