Effects on resting‐state EEG phase‐amplitude coupling in insomnia disorder patients following 1 Hz left dorsolateral prefrontal cortex rTMS

Abstract

Despite burgeoning evidence for cortical hyperarousal in insomnia disorder, the existing results on electroencephalography spectral features are highly heterogeneous. Phase‐amplitude coupling, which refers to the modulation of the low‐frequency phase to a high‐frequency amplitude, is probably a more sensitive quantitative measure for characterizing abnormal neural oscillations and explaining the therapeutic effect of repetitive transcranial magnetic stimulation in the treatment of patients with insomnia disorder. Sixty insomnia disorder patients were randomly divided into the active and sham treatment groups to receive 4 weeks of repetitive transcranial magnetic stimulation treatment. Behavioral assessments, resting‐state electroencephalography recordings, and sleep polysomnography recordings were performed before and after repetitive transcranial magnetic stimulation treatment. Forty good sleeper controls underwent the same assessment. We demonstrated that phase‐amplitude coupling values in the frontal and temporal lobes were weaker in Insomnia disorder patients than in those with good sleeper controls at baseline and that phase‐amplitude coupling values near the intervention area were significantly enhanced after active repetitive transcranial magnetic stimulation treatment. Furthermore, the enhancement of phase‐amplitude coupling values was significantly correlated with the improvement of sleep quality. This study revealed the potential of phase‐amplitude coupling in assessing the severity of insomnia disorder and the efficacy of repetitive transcranial magnetic stimulation treatment, providing new insights on the abnormal physiological mechanisms and future treatments for insomnia disorder.

Electroencephalography microstates as novel functional biomarkers for insomnia disorder

“…The rTMS therapy was carried out by using a pulsed magnetic stimulation device (M-100 Ultimate; Shenzhen Yingchi Technology, Shenzhen, China) with a figure-eight stimulation coil at the left DLPFC, as described in our previous study. 10 The specific parameters were as follows: stimulus frequency at 1 Hz, stimulus intensity at 80% of the motion threshold, stimulation number at 10 pulses per string and 150 strings, string interval at 2 s, and total stimulation pulses at 1500. For each rTMS session, the total stimulation time is 30 min, one session per day.…”

“…Patients with ID exhibited increased betaband power, resting-state EEG coherence abnormalities (eg, abnormally elevated coherence between F7 and O1 electrodes, T6 and O1 electrodes) and reduced prefrontal theta-gamma phase-amplitude coupling. [8][9][10] Repetitive transcranial magnetic stimulation (rTMS) is an emerging physical therapy modality that is widely used in psychiatric and neurological disorders. 11 Low frequency (1 Hz) rTMS can induce the inhibitory function of neurons and has achieved positive results in ID treatment.…”

“…Individuals with other sleep disorders were excluded from the study. 10 Two datasets were included in this study. The primary dataset included 40 GSC and 60 patients with ID.…”

EEG Biofeedback Decreases Theta and Beta Power While Increasing Alpha Power in Insomniacs: An Open-Label Study

“…Wavelet transform was performed on the pre-processed signal to decompose the alpha signal from 8 to 13 Hz and calculate the mean value. EMG signals were similarly captured, with high-and low-pass filtering per unit of time, and then averaged to calculate the display of real-time results [35][36][37].…”

Dual roles of the amygdala–hippocampus circuit in the regulation of rapid eye movement sleep and depression symptoms by repetitive transcranial magnetic stimulation in patients with insomnia

“… 5 Repetitive transcranial magnetic stimulation (rTMS) is a commonly used non-invasive neuroregulation technique that regulates sleep by modulating synaptic plasticity and the strength of connections between brain regions. 6 While evidence suggests the potential of 1 Hz trams at the left dorsal lateral prefrontal cortex (DLPFC_L) to improve sleep quality for patients with insomnia, 7 the extent to which it influences REM sleep and the mechanisms involved remain unclear. REM sleep is initiated by basolateral amygdala dopamine signalling.…”