Decreased regional brain activity in response to sleep‐related sounds after cognitive behavioral therapy for psychophysiological insomnia

Kim, Nambeom; Kang, Seung-Gul; Lee, Yu Jin; Kim, Seog Ju; Kim, Soohyun; Choi, Jae Won; Oh, Seong Min; Park, Juhyun; Gwak, Ah Reum; Kim, Hang Keun; Jeong, Do Un

doi:10.1111/pcn.12822

Cited by 20 publications

(10 citation statements)

References 30 publications

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“…For example, patients with ID showed thalamic atrophy, as well as disruption of thalamus's functional connectivity with the ACC, orbitofrontal cortex, hippocampus, caudate, and putamen which were negatively correlated with PSQI score (59). Kim et al observed cortical and thalamic hyperactivity in response to sleep-related tasks in psychophysiological insomnia (60). These studies indicate maladaptive role of amygdala, hippocampus, and thalamus in pathophysiology of ID, mainly in psychophysiological subtype.…”

Section: Discussionmentioning

confidence: 97%

Alterations of Subcortical Brain Structures in Paradoxical and Psychophysiological Insomnia Disorder

et al. 2021

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Insomnia disorder (ID) is a common illness associated with mood and cognitive impairments. Subtyping ID is an ongoing debate in sleep medicine, but the underlying mechanisms of each subtype is poorly understood. Growing evidence suggests that subcortical brain structures play the key roles in pathophysiology of ID and its subtypes. Here, we aimed to investigate structural alteration of subcortical regions in patients with two common ID subtypes i.e., paradoxical and psychophysiological insomnia. Fifty-five patients and 49 healthy controls were recruited for this study and T1-weighted images and subjective and objective sleep parameters (i.e., Pittsburgh Sleep Quality Index and polysomnography) were collected from participants. Subcortical structures including the hippocampus, amygdala, caudate, putamen, globus pallidus, nucleus accumbens, and thalamus were automatically segmented in FSL. Volume and shape (using surface vertices) of each structure were compared between the groups, controlled for covariates, and corrected for multiple comparisons. In addition, correlations of sleep parameters and surface vertices or volumes were calculated. The caudate's volume was smaller in patients than controls. Compared with controls, we found regional shrinkage in the caudate, nucleus accumbens, posterior putamen, hippocampus, thalamus, and amygdala in paradoxical insomnia and shrinkage in the amygdala, caudate, hippocampus, and putamen in psychophysiological insomnia. Interestingly, comparing two patients groups, shape alteration in the caudate, putamen, and nucleus accumbens in paradoxical insomnia and shrinkage in the thalamus, amygdala, and hippocampus in psychophysiological insomnia were observed. Both subjective and objective sleep parameters were associated with these regional shape alterations in patients. Our results support the differential role of subcortical brain structures in pathophysiology of paradoxical and psychophysiological insomnia.

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Section: Discussionmentioning

confidence: 97%

Alterations of Subcortical Brain Structures in Paradoxical and Psychophysiological Insomnia Disorder

et al. 2021

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“…Kim et al reported hyper-responses of the precentral cortex, prefrontal cortex, and default mode network to insomnia-related pictures in psychophysiological insomnia and normalization of hyper-responses after cognitive behavioral therapy for insomnia (CBT-I) 15 . In addition, Kim et al reported that in an fMRI study before and after CBT-I in patients with psychophysiological insomnia, brain activity in the left middle temporal and occipital areas decreased after treatment 19 . Spiegelhalder et al, in order to further the study of Baglioni et al, collected fMRI during the presentation of sleep-related and control words with positive and negative valence 16 .…”

Section: Discussionmentioning

confidence: 99%

“…The volume images were realigned to the first image in the time series to correct for between-scan rigid body motion. After realignment, the volume images were co-registered to the T1-weighted images and normalized to the Montreal Neurological Institute space utilizing a transformation matrix developed from the T1 image segmentation, using methods described previously 19 . After normalization, the volume images were spatially smoothed with an 8-mm full width at half maximum isotropic Gaussian kernel to adjust residual between-participant variability as well as to increase statistical sensitivity.…”

Section: Statistical Analysis Of Clinical Datamentioning

confidence: 99%

Brain reactivity using fMRI to insomnia stimuli in insomnia patients with discrepancy between subjective and objective sleep

Kim

Lee

et al. 2021

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Subjective–objective discrepancy of sleep (SODS) might be related to the distorted perception of sleep deficit and hypersensitivity to insomnia-related stimuli. We investigated differences in brain activation to insomnia-related stimuli among insomnia patients with SODS (SODS group), insomnia patients without SODS (NOSODS group), and healthy controls (HC). Participants were evaluated for subjective and objective sleep using sleep diary and polysomnography. Functional magnetic resonance imaging was conducted during the presentation of insomnia-related (Ins), general anxiety-inducing (Gen), and neutral (Neu) stimuli. Brain reactivity to the contrast of Ins vs. Neu and Gen vs. Neu was compared among the SODS (n = 13), NOSODS (n = 15), and HC (n = 16) groups. In the SODS group compared to other groups, brain areas including the left fusiform, bilateral precuneus, right superior frontal gyrus, genu of corpus callosum, and bilateral anterior corona radiata showed significantly increased blood oxygen level dependent (BOLD) signal in the contrast of Ins vs. Neu. There was no brain region with significantly increased BOLD signal in the Gen vs. Neu contrast in the group comparisons. Increased brain activity to insomnia-related stimuli in several brain regions of the SODS group is likely due to these individuals being more sensitive to sleep-related threat and negative cognitive distortion toward insomnia.

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“…One study showed the thalamus to be affected in response to sleep-related sounds after cognitive-behavioral therapy in patients with psychophysiological insomnia [43]. Another study showed that effective cognitive-behavioral therapy for insomnia resulted in decreased functional connectivity in the thalamus and parietal cortex, putamen and motor cortices, and the amygdala and lingual gyrus, but increased functional connectivity between the caudate and supramarginal gyrus, the pallidum and orbitofrontal cortex, and the hippocampus and frontal/parietal gyri [44].…”

Section: Sleep Disordersmentioning

confidence: 99%

An fMRI Study of the Effects of Vibroacoustic Stimulation on Functional Connectivity in Patients with Insomnia

et al. 2020

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Background. It is well known that vibratory and auditory stimuli from vehicles such as cars and trains can help induce sleep. More recent literature suggests that specific types of vibratory and acoustic stimulation might help promote sleep, but this has not been tested with neuroimaging. Thus, the purpose of this study was to observe the effects of vibroacoustic stimulation (providing both vibratory and auditory stimuli) on functional connectivity changes in the brain using resting state functional magnetic resonance imaging (rs-fMRI), and compare these changes to improvements in sleep in patients with insomnia. Methods. For this study, 30 patients with insomnia were randomly assigned to receive one month of a vibroacoustic stimulation or be placed in a waitlist control. Patients were evaluated pre- and postprogram with qualitative sleep questionnaires and measurement of sleep duration with an actigraphy watch. In addition, patients underwent rs-fMRI to assess functional connectivity. Results. The results demonstrated that those patients receiving the vibroacoustic stimulation had significant improvements in measured sleep minutes as well as in scores on the Insomnia Severity Index questionnaire. In addition, significant changes were noted in functional connectivity in association with the vermis, cerebellar hemispheres, thalamus, sensorimotor area, nucleus accumbens, and prefrontal cortex. Conclusions. The results of this study show that vibroacoustic stimulation alters the brain’s functional connectivity as well as improves sleep in patients with insomnia.

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Decreased regional brain activity in response to sleep‐related sounds after cognitive behavioral therapy for psychophysiological insomnia

Cited by 20 publications

References 30 publications

Alterations of Subcortical Brain Structures in Paradoxical and Psychophysiological Insomnia Disorder

Alterations of Subcortical Brain Structures in Paradoxical and Psychophysiological Insomnia Disorder

Brain reactivity using fMRI to insomnia stimuli in insomnia patients with discrepancy between subjective and objective sleep

An fMRI Study of the Effects of Vibroacoustic Stimulation on Functional Connectivity in Patients with Insomnia

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