NREM sleep cerebral blood flow before and after behavior therapy for chronic primary insomnia: preliminary single photon emission computed tomography (SPECT) data

Smith, Michael T.; Perlis, Michael L.; Chengazi, Vaseem; Soeffing, James; McCann, Una D.

doi:10.1016/j.sleep.2004.10.003

Cited by 41 publications

(19 citation statements)

References 3 publications

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“…In CPI patients, alterations in mPFC/ACC and PCUN have been reported in several studies, including hypoperfusion and hypometabolism in this region (Nofzinger et al, 2006) by positron emission tomography (Smith et al, 2002) and SPECT (Smith et al, 2005). The inability to deactivate task-irrelevant brain regions during performance (Altena et al, 2008, Drummond et al, 2013), even in female CPI patients, is also correlated with lower ALFF in mPFC/ACC (Dai et al, 2016).…”

Section: Discussionmentioning

confidence: 97%

Frequency-dependent changes in local intrinsic oscillations in chronic primary insomnia: A study of the amplitude of low-frequency fluctuations in the resting state

Zhou

Huang

Zhuang

et al. 2017

NeuroImage: Clinical

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New neuroimaging techniques have led to significant advancements in our understanding of cerebral mechanisms of primary insomnia. However, the neuronal low-frequency oscillation remains largely uncharacterized in chronic primary insomnia (CPI). In this study, the amplitude of low-frequency fluctuation (ALFF), a data-driven method based on resting-state functional MRI, was used to examine local intrinsic activity in 27 patients with CPI and 27 age-, sex-, and education-matched healthy controls. We examined neural activity in two frequency bands, slow-4 (between 0.027 and 0.073 Hz) and slow-5 (0.010–0.027 Hz), because blood-oxygen level dependent (BOLD) fluctuations in different low-frequency bands may present different neurophysiological manifestations that pertain to a spatiotemporal organization. The ALFF associated with the primary disease effect was widely distributed in the cerebellum posterior lobe (CPL), dorsal and ventral prefrontal cortex, anterior cingulate cortex, precuneus, somatosensory cortex, and several default-mode sub-regions. Several brain regions (i.e., the right cerebellum, anterior lobe, and left putamen) exhibited an interaction between the frequency band and patient group. In the slow-5 band, increased ALFF of the right postcentral gyrus/inferior parietal lobule (PoCG/IPL) was enhanced in association with the sleep quality (ρ = 0.414, P = 0.044) and anxiety index (ρ = 0.406, P = 0.049) of the CPI patients. These findings suggest that during chronic insomnia, the intrinsic functional plasticity primarily responds to the hyperarousal state, which is the loss of inhibition in sensory-informational processing. Our findings regarding an abnormal sensory input and intrinsic processing mechanism might provide novel insight into the pathophysiology of CPI. Furthermore, the frequency factor should be taken into consideration when exploring ALFF-related clinical manifestations.

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Section: Discussionmentioning

confidence: 97%

Frequency-dependent changes in local intrinsic oscillations in chronic primary insomnia: A study of the amplitude of low-frequency fluctuations in the resting state

Zhou

Huang

Zhuang

et al. 2017

NeuroImage: Clinical

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“…The few neuroimaging studies conducted on CBTI suggest that this treatment improves several of the neural alterations that differentiate insomnia patients from GS. Despite not being designed to specifically target brain regions associated with insomnia, techniques used in CBTI have been shown to increase brain activity during engagement in tasks of executive functioning(i.e., letter and category fluency) [54]; and increase regional blood flow during NREM sleep [106] in brain regions where they were lower than in GS at baseline. Treatment components of CBTI are often conceptualized in the literature as reducing arousal by enhancing parasympathetic activation (e.g., relaxation), removing arousing stimuli from the sleep environment (i.e., stimulus control), and aligning the sleep drive with the circadian phase when it has the lowest intrinsic wake drive (e.g., sleep restriction).…”

Section: Treatmentmentioning

confidence: 99%

Hyperarousal and Beyond: New Insights to the Pathophysiology of Insomnia Disorder through Functional Neuroimaging Studies

2017

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Neuroimaging studies have produced seemingly contradictory findings in regards to the pathophysiology of insomnia. Although most study results are interpreted from the perspective of a “hyperarousal” model, the aggregate findings from neuroimaging studies suggest a more complex model is needed. We provide a review of the major findings from neuroimaging studies, then discuss them in relation to a heuristic model of sleep-wake states that involves three major factors: wake drive, sleep drive, and level of conscious awareness. We propose that insomnia involves dysregulation in these factors, resulting in subtle dysregulation of sleep-wake states throughout the 24 h light/dark cycle.

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“…Positron emission tomography (PET) and single-photon emission computed tomography (SPECT) have been used to investigate insomnia patients' brain function during sleep [43][44][45][46]. In the most frequently cited neuroimaging study, Nofzinger et al observed elevated (or attenuated decrease in) cerebral metabolism from wake to NREM sleep in insomnia patients relative to healthy controls [45].…”

Section: Functional Neuroimagingmentioning

confidence: 99%

Neuroimaging Insights into Insomnia

Spiegelhalder

Regen

Baglioni

et al. 2015

Curr Neurol Neurosci Rep

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Insomnia is one of the most prevalent health complaints afflicting approximately 10% of the population in Western industrialized countries at a clinical level. Despite the proposition that both biological and psychological factors play a role in the experience of insomnia, the field continues to puzzle over so-called "discrepancies" between objective and subjective measurements of sleep and daytime functioning. The promise of neuroimaging is to uncover physiological processes that may readily explain patient reports. However, while there has been an explosion in the number of studies investigating the neural correlates of insomnia with neuroimaging technologies, there appears to be little consistency in findings across studies. We suggest a number of methodological reasons which may, at least partially, explain variability in findings across neuroimaging studies in insomnia.

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NREM sleep cerebral blood flow before and after behavior therapy for chronic primary insomnia: preliminary single photon emission computed tomography (SPECT) data

Cited by 41 publications

References 3 publications

Frequency-dependent changes in local intrinsic oscillations in chronic primary insomnia: A study of the amplitude of low-frequency fluctuations in the resting state

Frequency-dependent changes in local intrinsic oscillations in chronic primary insomnia: A study of the amplitude of low-frequency fluctuations in the resting state

Hyperarousal and Beyond: New Insights to the Pathophysiology of Insomnia Disorder through Functional Neuroimaging Studies

Neuroimaging Insights into Insomnia

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