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Yin X, Jiang T, Song Z, Zhu L, Wang G, Guo J. Increased functional connectivity within the salience network in patients with insomnia. Sleep Breath 2024:10.1007/s11325-024-03002-7. [PMID: 38329566 DOI: 10.1007/s11325-024-03002-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2023] [Revised: 01/10/2024] [Accepted: 01/12/2024] [Indexed: 02/09/2024]
Abstract
BACKGROUND Insomnia is a common sleep disorder with significant negative impacts on emotional states; however, the underlying mechanism of insomnia with comorbid emotional dysregulation remains largely unknown. The salience network (SN) plays an important role in both sleep and emotional regulation. The study aimed to explore the specific alterations in functional connectivity (FC) within the SN in insomnia patients. METHODS A total of 30 eligible patients with insomnia disorder (ID group) and 30 healthy controls (HC group) underwent resting-state functional magnetic resonance imaging (fMRI) scanning and psychometric assessments. Differences in FC within the SN were examined using seed-based region-to-region connectivity analysis. RESULTS Compared with healthy controls, patients with insomnia showed increased FC within the SN, mainly between the anterior cingulate cortex (ACC) and right superior frontal gyrus (SFG), the right SFG and right supramarginal gyrus (SMG), and between the right insular (INS) and left SMG (P<0.05). Additionally, significant correlations were observed between increased FC and the Hamilton Depression Rating Scale (HAMD), Pittsburgh Sleep Quality Index (PSQI), and Hamilton Anxiety Rating Scale (HAMA) scores (P<0.05, after Bonferroni correction). CONCLUSIONS These results suggest that increased FC within the SN may be related to poor sleep quality and negative emotions, highlighting the importance of the SN in the pathophysiological mechanisms of insomnia with comorbid emotional dysregulation.
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Affiliation(s)
- Xuejiao Yin
- Beijing Key Laboratory of Acupuncture Neuromodulation, Department of Acupuncture and Moxibustion, Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Beijing, 100010, China
| | - Tongfei Jiang
- Beijing Key Laboratory of Acupuncture Neuromodulation, Department of Acupuncture and Moxibustion, Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Beijing, 100010, China
| | - Zhangxiao Song
- Beijing University of Chinese Medicine, Beijing, 100105, China
| | - Liying Zhu
- Beijing University of Chinese Medicine, Beijing, 100105, China
| | - Guiling Wang
- Beijing Key Laboratory of Acupuncture Neuromodulation, Department of Acupuncture and Moxibustion, Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Beijing, 100010, China
| | - Jing Guo
- Beijing Key Laboratory of Acupuncture Neuromodulation, Department of Acupuncture and Moxibustion, Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Beijing, 100010, China.
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Aquino G, Benz F, Dressle RJ, Gemignani A, Alfì G, Palagini L, Spiegelhalder K, Riemann D, Feige B. Towards the neurobiology of insomnia: A systematic review of neuroimaging studies. Sleep Med Rev 2024; 73:101878. [PMID: 38056381 DOI: 10.1016/j.smrv.2023.101878] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2022] [Revised: 11/03/2023] [Accepted: 11/10/2023] [Indexed: 12/08/2023]
Abstract
Insomnia disorder signifies a major public health concern. The development of neuroimaging techniques has permitted to investigate brain mechanisms at a structural and functional level. The present systematic review aims at shedding light on functional, structural, and metabolic substrates of insomnia disorder by integrating the available published neuroimaging data. The databases PubMed, PsycARTICLES, PsycINFO, CINAHL and Web of Science were searched for case-control studies comparing neuroimaging data from insomnia patients and healthy controls. 85 articles were judged as eligible. For every observed finding of each study, the effect size was calculated from standardised mean differences, statistic parameters and figures, showing a marked heterogeneity that precluded a comprehensive quantitative analysis. From a qualitative point of view, considering the findings of significant group differences in the reported regions across the articles, this review highlights the major involvement of the anterior cingulate cortex, thalamus, insula, precuneus and middle frontal gyrus, thus supporting some central themes in the debate on the neurobiology of and offering interesting insights into the psychophysiology of sleep in this disorder.
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Affiliation(s)
- Giulia Aquino
- Department of Surgical, Medical, Molecular Pathology and Critical Care Medicine - University of Pisa, Pisa, Italy.
| | - Fee Benz
- Department of Psychiatry and Psychotherapy, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Raphael J Dressle
- Department of Psychiatry and Psychotherapy, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Angelo Gemignani
- Department of Surgical, Medical, Molecular Pathology and Critical Care Medicine - University of Pisa, Pisa, Italy
| | - Gaspare Alfì
- Department of Surgical, Medical, Molecular Pathology and Critical Care Medicine - University of Pisa, Pisa, Italy
| | - Laura Palagini
- Department of Experimental and Clinic Medicine, Section of Psychiatry, University of Pisa, Pisa, Italy
| | - Kai Spiegelhalder
- Department of Psychiatry and Psychotherapy, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Dieter Riemann
- Department of Psychiatry and Psychotherapy, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany; Center for Basics in NeuroModulation (NeuroModulBasics), Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Bernd Feige
- Department of Psychiatry and Psychotherapy, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany; Center for Basics in NeuroModulation (NeuroModulBasics), Faculty of Medicine, University of Freiburg, Freiburg, Germany
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Chao X, Wang J, Dong Y, Fang Y, Yin D, Wen J, Wang P, Sun W. Neuroimaging of neuropsychological disturbances following ischaemic stroke (CONNECT): a prospective cohort study protocol. BMJ Open 2024; 14:e077799. [PMID: 38286706 PMCID: PMC10826587 DOI: 10.1136/bmjopen-2023-077799] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/15/2023] [Accepted: 01/09/2024] [Indexed: 01/31/2024] Open
Abstract
INTRODUCTION Neuropsychiatric distubance is a common clinical manifestation in acute ischemic stroke. However, it is frequently overlooked by clinicians. This study aimed to explore the possible aetiology and pathogenesis of neuropsychiatric disturbances following ischaemic stroke (NDIS) from an anatomical and functional perspective with the help of neuroimaging methods. METHOD AND ANALYSIS CONNECT is a prospective cohort study of neuroimaging and its functional outcome in NDIS. We aim to enrol a minimum of 300 individuals with first-ever stroke. The neuropsychological disturbances involved in this study include depression, anxiety disorder, headache, apathy, insomnia, fatigue and cognitive impairment. Using scales that have been shown to be effective in assessing the above symptoms, the NDIS evaluation battery requires at least 2 hours at baseline. Moreover, all patients will be required to complete 2 years of follow-up, during which the NDIS will be re-evaluated at 3 months, 12 months and 24 months by telephone and 6 months by outpatient interview after the index stroke. The primary outcome of our study is the incidence of NDIS at the 6-month mark. Secondary outcomes are related to the severity of NDIS as well as functional rehabilitation of patients. Functional imaging evaluation will be performed at baseline and 6-month follow-up using specific sequences including resting-state functional MRI, diffusion tensor imaging, T1-weighted imaging, T2-weighted imaging, diffusion-weighted imaging, arterial spin labelling, quantitative susceptibility mapping and fluid-attenuated inversion recovery imaging. In addition, we collect haematological information from patients to explore potential biological and genetic markers of NDIS through histological analysis. ETHICS AND DISSEMINATION The CONNECT Study was approved by the Ethics Review Committee of the First Hospital of the University of Science and Technology of China (2021-ky012) and written informed consent will be obtained from all participants. Results will be disseminated via a peer-reviewed journal. TRIAL REGISTRATION NUMBER ChiCTR2100043886.
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Affiliation(s)
- Xian Chao
- Department of Neurology, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui, China
| | - Jinjing Wang
- Department of Neurology, Nanjing Jinling Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, China
| | - Yiran Dong
- Department of Neurology, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui, China
| | - Yirong Fang
- Department of Neurology, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui, China
| | - Dawei Yin
- Department of Radiology, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui, China
| | - Jie Wen
- Department of Radiology, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui, China
| | - Peng Wang
- Department of Radiology, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui, China
| | - Wen Sun
- Department of Neurology, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui, China
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Jiang T, Yin X, Zhu L, Jia W, Tan Z, Li B, Guo J. Abnormal alterations of regional spontaneous neuronal activity and functional connectivity in insomnia patients with difficulty falling asleep: a resting-state fMRI study. BMC Neurol 2023; 23:430. [PMID: 38049760 PMCID: PMC10694975 DOI: 10.1186/s12883-023-03481-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2023] [Accepted: 11/28/2023] [Indexed: 12/06/2023] Open
Abstract
BACKGROUND Insomnia disorder (ID) seriously affects people's daily life. Difficulty falling asleep is the most commonly reported complaint in patients with ID. However, the mechanism of prolonged sleep latency (SL) is still obscure. The aim of our present study was to investigate the relationship between prolonged SL and alterations in spontaneous neural activity and brain functional connectivity (FC) in ID patients using functional magnetic resonance imaging (fMRI). METHODS A total of 52 insomniacs with difficulty falling asleep and 30 matched healthy controls (HCs) underwent resting-state fMRI. The amplitude of low-frequency fluctuation (ALFF) was measured and group differences were compared. The peak areas with significantly different ALFF values were identified as the seed regions to calculate FC to the whole brain. SL was assessed by a wrist actigraphy device in ID patients. The Pittsburgh Sleep Quality Index (PSQI), Hamilton Anxiety Rating Scale (HAMA), and Hyperarousal Scale (HAS) were evaluated in both ID patients and HCs. Finally, correlation analyses were performed between the clinical features and FC/ALFF values. RESULTS ID patients showed higher PSQI, HAMA, HAS scores than HCs. The functional MRI results indicated increased ALFF value in the left insula and right amygdala and decreased ALFF value in the right superior parietal lobe (SPL) in ID patients. The seed-based FC analysis demonstrated increased FC between the left insula and the bilateral precentral gyrus and FC between the right amygdala and the left posterior cingulate cortex (PCC) in patients with ID. Correlation analysis indicated that the increased FC value of the right amygdala-left PCC was positively correlated with SL measured by actigraphy. CONCLUSION This study revealed abnormal regional spontaneous fluctuations in the right amygdala, left insula, and right SPL, as well as increased FC in the left insula-precentral and right amygdala-left PCC. Moreover, the prolonged SL was positively correlated with the abnormal FC in the right amygdala-left PCC in ID patients. The current study showed the correlation between prolonged SL and the abnormal function of emotion-related brain regions in ID patients, which may contribute to a better understanding of the neural mechanisms underlying difficulty falling asleep in patients with ID. CLINICAL TRIAL REGISTRATION http://www.chictr.org.cn ., ChiCTR1800015282. Registered on 20th March 2018.
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Affiliation(s)
- Tongfei Jiang
- Department of Acupuncture and Moxibustion, Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Beijing Key Laboratory of Acupuncture Neuromodulation, Beijing, 100010, China
| | - Xuejiao Yin
- Department of Acupuncture and Moxibustion, Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Beijing Key Laboratory of Acupuncture Neuromodulation, Beijing, 100010, China
| | - Liying Zhu
- Graduate School, Beijing University of Chinese Medicine, Beijing, 100029, China
| | - Weilin Jia
- Department of Acupuncture and Moxibustion, Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Beijing Key Laboratory of Acupuncture Neuromodulation, Beijing, 100010, China
| | - Zhongjian Tan
- Department of Radiology, Dong Zhimen Hospital Beijing University of Chinese Medicine, Beijing, 100010, China
| | - Bin Li
- Department of Acupuncture and Moxibustion, Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Beijing Key Laboratory of Acupuncture Neuromodulation, Beijing, 100010, China
| | - Jing Guo
- Department of Acupuncture and Moxibustion, Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Beijing Key Laboratory of Acupuncture Neuromodulation, Beijing, 100010, China.
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Aquino G, Schiel JE. Neuroimaging in insomnia: Review and reconsiderations. J Sleep Res 2023; 32:e14030. [PMID: 37730282 DOI: 10.1111/jsr.14030] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2023] [Accepted: 08/16/2023] [Indexed: 09/22/2023]
Abstract
Over the last decades, neuroimaging has become a substantial component of insomnia research. While theoretical underpinnings of different studies vary just like methodological choices and the experimental design, it is suggested that major features of insomnia disorder rely on the impaired function, structure, metabolism and connectivity of brain areas involved in sleep generation, emotion regulation, self-processing/-awareness and attentional orientation. However, neuroimaging research on insomnia often suffers from small sample sizes, heterogeneous methodology and a lack of replicability. With respect to these issues, the field needs to address the questions: (1a) how sufficiently large sample sizes can be accumulated within a reasonable economic framework; (1b) how effect sizes in insomnia-related paradigms can be amplified; (2a) how a higher degree of standardisation and transparency in methodology can be provided; and (2b) how an adequate amount of flexibility/complexity in study design can be maintained. On condition that methodological consistency and a certain degree of adaptability are given, pooled data/large cohort analyses can be considered to be one way to answer these questions. Regarding experimental single-centre trials, it might be helpful to focus on insomnia-related transdiagnostic concepts. In doing so, expectable effect sizes (in between-subjects designs) can be increased by: (a) comparing groups that are truly distinct regarding the variables examined in a concept-specific paradigm; and (b) facilitated, intensified and precise elicitation of a target symptom.
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Affiliation(s)
- Giulia Aquino
- Department of Surgical, Medical, Molecular Pathology and Critical Care Medicine - University of Pisa, Pisa, Italy
| | - Julian E Schiel
- Department of Psychiatry and Psychotherapy, Faculty of Medicine, Medical Center - University of Freiburg, Freiburg, Germany
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Kweon W, Lee KH, Choi SH, Shin J, Seo M, Jeon JE, Lee HY, Park C, Kim SY, Kim JW, Chang JH, Lee YJ. Amygdala resting-state functional connectivity alterations in patients with chronic insomnia disorder: correlation with electroencephalography beta power during sleep. Sleep 2023; 46:zsad205. [PMID: 37531589 DOI: 10.1093/sleep/zsad205] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2023] [Revised: 07/09/2023] [Indexed: 08/04/2023] Open
Abstract
STUDY OBJECTIVES This study investigated alterations in resting-state functional connectivity (RSFC) and hyperarousal biomarkers in patients with chronic insomnia disorder (CID), compared with good sleepers (GS). We also examined the relationships between altered RSFC and hyperarousal biomarkers. METHODS Fifty patients with CID and 52 GS completed self-reporting questionnaires, and then underwent polysomnography and resting-state functional magnetic resonance imaging. We analyzed RSFC in the amygdala (AMG) and anterior insula (aINS), which are core regions of the salience network that are likely to be involved in hyperarousal. We also analyzed electroencephalography (EEG) relative beta power and heart rate variability (HRV) parameters (e.g. low and high frequency) during sleep. We then tested between-group differences in the RSFC and hyperarousal biomarkers; we examined correlations of RSFC with EEG beta power and HRV. RESULTS Compared with GS, patients with CID showed more negative RSFC between the right amygdala (R.AMG) and left supramarginal gyrus (L.SMG), but less positive RSFC between the left aINS and bilateral lateral prefrontal cortex. The R.AMG-L.SMG RSFC was negatively correlated with EEG beta power in central regions (C3: r = -0.336, p = 0.012; C4: r = -0.314, p = 0.024). CONCLUSIONS Decreased RSFC between the R.AMG and L.SMG in patients with insomnia may reflect the difficulty in cortical top-down regulation of the AMG, indicating daytime hyperarousal. Individuals who experience hyperarousal during the daytime may also exhibit cortical hyperarousal during sleep, as indicated by increased EEG beta power.
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Affiliation(s)
- Woojin Kweon
- Department of Neuropsychiatry, Seoul National University Hospital, Seoul, Republic of Korea
| | - Kyung Hwa Lee
- Division of Child and Adolescent Psychiatry, Department of Psychiatry, Seoul National University Hospital, Seoul, Republic of Korea
- Department of Psychiatry and Center for Sleep and Chronobiology, Seoul National University College of Medicine, Seoul National University Hospital, Seoul, Republic of Korea
| | - Sang Ho Choi
- School of Computer and Information Engineering, Kwangwoon University, Seoul, Republic of Korea
| | - Jiyoon Shin
- Department of Psychiatry and Center for Sleep and Chronobiology, Seoul National University College of Medicine, Seoul National University Hospital, Seoul, Republic of Korea
| | - Mincheol Seo
- Department of Psychiatry, Veteran Health Service Medical Center, Seoul, Republic of Korea
- Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Jeong Eun Jeon
- Department of Psychiatry and Center for Sleep and Chronobiology, Seoul National University College of Medicine, Seoul National University Hospital, Seoul, Republic of Korea
| | - Ha Young Lee
- Department of Psychiatry and Center for Sleep and Chronobiology, Seoul National University College of Medicine, Seoul National University Hospital, Seoul, Republic of Korea
| | - Chowon Park
- Department of Psychiatry and Center for Sleep and Chronobiology, Seoul National University College of Medicine, Seoul National University Hospital, Seoul, Republic of Korea
| | - Sun-Young Kim
- Department of Psychiatry, Ewha Womans University College of Medicine, Ewha Womans University Seoul Hospital, Seoul, Republic of Korea
| | - Jong Won Kim
- Department of Healthcare IT, Inje University, Kimhae, Kyunsangnam-do, Republic of Korea
| | - Jun Hyuk Chang
- Department of Computer Science, University of Chicago, Chicago, IL, USA
| | - Yu Jin Lee
- Department of Psychiatry and Center for Sleep and Chronobiology, Seoul National University College of Medicine, Seoul National University Hospital, Seoul, Republic of Korea
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You S, Lv T, Qin R, Hu Z, Ke Z, Yao W, Zhao H, Bai F. Neuro-Navigated rTMS Improves Sleep and Cognitive Impairment via Regulating Sleep-Related Networks' Spontaneous Activity in AD Spectrum Patients. Clin Interv Aging 2023; 18:1333-1349. [PMID: 37601952 PMCID: PMC10439779 DOI: 10.2147/cia.s416992] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Accepted: 08/03/2023] [Indexed: 08/22/2023] Open
Abstract
Study Objectives By examining spontaneous activity changes of sleep-related networks in patients with the Alzheimer's disease (AD) spectrum with or without insomnia disorder (ID) over time via neuro-navigated repetitive transcranial magnetic stimulation (rTMS), we revealed the effect and mechanism of rTMS targeting the left-angular gyrus in improving the comorbidity symptoms of the AD spectrum with ID. Methods A total of 34 AD spectrum patients were recruited in this study, including 18 patients with ID and the remaining 16 patients without ID. All of them were measured for cognitive function and sleep by using the cognitive and sleep subscales of the neuropsychiatric inventory. The amplitude of low-frequency fluctuation changes in sleep-related networks was revealed before and after neuro-navigated rTMS treatment between these two groups, and the behavioral significance was further explored. Results Affective auditory processing and sensory-motor collaborative sleep-related networks with hypo-spontaneous activity were observed at baseline in the AD spectrum with ID group, while substantial increases in activity were evident at follow-up in these subjects. In addition, longitudinal affective auditory processing, sensory-motor and default mode collaborative sleep-related networks with hyper-spontaneous activity were also revealed at follow-up in the AD spectrum with ID group. In particular, longitudinal changes in sleep-related networks were associated with improvements in sleep quality and episodic memory scores in AD spectrum with ID patients. Conclusion We speculated that left angular gyrus-navigated rTMS therapy may enhance the memory function of AD spectrum patients by regulating the spontaneous activity of sleep-related networks, and it was associated with memory consolidation in the hippocampus-cortical circuit during sleep. Clinical Trial Registration The study was registered at the Chinese Clinical Trial Registry, registration ID: ChiCTR2100050496, China.
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Affiliation(s)
- Shengqi You
- Department of Neurology, Nanjing Drum Tower Hospital Clinical College of Traditional Chinese and Western Medicine, Nanjing University of Chinese Medicine, Nanjing, 210008, People’s Republic of China
| | - Tingyu Lv
- Department of Neurology, Nanjing Drum Tower Hospital Clinical College of Traditional Chinese and Western Medicine, Nanjing University of Chinese Medicine, Nanjing, 210008, People’s Republic of China
| | - Ruomeng Qin
- Department of Neurology, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, 210008, People’s Republic of China
| | - Zheqi Hu
- Department of Neurology, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, 210008, People’s Republic of China
| | - Zhihong Ke
- Department of Neurology, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, 210008, People’s Republic of China
| | - Weina Yao
- Department of Neurology, Nanjing Drum Tower Hospital Clinical College of Traditional Chinese and Western Medicine, Nanjing University of Chinese Medicine, Nanjing, 210008, People’s Republic of China
| | - Hui Zhao
- Department of Neurology, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, 210008, People’s Republic of China
| | - Feng Bai
- Department of Neurology, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, 210008, People’s Republic of China
- Geriatric Medicine Center, Taikang Xianlin Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, 210008, People’s Republic of China
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Wu Q, Lei H, Mao T, Deng Y, Zhang X, Jiang Y, Zhong X, Detre JA, Liu J, Rao H. Test-Retest Reliability of Resting Brain Small-World Network Properties across Different Data Processing and Modeling Strategies. Brain Sci 2023; 13:brainsci13050825. [PMID: 37239297 DOI: 10.3390/brainsci13050825] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2023] [Revised: 05/02/2023] [Accepted: 05/12/2023] [Indexed: 05/28/2023] Open
Abstract
Resting-state functional magnetic resonance imaging (fMRI) with graph theoretical modeling has been increasingly applied for assessing whole brain network topological organization, yet its reproducibility remains controversial. In this study, we acquired three repeated resting-state fMRI scans from 16 healthy controls during a strictly controlled in-laboratory study and examined the test-retest reliability of seven global and three nodal brain network metrics using different data processing and modeling strategies. Among the global network metrics, the characteristic path length exhibited the highest reliability, whereas the network small-worldness performed the poorest. Nodal efficiency was the most reliable nodal metric, whereas betweenness centrality showed the lowest reliability. Weighted global network metrics provided better reliability than binary metrics, and reliability from the AAL90 atlas outweighed those from the Power264 parcellation. Although global signal regression had no consistent effects on the reliability of global network metrics, it slightly impaired the reliability of nodal metrics. These findings provide important implications for the future utility of graph theoretical modeling in brain network analyses.
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Affiliation(s)
- Qianying Wu
- Key Laboratory of Brain-Machine Intelligence for Information Behavior (Ministry of Education and Shanghai), School of Business and Management, Shanghai International Studies University, Shanghai 201613, China
- Department of Neurology, University of Pennsylvania, Philadelphia, PA 19104, USA
- School of Life Sciences, University of Science and Technology of China, Hefei 230026, China
| | - Hui Lei
- Department of Neurology, University of Pennsylvania, Philadelphia, PA 19104, USA
- College of Education, Hunan Agricultural University, Changsha 410127, China
| | - Tianxin Mao
- Key Laboratory of Brain-Machine Intelligence for Information Behavior (Ministry of Education and Shanghai), School of Business and Management, Shanghai International Studies University, Shanghai 201613, China
- Department of Neurology, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Yao Deng
- Key Laboratory of Brain-Machine Intelligence for Information Behavior (Ministry of Education and Shanghai), School of Business and Management, Shanghai International Studies University, Shanghai 201613, China
- Department of Neurology, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Xiaocui Zhang
- Department of Neurology, University of Pennsylvania, Philadelphia, PA 19104, USA
- Medical Psychological Center, The Second Xiangya Hospital, Central South University, Changsha 410017, China
- Medical Psychological Institute, Central South University, Changsha 410017, China
- National Clinical Research Center for Mental Disorders, Changsha 410011, China
| | - Yali Jiang
- Department of Neurology, University of Pennsylvania, Philadelphia, PA 19104, USA
- Medical Psychological Center, The Second Xiangya Hospital, Central South University, Changsha 410017, China
| | - Xue Zhong
- Department of Neurology, University of Pennsylvania, Philadelphia, PA 19104, USA
- Medical Psychological Center, The Second Xiangya Hospital, Central South University, Changsha 410017, China
| | - John A Detre
- Department of Neurology, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Jianghong Liu
- Department of Family and Community Health, School of Nursing, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Hengyi Rao
- Key Laboratory of Brain-Machine Intelligence for Information Behavior (Ministry of Education and Shanghai), School of Business and Management, Shanghai International Studies University, Shanghai 201613, China
- Department of Neurology, University of Pennsylvania, Philadelphia, PA 19104, USA
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Zheng H, Zhou Q, Yang J, Lu Q, Qiu H, He C, Yan H. Altered functional connectivity of the default mode and frontal control networks in patients with insomnia. CNS Neurosci Ther 2023. [PMID: 36942498 DOI: 10.1111/cns.14183] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2022] [Revised: 02/20/2023] [Accepted: 03/05/2023] [Indexed: 03/23/2023] Open
Abstract
AIMS The purpose of this study was to investigate the association between spontaneous regional activity and brain functional connectivity, which maybe can distinguish insomnia while being responsive to repetitive transcranial magnetic stimulation (rTMS) treatment effects in insomnia patients. METHODS Using resting-state functional magnetic resonance imaging data from 38 chronic insomnia patients and 36 healthy volunteers, we compared the amplitude of low-frequency fluctuations (ALFF) between the two groups. Of all the patients with insomnia, 20 received rTMS for 4 weeks, while 18 patients received a 4-week pseudo-stimulation intervention. Seed-based resting-state functional connectivity (RSFC) analysis was conducted from regions with significantly different ALFF values, and the association between RSFC value and Pittsburgh Sleep Quality Index score was determined. RESULTS Our results revealed that insomnia patients presented a significantly higher ALFF value in the posterior cingulate cortex (PCC), whereas a significantly lower ALFF value was observed in the superior parietal lobule (SPL). Moreover, significantly reduced RSFC was detected from both PCC to prefrontal cortex connections, as well as from left SPL to frontal pole connections. In addition, RSFC from frontal pole to left SPL negatively predicted sleep quality (PSQI) and treatment response in patients' group. CONCLUSION Our findings suggest that disrupted frontoparietal network connectivity may be a biomarker for insomnia in middle-aged adults, reinforcing the potential of rTMS targeting the frontal lobes. Monitoring pretreatment RSFC could offer greater insight into how rTMS treatments are responded to by insomniacs.
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Affiliation(s)
- Hui Zheng
- Department of Rehabilitation Medicine, The Affiliated Jiangsu Shengze Hospital of Nanjing Medical University, Suzhou, Jiangsu, China
- Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Qin Zhou
- Department of Rehabilitation Medicine, The Affiliated Jiangsu Shengze Hospital of Nanjing Medical University, Suzhou, Jiangsu, China
| | - Junjie Yang
- Department of Rehabilitation Medicine, The Affiliated Jiangsu Shengze Hospital of Nanjing Medical University, Suzhou, Jiangsu, China
| | - Qian Lu
- Department of Rehabilitation Medicine, The Affiliated Jiangsu Shengze Hospital of Nanjing Medical University, Suzhou, Jiangsu, China
| | - Huaide Qiu
- Rehabilitation Medicine Center, The First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, China
| | - Chuan He
- Department of Rehabilitation Medicine, The Affiliated Jiangsu Shengze Hospital of Nanjing Medical University, Suzhou, Jiangsu, China
| | - Hailang Yan
- Department of Rehabilitation Medicine, The Affiliated Jiangsu Shengze Hospital of Nanjing Medical University, Suzhou, Jiangsu, China
- Department of Radiology, The Affiliated Jiangsu Shengze Hospital of Nanjing Medical University, Suzhou, Jiangsu, China
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10
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Li Y, Ma M, Shao Y, Wang W. Enhanced effective connectivity from the middle frontal gyrus to the parietal lobe is associated with impaired mental rotation after total sleep deprivation: An electroencephalogram study. Front Neurosci 2022; 16:910618. [PMID: 36248651 PMCID: PMC9566834 DOI: 10.3389/fnins.2022.910618] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Accepted: 09/07/2022] [Indexed: 11/13/2022] Open
Abstract
Sleep deprivation impairs cognitive functions, including attention, memory, and decision-making. Studies on the neuro-electro-physiological mechanisms underlying total sleep deprivation (TSD) that impairs spatial cognition are limited. Based on electroencephalogram (EEG) and Exact Low Resolution Brain Electromagnetic Tomography (eLORETA), this study focused on the effects of TSD on mental rotation and the cognitive neural mechanisms underlying its damage. Twenty-four healthy college students completed mental rotation tasks while resting and after 36 h of TSD; their EEG data were simultaneously recorded. The amplitude of P300 component associated with mental rotation was observed and localized through source reconstruction, while changes in effective connectivity between multiple brain regions associated with mental rotation cognitive processing were calculated using isolated effective coherence (iCoh) of eLORETA. Compared with the baseline before TSD, the amplitude of the P300 component related to mental rotation decreased. The task-state data of P300 were localized to the source of the difference in ERP current density, and it was found that the brain regions related to the difference in the decrease in P300 amplitude included the superior parietal lobule, precuneus, prefrontal lobe, and other related regions. Effective connectivity analysis found that TSD enhanced the effective connectivity from the left middle frontal gyrus to the left superior parietal lobule, left inferior parietal lobule, and left precuneus under the identical condition. Pearson correlation analysis showed a positive correlation between the decrease in accuracy of mental rotation and increase in effective connectivity. Thus, our study suggests that TSD impairs the ability of the mental rotation, showing a decrease in P300 amplitude and an enhanced effective connectivity between the middle frontal gyrus and the parietal lobe in the task state.
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Affiliation(s)
- Yutong Li
- School of Psychology, Beijing Sport University, Beijing, China
| | - Mengke Ma
- School of Psychology, Beijing Sport University, Beijing, China
| | - Yongcong Shao
- School of Psychology, Beijing Sport University, Beijing, China
- *Correspondence: Yongcong Shao,
| | - Wei Wang
- Department of Criminal Psychology, Northwest University of Political Science and Law, Xi’an, China
- Wei Wang,
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11
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Abnormalities of the Default Mode Network Functional Connectivity in Patients with Insomnia Disorder. CONTRAST MEDIA & MOLECULAR IMAGING 2022; 2022:9197858. [PMID: 36101797 PMCID: PMC9440808 DOI: 10.1155/2022/9197858] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/07/2022] [Revised: 07/14/2022] [Accepted: 08/01/2022] [Indexed: 11/24/2022]
Abstract
Objective This paper aimed to probe changes in the default mode network (DMN) functional connectivity (DMNFC) of the brain of patients with insomnia disorder (ID) under the resting state. Methods A total of 67 patients with ID and 67 graphically matched healthy controls were selected. Then, their general information was collected, followed by a psychological scale valuation. Resting state functional magnetic resonance imaging (rs-fMRI) scanning was conducted. Subsequently, collected statistics were processed, bilateral precuneus and medial superior frontal gyrus were defined as regions of interest (ROI), and the difference in intensity between these two groups was compared. Results Compared with the healthy control group, the patients in the ID group were observed with abnormalities of DMNFC. Specifically, a significant increase in the functional connectivity (FC) could be observed between the left medial superior frontal gyrus and left central anterior gyrus, the left medial superior frontal gyrus and anterior cingulate gyrus, the right medial superior frontal gyrus and left central anterior gyrus, the left anterior cuneiform and left central anterior/posterior gyrus, the left anterior cuneiform and left superior occipital gyrus, as well as the right anterior cuneiform and left central posterior gyrus. However, the FC between the left anterior cuneiform and the right middle frontal gyrus was weakened, as well as between the left anterior cuneiform and the right angle gyrus and between the right precuneus and the left inferior temporal gyrus. Conclusion ID patients may suffer changes in FC. The decline of FC in DMN may be one of the underlying causes of ID; the enhancement of FC between DMN and the visual-spatial attention network may play a key role in the mechanisms of impaired brain functional networks of ID.
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12
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Huang G, Fang Y, Zhang W, Su X, Xie Y, Liang F, Gao Y, Lu Y, Zhao L. Altered thalamic functional connectivity and cerebral blood flow in insomnia disorder: a resting-state functional magnetic resonance imaging study. Clin Imaging 2022; 88:17-23. [DOI: 10.1016/j.clinimag.2022.04.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2021] [Revised: 04/22/2022] [Accepted: 04/26/2022] [Indexed: 11/03/2022]
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13
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Zhang C, Sun L, Ge S, Chang Y, Jin M, Xiao Y, Gao H, Wang L, Cong F. Quantitative evaluation of short-term resting-state brain networks for primary insomnia diagnosis. Biomed Signal Process Control 2022. [DOI: 10.1016/j.bspc.2022.103498] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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14
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Qi S, Zhang Y, Li X, Sun C, Ma X, Li S, Li L, Ren K, Xi M, Huang ZG. Improved Functional Organization in Patients With Primary Insomnia After Individually-Targeted Transcranial Magnetic Stimulation. Front Neurosci 2022; 16:859440. [PMID: 35360154 PMCID: PMC8960275 DOI: 10.3389/fnins.2022.859440] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2022] [Accepted: 02/14/2022] [Indexed: 11/24/2022] Open
Abstract
Primary insomnia (PI) is among the most prevalent sleep-related disorders and has a far-reaching impact on daytime functioning. Repetitive transcranial magnetic stimulation (rTMS) has drawn attention because of its effectiveness and safety. The purpose of the current study was to detect changes in the topological organization of whole-brain functional networks and to determine their associations with the clinical treatment effects of rTMS. Resting-state functional magnetic resonance imaging (rsfMRI) data from 32 patients with PI were collected and compared with findings from 32 age- and gender-matched healthy controls (HCs). The patients were treated with Stanford accelerated intelligent neuromodulation therapy, which is a recently validated neuroscience-informed accelerated intermittent theta-burst stimulation protocol. Graph theoretical analysis was used to construct functional connectivity matrices and to extract the attribute features of small-world networks in insomnia. Scores on the Insomnia Severity Index (ISI), Pittsburgh Sleep Quality Index, Self-Rating Anxiety Scale, Self-Rating Depression Scale, and the associations between these clinical characteristics and functional metrics, were the primary outcomes. At baseline, the patients with PI showed inefficient small-world property and aberrant functional segregation and functional integration compared with the HCs. These properties showed renormalization after individualized rTMS treatment. Furthermore, low functional connectivity between the right insula and left medial frontal gyrus correlated with improvement in ISI scores. We highlight functional network dysfunctions in PI patients and provide evidence into the pathophysiological mechanisms involved and the possible mode of action of rTMS.
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Affiliation(s)
- Shun Qi
- The Key Laboratory of Biomedical Information Engineering of Ministry of Education, Institute of Health and Rehabilitation Science, School of Life Science and Technology, Research Center for Brain-Inspired Intelligence, Xi’an Jiaotong University, Xi’an, China
- Shaanxi Brain Modulation and Scientific Research Center, Xi’an, China
| | - Yao Zhang
- Xijing Hospital, The Air Force Military Medical University, Xi’an, China
| | - Xiang Li
- The Key Laboratory of Biomedical Information Engineering of Ministry of Education, Institute of Health and Rehabilitation Science, School of Life Science and Technology, Research Center for Brain-Inspired Intelligence, Xi’an Jiaotong University, Xi’an, China
- The Key Laboratory of Biomedical Information Engineering of Ministry of Education, Institute of Health and Rehabilitation Science, School of Life Sciences and Technology, Xi’an Jiaotong University, Xi’an, China
- The Key Laboratory of Neuro-Informatics and Rehabilitation Engineering of Ministry of Civil Affairs, Xi’an, China
- Xi’an Solide Brain Control Medical Technology Company, Xi’an, China
| | - Chuanzhu Sun
- The Key Laboratory of Biomedical Information Engineering of Ministry of Education, Institute of Health and Rehabilitation Science, School of Life Sciences and Technology, Xi’an Jiaotong University, Xi’an, China
- The Key Laboratory of Neuro-Informatics and Rehabilitation Engineering of Ministry of Civil Affairs, Xi’an, China
| | - Xiaowei Ma
- Department of Nuclear Medicine, The Second Xiangya Hospital, Central South University, Changsha, China
| | - Sanzhong Li
- Department of Neurosurgery, Xijing Hospital, The Air Force Military Medical University, Xi’an, China
| | - Li Li
- Center of Treatment and Rehabilitation of Severe Neurological Disorders, Xi’an International Medical Center Hospital, Xi’an, China
| | - Kai Ren
- Department of Cardiovascular Surgery, Xijing Hospital, Air Force Military Medical University, Xi’an, China
| | - Min Xi
- The Key Laboratory of Biomedical Information Engineering of Ministry of Education, Institute of Health and Rehabilitation Science, School of Life Science and Technology, Research Center for Brain-Inspired Intelligence, Xi’an Jiaotong University, Xi’an, China
- The Key Laboratory of Biomedical Information Engineering of Ministry of Education, Institute of Health and Rehabilitation Science, School of Life Sciences and Technology, Xi’an Jiaotong University, Xi’an, China
- The Key Laboratory of Neuro-Informatics and Rehabilitation Engineering of Ministry of Civil Affairs, Xi’an, China
- Hospital of Northwestern Polytechnical University, Xi’an, China
- *Correspondence: Min Xi,
| | - Zi-Gang Huang
- The Key Laboratory of Biomedical Information Engineering of Ministry of Education, Institute of Health and Rehabilitation Science, School of Life Science and Technology, Research Center for Brain-Inspired Intelligence, Xi’an Jiaotong University, Xi’an, China
- The Key Laboratory of Biomedical Information Engineering of Ministry of Education, Institute of Health and Rehabilitation Science, School of Life Sciences and Technology, Xi’an Jiaotong University, Xi’an, China
- The Key Laboratory of Neuro-Informatics and Rehabilitation Engineering of Ministry of Civil Affairs, Xi’an, China
- The State Key Laboratory of Cognitive Neuroscience and Learning, Beijing Normal University, Beijing, China
- Zi-Gang Huang,
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15
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Li X, Li Z, Zou Z, Wu X, Gao H, Wang C, Zhou J, Qi F, Zhang M, He J, Qi X, Yan F, Dou S, Zhang H, Tong L, Li Y. Real-Time fMRI Neurofeedback Training Changes Brain Degree Centrality and Improves Sleep in Chronic Insomnia Disorder: A Resting-State fMRI Study. Front Mol Neurosci 2022; 15:825286. [PMID: 35283729 PMCID: PMC8904428 DOI: 10.3389/fnmol.2022.825286] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Accepted: 01/31/2022] [Indexed: 11/13/2022] Open
Abstract
BackgroundChronic insomnia disorder (CID) is considered a major public health problem worldwide. Therefore, innovative and effective technical methods for studying the pathogenesis and clinical comprehensive treatment of CID are urgently needed.MethodsReal-time fMRI neurofeedback (rtfMRI-NF), a new intervention, was used to train 28 patients with CID to regulate their amygdala activity for three sessions in 6 weeks. Resting-state fMRI data were collected before and after training. Then, voxel-based degree centrality (DC) method was used to explore the effect of rtfMRI-NF training. For regions with altered DC, we determined the specific connections to other regions that most strongly contributed to altered functional networks based on DC. Furthermore, the relationships between the DC value of the altered regions and changes in clinical variables were determined.ResultsPatients with CID showed increased DC in the right postcentral gyrus, Rolandic operculum, insula, and superior parietal gyrus and decreased DC in the right supramarginal gyrus, inferior parietal gyrus, angular gyrus, middle occipital gyrus, and middle temporal gyrus. Seed-based functional connectivity analyses based on the altered DC regions showed more details about the altered functional networks. Clinical scores in Pittsburgh sleep quality index, insomnia severity index (ISI), Beck depression inventory, and Hamilton anxiety scale decreased. Furthermore, a remarkable positive correlation was found between the changed ISI score and DC values of the right insula.ConclusionsThis study confirmed that amygdala-based rtfMRI-NF training altered the intrinsic functional hubs, which reshaped the abnormal functional connections caused by insomnia and improved the sleep of patients with CID. These findings contribute to our understanding of the neurobiological mechanism of rtfMRI-NF in insomnia treatment. However, additional double-blinded controlled clinical trials with larger sample sizes need to be conducted to confirm the effect of rtfMRI-NF from this initial study.
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Affiliation(s)
- Xiaodong Li
- Department of Radiology, Henan Provincial People’s Hospital, People’s Hospital of Zhengzhou University, Zhengzhou, China
| | - Zhonglin Li
- Department of Radiology, Henan Provincial People’s Hospital, People’s Hospital of Zhengzhou University, Zhengzhou, China
| | - Zhi Zou
- Department of Radiology, Henan Provincial People’s Hospital, People’s Hospital of Zhengzhou University, Zhengzhou, China
| | - Xiaolin Wu
- Department of Nuclear Medicine, Henan Provincial People’s Hospital, People’s Hospital of Zhengzhou University, Zhengzhou, China
| | - Hui Gao
- Henan Key Laboratory of Imaging and Intelligent Processing, PLA Strategic Support Force Information Engineering University, Zhengzhou, China
| | - Caiyun Wang
- Department of Radiology, Henan Provincial People’s Hospital, People’s Hospital of Zhengzhou University, Zhengzhou, China
| | - Jing Zhou
- Health Management Center, Henan Provincial People’s Hospital, People’s Hospital of Zhengzhou University, Zhengzhou, China
| | - Fei Qi
- Department of Radiology, Henan Provincial People’s Hospital, People’s Hospital of Zhengzhou University, Zhengzhou, China
| | - Miao Zhang
- Department of Radiology, Henan Provincial People’s Hospital, People’s Hospital of Zhengzhou University, Zhengzhou, China
| | - Junya He
- Department of Radiology, Henan Provincial People’s Hospital, People’s Hospital of Zhengzhou University, Zhengzhou, China
| | - Xin Qi
- Department of Radiology, Henan Provincial People’s Hospital, People’s Hospital of Zhengzhou University, Zhengzhou, China
| | - Fengshan Yan
- Department of Radiology, Henan Provincial People’s Hospital, People’s Hospital of Zhengzhou University, Zhengzhou, China
| | - Shewei Dou
- Department of Radiology, Henan Provincial People’s Hospital, People’s Hospital of Zhengzhou University, Zhengzhou, China
| | - Hongju Zhang
- Department of Neurology, Henan Provincial People’s Hospital, People’s Hospital of Zhengzhou University, Zhengzhou, China
| | - Li Tong
- Henan Key Laboratory of Imaging and Intelligent Processing, PLA Strategic Support Force Information Engineering University, Zhengzhou, China
- *Correspondence: Li Tong,
| | - Yongli Li
- Health Management Center, Henan Provincial People’s Hospital, People’s Hospital of Zhengzhou University, Zhengzhou, China
- Yongli Li,
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16
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Jiang G, Feng Y, Li M, Wen H, Wang T, Shen Y, Chen Z, Li S. Distinct alterations of functional connectivity of the basal forebrain subregions in insomnia disorder. Front Psychiatry 2022; 13:1036997. [PMID: 36311494 PMCID: PMC9606586 DOI: 10.3389/fpsyt.2022.1036997] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2022] [Accepted: 09/22/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Cholinergic basal forebrain (BF) plays an important role in sleep-wake regulation and is implicated in cortical arousal and activation. However, less is known currently regarding the abnormal BF-related neuronal circuit in human patients with insomnia disorder (ID). In this study, we aimed to explore alterations of functional connectivity (FC) in subregions of the BF and the relationships between FC alterations and sleep and mood measures in ID. MATERIALS AND METHODS One hundred and two ID patients and ninety-six healthy controls (HC) were included in this study. Each subject underwent both resting-state fMRI and high-resolution anatomical scanning. All participants completed the sleep and mood questionnaires in ID patients. Voxel-based resting-state FC in each BF subregion (Ch_123 and Ch_4) were computed. For the voxel-wise FC differences between groups, a two-sample t-test was performed on the individual maps in a voxel-by-voxel manner. To examine linear relationships with sleep and mood measures, Pearson correlations were calculated between FC alterations and sleep and mood measures, respectively. RESULTS The ID group showed significantly decreased FC between the medial superior frontal gyrus and Ch_123 compared to HC. However, increased FC between the midbrain and Ch_4 was found in ID based on the voxel-wise analysis. The correlation analysis only revealed that the altered FC between the midbrain with Ch_4 was significantly negatively correlated with the self-rating anxiety scale. CONCLUSION Our findings of decreased FC between Ch_123 and medial superior frontal gyrus and increased FC between midbrain and Ch4 suggest distinct roles of subregions of BF underlying the neurobiology of ID.
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Affiliation(s)
- Guihua Jiang
- Department of Medical Imaging, Guangdong Second Provincial General Hospital, Guangzhou, China
| | - Ying Feng
- Department of Radiology, Affiliated Hospital of Chengdu University, Chengdu, China
| | - Meng Li
- Department of Medical Imaging, Guangdong Second Provincial General Hospital, Guangzhou, China
| | - Hua Wen
- Department of Medical Imaging, Guangdong Second Provincial General Hospital, Guangzhou, China
| | - Tianyue Wang
- Department of Medical Imaging, Guangdong Second Provincial General Hospital, Guangzhou, China
| | - Yanan Shen
- The First School of Clinical Medicine, Guangdong Medical University, Zhanjiang, China
| | - Ziwei Chen
- Department of Medical Imaging, Guangdong Second Provincial General Hospital, Jinan University, Guangzhou, China
| | - Shumei Li
- Department of Medical Imaging, Guangdong Second Provincial General Hospital, Guangzhou, China
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17
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Zhang T, Xie X, Li Q, Zhang L, Chen Y, Ji GJ, Hou Q, Li T, Zhu C, Tian Y, Wang K. Hypogyrification in Generalized Anxiety Disorder and Associated with Insomnia Symptoms. Nat Sci Sleep 2022; 14:1009-1019. [PMID: 35642211 PMCID: PMC9148579 DOI: 10.2147/nss.s358763] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Accepted: 05/03/2022] [Indexed: 01/04/2023] Open
Abstract
PURPOSE Insomnia is a recognized feature of generalized anxiety disorder (GAD). The underlying neural substrate of insomnia in GAD is still unclear. Cortical folding is a reliable index and possibly an endophenotype of psychiatric disease. The aim of this study was to explore whether the aberrant cortical morphology was associated with insomnia in GAD. PATIENTS AND METHODS We enrolled 73 patients with GAD and 74 matched healthy controls (HCs) to undergo neuropsychiatric assessment and 3.0 T magnetic resonance imaging scanning. Neuropsychiatric batteries included the 14-item Hamilton Anxiety Rating Scale (HAMA) and the Insomnia Severity Index (ISI). Using FreeSurfer7.1.1, we calculated local gyrification index, cortical thickness and surface area and identified group differences in these parameters. Then, we calculated the functional connectivity of these identified regions and determined functional alterations. The relationship between these neuroimaging indicators and clinical measurement was explored. RESULTS Compared with HCs, the LGI in the bilateral orbitofrontal cortex (OFC), bilateral insula, left middle frontal gyrus, left temporal pole, and left fusiform area was significantly decreased in GAD. GAD patients had concurrent decreased surface area in the left OFC and thicker right OFC. GAD patients also exhibited increased functional connectivity between the left insula and frontoparietal control network. In addition, a negative relationship was observed between decreased LGI in these limbic regions and ISI score. CONCLUSION GAD patients presented aberrant cortical folding in limbic network. Cortical morphology is a potential endophenotype in GAD, corresponding to an insomnia phenotype.
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Affiliation(s)
- Ting Zhang
- Department of Psychiatry, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui Province, People's Republic of China.,Collaborative Innovation Center of Neuropsychiatric Disorders and Mental Health, Hefei, Anhui Province, People's Republic of China.,Anhui Province Key Laboratory of Cognition and Neuropsychiatric Disorders, Hefei, People's Republic of China
| | - Xiaohui Xie
- Collaborative Innovation Center of Neuropsychiatric Disorders and Mental Health, Hefei, Anhui Province, People's Republic of China.,Anhui Province Key Laboratory of Cognition and Neuropsychiatric Disorders, Hefei, People's Republic of China.,Department of Neurology, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui Province, People's Republic of China
| | - Qianqian Li
- Department of Psychiatry, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui Province, People's Republic of China.,Collaborative Innovation Center of Neuropsychiatric Disorders and Mental Health, Hefei, Anhui Province, People's Republic of China.,Anhui Province Key Laboratory of Cognition and Neuropsychiatric Disorders, Hefei, People's Republic of China
| | - Lei Zhang
- Collaborative Innovation Center of Neuropsychiatric Disorders and Mental Health, Hefei, Anhui Province, People's Republic of China.,Anhui Province Key Laboratory of Cognition and Neuropsychiatric Disorders, Hefei, People's Republic of China.,School of Mental Health and Psychological Sciences, Anhui Medical University, Hefei, Anhui Province, People's Republic of China.,Department of Psychiatry, The Second Affiliated Hospital of Anhui Medical University, Hefei, Anhui Province, People's Republic of China
| | - Yue Chen
- Collaborative Innovation Center of Neuropsychiatric Disorders and Mental Health, Hefei, Anhui Province, People's Republic of China.,Department of Neurology, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui Province, People's Republic of China
| | - Gong-Jun Ji
- Collaborative Innovation Center of Neuropsychiatric Disorders and Mental Health, Hefei, Anhui Province, People's Republic of China.,Anhui Province Key Laboratory of Cognition and Neuropsychiatric Disorders, Hefei, People's Republic of China.,School of Mental Health and Psychological Sciences, Anhui Medical University, Hefei, Anhui Province, People's Republic of China
| | - Qiangqiang Hou
- Collaborative Innovation Center of Neuropsychiatric Disorders and Mental Health, Hefei, Anhui Province, People's Republic of China.,Anhui Province Key Laboratory of Cognition and Neuropsychiatric Disorders, Hefei, People's Republic of China.,Department of Neurology, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui Province, People's Republic of China
| | - Tianxia Li
- Anhui Mental Health Center, Hefei, Anhui Province, People's Republic of China
| | - Chunyan Zhu
- Collaborative Innovation Center of Neuropsychiatric Disorders and Mental Health, Hefei, Anhui Province, People's Republic of China.,Anhui Province Key Laboratory of Cognition and Neuropsychiatric Disorders, Hefei, People's Republic of China.,School of Mental Health and Psychological Sciences, Anhui Medical University, Hefei, Anhui Province, People's Republic of China.,Department of Psychiatry, The Second Affiliated Hospital of Anhui Medical University, Hefei, Anhui Province, People's Republic of China
| | - Yanghua Tian
- Department of Neurology, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui Province, People's Republic of China.,Department of Neurology, The Second Affiliated Hospital of Anhui Medical University, Hefei, Anhui Province, People's Republic of China.,Institute of Artificial Intelligence, Hefei Comprehensive National Science Center, Hefei, People's Republic of China
| | - Kai Wang
- Collaborative Innovation Center of Neuropsychiatric Disorders and Mental Health, Hefei, Anhui Province, People's Republic of China.,Anhui Province Key Laboratory of Cognition and Neuropsychiatric Disorders, Hefei, People's Republic of China.,Department of Neurology, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui Province, People's Republic of China.,School of Mental Health and Psychological Sciences, Anhui Medical University, Hefei, Anhui Province, People's Republic of China.,Institute of Artificial Intelligence, Hefei Comprehensive National Science Center, Hefei, People's Republic of China
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18
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Kim N, Won E, Cho SE, Kang CK, Kang SG. Thalamocortical functional connectivity in patients with insomnia using resting-state fMRI. J Psychiatry Neurosci 2021; 46:E639-E646. [PMID: 34815270 PMCID: PMC8612467 DOI: 10.1503/jpn.210066] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2021] [Revised: 07/21/2021] [Accepted: 09/06/2021] [Indexed: 02/02/2023] Open
Abstract
BACKGROUND Insomnia is a common disorder that affects a vast number of patients; the hyperarousal theory of insomnia postulates that patients with insomnia are physiologically activated not only at nighttime but also during the daytime. We aimed to investigate the differences in the resting-state functional connectivity (RSFC) of the thalamus with cortical areas between patients with insomnia disorder and healthy controls. METHODS All participants completed clinical questionnaires and underwent portable polysomnography and resting-state fMRI. RESULTS Patients in the insomnia group (n = 50) showed increased RSFC between the thalamus and right medial superior frontal area, bilateral middle temporal areas, left rectus and right parahippocampal areas compared with controls (n = 42) after controlling for age, sex and education level. Among the pairs that showed increased connectivity, several functional connections were negatively correlated with sleep efficiency, measured by polysomnography.Limitations: We used a small sample size. CONCLUSION We consider these results on increased thalamocortical hyperactivity in brain areas related to sensory functions as providing evidence for the hyperarousal theory of insomnia.
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Affiliation(s)
| | | | | | | | - Seung-Gul Kang
- From the Department of Biomedical Engineering Research Center (N. Kim); Department of Psychiatry (S.-G. Kang, S.-E. Cho), Gil Medical Center, College of Medicine; and Department of Radiological Science (C.-K. Kang), College of Health Science, Gachon University, Incheon, Republic of Korea; Department of Psychiatry, CHA Bundang Medical Center, CHA University, Seongnam, Republic of Korea (E. Won); Department of Psychiatry, Chaum, Seoul, Republic of Korea (E. Won)
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19
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Fasiello E, Gorgoni M, Scarpelli S, Alfonsi V, Ferini Strambi L, De Gennaro L. Functional connectivity changes in insomnia disorder: A systematic review. Sleep Med Rev 2021; 61:101569. [PMID: 34902821 DOI: 10.1016/j.smrv.2021.101569] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Revised: 11/03/2021] [Accepted: 11/03/2021] [Indexed: 02/05/2023]
Abstract
Insomnia (ID) is the most common sleep disorder; however pathogenetic mechanisms underlying ID symptoms are not fully understood. Adopting a multifactorial view and considering ID a condition that involves interregional neuronal coordination would be useful to understand the ID pathophysiology. Functional connectivity (FC) may help to shed light on functional processes and neural correlates underlying ID symptoms. Despite a growing number of studies assessing FC anomalies, insight into ID pathophysiology is still fragmentary. This systematic review aims to search empirical evidence regarding FC changes in ID during resting-state. Thirty-one studies involving 1052 ID participants met the inclusion criteria for this review. Results suggested several associations between ID symptoms and impaired intra- and inter-hemispheric interactions of principal resting-state networks. Overall, evidence supported the hypothesis that a disrupted organization of the brain functional connectome characterizes ID, resulting in a decline in sleep, cognition, emotion, and memory. However, the wide methodological heterogeneity between reviewed studies and limitations in terms of study protocols and statistical approaches raised from this systematic review, makes it difficult to provide a univocal framework of ID pathophysiology. Future researches in this field should lead towards shared and rigorous search designs to ensure solid research evidence in the ID pathophysiology.
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Affiliation(s)
| | - Maurizio Gorgoni
- Department of Psychology, Sapienza - University of Rome, Rome, Italy
| | - Serena Scarpelli
- Department of Psychology, Sapienza - University of Rome, Rome, Italy
| | - Valentina Alfonsi
- Department of Psychology, Sapienza - University of Rome, Rome, Italy; IRCCS Fondazione Santa Lucia, Rome, Italy
| | - Luigi Ferini Strambi
- Vita-Salute San Raffaele University, Milan, Italy; Sleep Disorders Center, Division of Neuroscience, San Raffaele Scientific Institute, Milan, Italy
| | - Luigi De Gennaro
- Department of Psychology, Sapienza - University of Rome, Rome, Italy; IRCCS Fondazione Santa Lucia, Rome, Italy.
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20
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The cerebral mechanism of acupuncture for chronic insomnia with gastrointestinal disorder: protocol for a randomized controlled trial. Trials 2021; 22:386. [PMID: 34098994 PMCID: PMC8186179 DOI: 10.1186/s13063-021-05332-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2020] [Accepted: 05/19/2021] [Indexed: 11/20/2022] Open
Abstract
Background Many patients with chronic insomnia disorder (CID) have gastrointestinal (GI) symptoms. First-line insomnia medications do not treat GI problems. Acupuncture has a comprehensive regulative action on both CID and GI disorder and is receiving increasing attention. Recent studies indicate that both CID and GI diseases may cause abnormal brain activity. However, the neurological mechanism underlying the effect of acupuncture on such diseases is still unclear. The aim of this study is to explore the pathological mechanisms of CID with GI discomfort, as well as the main response characteristics of acupuncture treatment from multiple perspectives using multimodal magnetic resonance imaging (MRI). Methods A total of 60 participants with CID and GI disorders will be randomly divided into two groups (real acupuncture group and sham acupuncture group; ratio of 1:1). Patients will receive 20 sessions (five sessions per week) of real acupuncture treatment or sham acupuncture treatment. The primary outcome is the aggregate score on the Pittsburgh Sleep Quality Index. Secondary outcomes are scores on the Gastrointestinal Symptom Rating Scale, Self-Rating Anxiety Scale, and Self-Rating Depression Scale. Multimodal MRI scans and clinical assessments will be performed both at baseline and post-treatment. Another 30 age-, sex-, and education-matched healthy subjects will be recruited as controls and will receive MRI scans and clinical evaluations. Discussion This study aims to provide scientific evidence for the mechanism of acupuncture in treating CID with GI disorder using multimodal MRI imaging data on brain structure, function, and metabolism. Trial registration Chinese Clinical Trial Registry, ChiCTR1800017092 (URL: http://www.chictr.org.cn/showproj.aspx?proj=27173). Registered on July 11, 2018. Supplementary Information The online version contains supplementary material available at 10.1186/s13063-021-05332-3.
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Zhang F, Yang Z, Qin K, Sweeney JA, Roberts N, Jia Z, Gong Q. Effect of jet lag on brain white matter functional connectivity. PSYCHORADIOLOGY 2021; 1:55-65. [PMID: 38665361 PMCID: PMC10917196 DOI: 10.1093/psyrad/kkaa003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/09/2020] [Revised: 11/18/2020] [Accepted: 11/25/2020] [Indexed: 02/05/2023]
Abstract
Background A long-haul flight across more than five time zones may produce a circadian rhythm sleep disorder known as jet lag. Little is known about the effect of jet lag on white matter (WM) functional connectivity (FC). Objective The present study is to investigate changes in WM FC in subjects due to recovery from jet lag after flying across six time zones. Methods Here, resting-state functional magnetic resonance imaging was performed in 23 participants within 24 hours of flying and again 50 days later. Gray matter (GM) and WM networks were identified by k-means clustering. WM FC and functional covariance connectivity (FCC) were analyzed. Next, a sliding window method was used to establish dynamic WM FC. WM static and dynamic FC and FCC were compared between when participants had initially completed their journey and 50 days later. Emotion was assessed using the Positive and Negative Affect Schedule and the State Anxiety Inventory. Results All participants were confirmed to have jet lag symptoms by the Columbian Jet Lag Scale. The static FC strengthes of cingulate network (WM7)- sensorimotor network and ventral frontal network- visual network were lower after the long-haul flight compared with recovery. Corresponding results were obtained for the dynamic FC analysis. The analysis of FCC revealed weakened connections between the WM7 and several other brain networks, especially the precentral/postcentral network. Moreover, a negative correlation was found between emotion scores and the FC between the WM7 and sensorimotor related regions. Conclusions The results of this study provide further evidence for the existence of WM networks and show that jet lag is associated with alterations in static and dynamic WM FC and FCC, especially in sensorimotor networks. Jet lag is a complex problem that not only is related to sleep rhythm but also influences emotion.
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Affiliation(s)
- Feifei Zhang
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu 610041, China
- Research Unit of Psychoradiology, Chinese Academy of Medical Sciences, Chengdu 610041, China
| | - Zhipeng Yang
- College of Electronic Engineering, Chengdu University of Information Technology, Chengdu 610225, China
| | - Kun Qin
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu 610041, China
- Research Unit of Psychoradiology, Chinese Academy of Medical Sciences, Chengdu 610041, China
| | - John A Sweeney
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu 610041, China
- Department of Psychiatry and Behavioral Neuroscience, University of Cincinnati, Cincinnati, OH, USA
| | - Neil Roberts
- School of Clinical Sciences, University of Edinburgh, EH16 4TJ, UK
| | - Zhiyun Jia
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu 610041, China
- Department of Nuclear Medicine, West China Hospital, Sichuan University, Chengdu 610041, China
| | - Qiyong Gong
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu 610041, China
- Research Unit of Psychoradiology, Chinese Academy of Medical Sciences, Chengdu 610041, China
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22
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Cao KX, Ma ML, Wang CZ, Iqbal J, Si JJ, Xue YX, Yang JL. TMS-EEG: An emerging tool to study the neurophysiologic biomarkers of psychiatric disorders. Neuropharmacology 2021; 197:108574. [PMID: 33894219 DOI: 10.1016/j.neuropharm.2021.108574] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2020] [Revised: 03/08/2021] [Accepted: 04/15/2021] [Indexed: 01/02/2023]
Abstract
The etiology of psychiatric disorders remains largely unknown. The exploration of the neurobiological mechanisms of mental illness helps improve diagnostic efficacy and develop new therapies. This review focuses on the application of concurrent transcranial magnetic stimulation and electroencephalography (TMS-EEG) in various mental diseases, including major depressive disorder, bipolar disorder, schizophrenia, autism spectrum disorder, attention-deficit/hyperactivity disorder, substance use disorder, and insomnia. First, we summarize the commonly used protocols and output measures of TMS-EEG; then, we review the literature exploring the alterations in neural patterns, particularly cortical excitability, plasticity, and connectivity alterations, and studies that predict treatment responses and clinical states in mental disorders using TMS-EEG. Finally, we discuss the potential mechanisms underlying TMS-EEG in establishing biomarkers for psychiatric disorders and future research directions.
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Affiliation(s)
- Ke-Xin Cao
- National Institute on Drug Dependence and Beijing Key Laboratory of Drug Dependence, Peking University, Beijing, China
| | - Mao-Liang Ma
- Department of Clinical Psychology, Tianjin Medical University General Hospital Airport Site, Tianjin, China
| | - Cheng-Zhan Wang
- Department of Clinical Psychology, Tianjin Medical University General Hospital, Tianjin, China
| | - Javed Iqbal
- School of Psychology, Shaanxi Normal University and Key Laboratory for Behavior and Cognitive Neuroscience of Shaanxi Province, Xi'an, China
| | - Ji-Jian Si
- Department of Clinical Psychology, Tianjin Medical University General Hospital, Tianjin, China
| | - Yan-Xue Xue
- National Institute on Drug Dependence and Beijing Key Laboratory of Drug Dependence, Peking University, Beijing, China; Key Laboratory for Neuroscience of Ministry of Education and Neuroscience, National Health and Family Planning Commission, Peking University, Beijing, China.
| | - Jian-Li Yang
- Department of Clinical Psychology, Tianjin Medical University General Hospital, Tianjin, China.
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23
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Zhang L, Shao Y, Jin X, Cai X, Du F. Decreased effective connectivity between insula and anterior cingulate cortex during a working memory task after prolonged sleep deprivation. Behav Brain Res 2021; 409:113263. [PMID: 33775776 DOI: 10.1016/j.bbr.2021.113263] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2020] [Revised: 03/05/2021] [Accepted: 03/22/2021] [Indexed: 10/21/2022]
Abstract
Total sleep deprivation (TSD) causes a decline in almost all cognitive domains, especially working memory. However, we do not have a clear understanding of the degree working memory is impaired under prolonged TSD, nor do we know the underlying neurophysiological mechanism. In this study, we recorded EEG data from 64 subjects while they performed a working memory task during resting wakefulness, after 24 h TSD, and after 30 h TSD. ANOVA was used to verify performance differences between 24 h and 30 h TSD in working memory tasks: (1) reaction time and accuracy hit rates, (2) P200, N200, and P300 amplitude and latency in measurements of event-related potential, as well as (3) effective connectivity strength between brain areas associated with working memory. Compared to 24 h TSD, 30 h TSD significantly decreased accuracy hit rates and induced a larger N200 difference waveform. The effective connectivity analysis showed that 30 h TSD also decreased beta frequency in effective connection strength from the right insular lobe to the left anterior cingulate cortex (ACC). Effective connection from the left ventrolateral prefrontal cortex to the left dorsolateral prefrontal cortex increased in the match condition of the 2-back task. In conclusion, 30 h TSD had a greater negative impact on working memory than 24 h TSD. This impairment of working memory is associated with decreased strength in the effective connection from the right insula to the left ACC.
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Affiliation(s)
- Liwei Zhang
- Key Laboratory of Behavioral Science, Institute of Psychology, Chinese Academy of Sciences, Beijing, 100101, China
| | - Yongcong Shao
- Department of Psychology, Beijing Sport University, Beijing, 100084, China
| | - Xueguang Jin
- College of Software and Big Data, Changzhou College of Information Technology, Changzhou, 213164, China
| | - Xiaoping Cai
- Department of Cadra Word 3 Division, PLA Army General Hospital, Beijing, 100700, China
| | - Feng Du
- Key Laboratory of Behavioral Science, Institute of Psychology, Chinese Academy of Sciences, Beijing, 100101, China; Department of Psychology, University of Chinese Academy of Sciences, Beijing, China.
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24
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黄 伟, 李 志, 吴 水, 洪 静, 文 戈. [Small-world network of patients with primary insomnia: a resting-state functional magnetic resonance imaging study]. NAN FANG YI KE DA XUE XUE BAO = JOURNAL OF SOUTHERN MEDICAL UNIVERSITY 2021; 41:424-429. [PMID: 33849835 PMCID: PMC8075793 DOI: 10.12122/j.issn.1673-4254.2021.03.16] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 09/25/2020] [Indexed: 06/12/2023]
Abstract
OBJECTIVE To explore the changes of small-world network properties in patients with primary insomnia based on resting-state functional magnetic resonance imaging (rs-fMRI). OBJECTIVE The rs-MRI data and neurological scale data of 65 patients and 60 matched healthy controls were collected. The brain network was constructed using GRENTA software. SPSS software and network-based statistical analysis methods were used for statistical analysis. OBJECTIVE There was no significant difference between the two groups in terms of age, gender or education level (P > 0.05), but PSQI, HAMA and HAMD scale scores differed significantly between the two groups (P < 0.05). Both of the groups showed attributes of the small-world network. Compared with the control group, the patients with insomnia showed lower Cp, γ, Eloc, λ, connectivity, and σ of the small world network (P < 0.05). OBJECTIVE Patients with primary insomnia have lower global and local efficiencies than healthy individuals, and their ability to transmit information on the surface topology is impaired. Our data provide objective imaging evidences for the neuropathological mechanism of patients with primary insomnia.
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Affiliation(s)
- 伟康 黄
- 南方医科大学南方医院增城分院(增城区中心医院),广东 广州 511340Zengcheng Branch of Nanfang Hospital, Southern Medical University, Guangzhou 511340, China
| | - 志铭 李
- 广州医科大学第二附属医院,广东 广州 510260Department of Radiology, Second Affiliated Hospital of Guangzhou Medical College, Guangzhou 510260, China
| | - 水天 吴
- 南方医科大学南方医院增城分院(增城区中心医院),广东 广州 511340Zengcheng Branch of Nanfang Hospital, Southern Medical University, Guangzhou 511340, China
| | - 静静 洪
- 南方医科大学南方医院增城分院(增城区中心医院),广东 广州 511340Zengcheng Branch of Nanfang Hospital, Southern Medical University, Guangzhou 511340, China
| | - 戈 文
- 南方医科大学南方医院增城分院(增城区中心医院),广东 广州 511340Zengcheng Branch of Nanfang Hospital, Southern Medical University, Guangzhou 511340, China
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25
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Disrupted frontostriatal connectivity in primary insomnia: a DTI study. Brain Imaging Behav 2021; 15:2524-2531. [PMID: 33651331 DOI: 10.1007/s11682-021-00454-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2020] [Revised: 12/28/2020] [Accepted: 01/10/2021] [Indexed: 12/20/2022]
Abstract
Dysfunction of the sleep-wake transition is considered to be associated with the pathology of patients with primary insomnia (PI). Previous animal study had reported that brain circuits between the striatum and cortex can regulate sleep-wake transitions. So far, few studies have systematically explored the structural connectivity of the striatum-centered circuits and their potential roles in patients with PI. In this study, we chosen the striatum as the seed and 10 priori target regions as masks to assess the structural connectivity by using seed-based classification with a diffusion tensor imaging (DTI) probabilistic tractography method. Track strengths of the striatum-centered circuits were compared between 22 patients with PI (41.27 ± 9.21 years) and 30 healthy controls (HC) (35.2 ± 8.14 years). Pittsburgh Sleep Quality Index (PSQI) was used to measure the sleep quality in all participants. Lower track strengths (left striatum- anterior cingulate cortex (ACC), left striatum- dorsal anterior cingulate cortex (dACC), left striatum-Hippocampus, and right striatum-Hippocampus) were observed in patients with PI compared to HC. Additionally, the lower track strengths of brain circuits mentioned above were negatively correlated with PSQI. Taken together, our findings revealed the lower tract strength of frontostriatal circuits in patients with PI and HC, which provided the implications of the system-level structural connections of frontostriatal circuits in the pathology of PI. We suggested that the track strengths of the frontostriatal circuits calculated from DTI can be the potential neuroimaging biomarkers of the sleep quality in patients with PI.
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26
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Insomnia disorder and its reciprocal relation with psychopathology. Curr Opin Psychol 2021; 41:34-39. [PMID: 33691218 DOI: 10.1016/j.copsyc.2021.02.001] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2020] [Revised: 01/06/2021] [Accepted: 02/03/2021] [Indexed: 01/07/2023]
Abstract
Sleep is crucial for daytime functioning. In populations with psychiatric conditions, many people suffer from insomnia symptoms or an insomnia disorder. Emerging evidence suggests a bidirectional relationship between insomnia and various psychopathologies, implying that insomnia not only may be a consequence of mental disorders but also may contribute to new development, symptom severity, and reoccurrence of diverse mental disorders. Research on potential mechanisms underlying the insomnia psychopathology association is important, both from the preventive and treatment perspective. Most hypotheses concern the influence of insomnia on emotion regulation and on shared pathophysiological pathways, ranging from gut microbiome composition to genetic and specific neurotransmitter system aberrations.
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27
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Brain reactivity using fMRI to insomnia stimuli in insomnia patients with discrepancy between subjective and objective sleep. Sci Rep 2021; 11:1592. [PMID: 33452376 PMCID: PMC7810854 DOI: 10.1038/s41598-021-81219-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2020] [Accepted: 12/21/2020] [Indexed: 12/03/2022] Open
Abstract
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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28
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Shen Y, Jin X, Zhang Y, Huang C, Lu J, Luo X, Zhang XY. Insomnia in Chinese College Students With Internet Addiction: Prevalence and Associated Clinical Correlates. Front Psychiatry 2020; 11:596683. [PMID: 33329147 PMCID: PMC7728739 DOI: 10.3389/fpsyt.2020.596683] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/20/2020] [Accepted: 10/23/2020] [Indexed: 12/15/2022] Open
Abstract
Background: Internet addiction (IA) has gained more and more attention for its negative impact on the subjects' study and daily life. However, in a large sample, there is little research on the association between IA and insomnia in Chinese college students. This study aimed to investigate the prevalence of insomnia and its related risk factors among Chinese college students with IA. Methods: A cross-sectional design was used to investigate 627 Chinese college students with IA. Each student completed a survey on demographic data, Internet addiction (Revised Chinese Internet Addiction Scale), depression (Self-Rating Depression Scale), insomnia (Athens Insomnia Scale), anxiety (Self-Rating Anxiety Scale), and suicidal behavior. Binary logistic regression analysis was employed to adjust for confounding factors. Results: The prevalence of insomnia among students with IA was 54.86%. Compared with IA students without insomnia, IA students with insomnia were more likely to be younger, smoking, drinking, have anxiety, depression, suicidal ideations, suicide plans, and suicide attempts (all p < 0.05). Moreover, drinking [OR, 1.664; 95% confidence interval (CI), 1.139-2.431; p = 0.008], anxiety (OR, 2.321; 95% CI, 1.116-4.826; p = 0.024), and suicidal ideation (OR, 1.942; 95% CI:1.295-2.911; p = 0.001) were independently associated with insomnia in IA students. Conclusions: Insomnia is very common in Chinese IA students. Drinking, anxiety, and suicidal ideation are independently correlated with insomnia. This study provides valuable evidence for school counselors and clinical professionals to assess Internet addiction, insomnia, and suicide risk.
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Affiliation(s)
- Yanmei Shen
- Department of Psychiatry, The Second Xiangya Hospital, Central South University, Changsha, China.,Hunan Key Laboratory of Psychiatry and Mental Health, China National Clinical Research Center on Mental Disorders (Xiangya), China National Technology Institute on Mental Disorders, Hunan Technology Institute of Psychiatry, Mental Health Institute of Central South University, Changsha, China
| | - Xingyue Jin
- Department of Psychiatry, The Second Xiangya Hospital, Central South University, Changsha, China.,Hunan Key Laboratory of Psychiatry and Mental Health, China National Clinical Research Center on Mental Disorders (Xiangya), China National Technology Institute on Mental Disorders, Hunan Technology Institute of Psychiatry, Mental Health Institute of Central South University, Changsha, China
| | - Yaru Zhang
- Department of Psychiatry, The Second Xiangya Hospital, Central South University, Changsha, China.,Hunan Key Laboratory of Psychiatry and Mental Health, China National Clinical Research Center on Mental Disorders (Xiangya), China National Technology Institute on Mental Disorders, Hunan Technology Institute of Psychiatry, Mental Health Institute of Central South University, Changsha, China
| | - Chunxiang Huang
- Department of Psychiatry, The Second Xiangya Hospital, Central South University, Changsha, China.,Hunan Key Laboratory of Psychiatry and Mental Health, China National Clinical Research Center on Mental Disorders (Xiangya), China National Technology Institute on Mental Disorders, Hunan Technology Institute of Psychiatry, Mental Health Institute of Central South University, Changsha, China
| | - Jianping Lu
- Department of Child and Adolescent Psychiatry of Shenzhen Kangning Hospital, Shenzhen Mental Health Center, Shenzhen, China
| | - Xuerong Luo
- Department of Psychiatry, The Second Xiangya Hospital, Central South University, Changsha, China.,Hunan Key Laboratory of Psychiatry and Mental Health, China National Clinical Research Center on Mental Disorders (Xiangya), China National Technology Institute on Mental Disorders, Hunan Technology Institute of Psychiatry, Mental Health Institute of Central South University, Changsha, China
| | - Xiang Yang Zhang
- Chinese Academy of Sciences (CAS) Key Laboratory of Mental Health, Institute of Psychology, Beijing, China
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Guo J, Yu S, Liu C, Wang G, Li B. Acupuncture for patients with insomnia disorder using resting-state functional magnetic resonance imaging: a protocol for a randomized controlled trial. Trials 2019; 20:685. [PMID: 31815645 PMCID: PMC6902344 DOI: 10.1186/s13063-019-3836-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2019] [Accepted: 10/23/2019] [Indexed: 12/12/2022] Open
Abstract
Background Insomnia is among the most prevalent of the sleep-related disorders. Insomnia disorder is associated with a brain hyperarousal state manifested by abnormal regional brain activity and resting state functional connectivity. Acupuncture improves sleep quality and modulates the hyperarousal state; however, the underlying neurobiological basis for improved sleep quality is poorly understood. The purpose of this clinical trial is to study the efficacy of acupuncture in the treatment of insomnia disorder. In addition, the neural mechanism by which acupuncture affects insomnia disorder will be explored using resting-state functional magnetic resonance imaging (rs-fMRI) and neuropsychological parameters. Methods and design A randomized, patient- and assessor-blinded trial will be conducted. We will randomize (in a 1:1 ratio) 60 eligible patients with insomnia disorder into a real acupuncture group or a sham acupuncture group. Interventions will be administered three times per week over a 4-week period, with an 8-week follow-up period. The healthy control group will consist of 30 age- and sex-matched healthy individuals who sleep well without any treatment intervention. All participants will undergo neuropsychological and rs-fMRI evaluations. The change in Pittsburgh Sleep Quality Index (PSQI) scores is the primary outcome parameter. The secondary outcome parameters include the Hyperarousal scale (HAS), rs-fMRI measurements, the Fatigue scale-14 (FS-14), the Hamilton depression scale (HAMD), the Hamilton anxiety scale (HAMA), a sleep diary, and an actigraph. Assessment of all parameters will be performed at baseline, post-treatment, and during follow-up. Analyses will be implemented based on intention-to-treat. Discussion The study results will be used to clarify the effectiveness and elucidate the mechanism by which acupuncture improves sleep quality in patients with insomnia disorder. Trial registration Chinese Clinical Trials Register, ChiCTR1800015282. Registered on 20 March 2018.
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Affiliation(s)
- Jing Guo
- Acupuncture and Moxibustion Department, Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, 23 Art Museum Backstreet, Dongcheng District, Beijing, 100010, China.
| | - Siyi Yu
- Chengdu University of Traditional Chinese Medicine, 37 Shi'er Qiao Road, Jinniu District, Chengdu, 610072, Sichuan, China
| | - Chunhong Liu
- Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Beijing Institute of Traditional Chinese Medicine, 23 Meishuguanhou Street, Dongcheng District, Beijing, 100010, China
| | - Guiling Wang
- Acupuncture and Moxibustion Department, Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, 23 Art Museum Backstreet, Dongcheng District, Beijing, 100010, China
| | - Bin Li
- Acupuncture and Moxibustion Department, Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, 23 Art Museum Backstreet, Dongcheng District, Beijing, 100010, China
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30
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Li C, Mai Y, Dong M, Yin Y, Hua K, Fu S, Wu Y, Jiang G. Multivariate Pattern Classification of Primary Insomnia Using Three Types of Functional Connectivity Features. Front Neurol 2019; 10:1037. [PMID: 31632335 PMCID: PMC6783513 DOI: 10.3389/fneur.2019.01037] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2019] [Accepted: 09/12/2019] [Indexed: 01/09/2023] Open
Abstract
Objective: To explore whether or not functional connectivity (FC) could be used as a potential biomarker for classification of primary insomnia (PI) at the individual level by using multivariate pattern analysis (MVPA). Methods: Thirty-eight drug-naive patients with PI, and 44 healthy controls (HC) underwent resting-state functional MR imaging. Voxel-wise functional connectivity strength (FCS), large-scale functional connectivity (large-scale FC) and regional homogeneity (ReHo) were calculated for each participant. We used support vector machine (SVM) with the three types of metrics as features separately to classify patients from healthy controls. Then we evaluated its classification performances. Finally, FC metrics with significant high classification performance were compared between the two groups and were correlated with clinical characteristics, i.e., Insomnia Severity Index (ISI), Pittsburgh Sleep Quality Index (PSQI), Self-rating Anxiety Scale (SAS), Self-rating Depression Scale (SDS) in the patients' group. Results: The best classifier could reach up to an accuracy of 81.5%, with a sensitivity of 84.9%, specificity of 79.1%, and area under the receiver operating characteristic curve (AUC) of 83.0% (all P < 0.001). Right anterior insular cortex (BA48), left precuneus (BA7), and left middle frontal gyrus (BA8) showed high classification weights. In addition, the right anterior insular cortex (BA48) and left middle frontal gyrus (BA8) were the overlapping regions between MVPA and group comparison. Correlation analysis showed that FCS in left middle frontal gyrus and head of right caudate nucleus were correlated with PSQI and SDS, respectively. Conclusion: The current study suggests abnormal FCS in right anterior insular cortex (BA48) and left middle frontal gyrus (BA8) might serve as a potential neuromarkers for PI.
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Affiliation(s)
- Chao Li
- Department of Medical Imaging, Guangdong Second Provincial General Hospital, Guangzhou, China
| | - Yuanqi Mai
- Maoming People's Hospital, Guangdong, China
| | - Mengshi Dong
- Department of Radiology, The First Affiliated Hospital of China Medical University, Shenyang, China
| | - Yi Yin
- Department of Medical Imaging, Guangdong Second Provincial General Hospital, Guangzhou, China
| | - Kelei Hua
- Department of Medical Imaging, Guangdong Second Provincial General Hospital, Guangzhou, China
| | - Shishun Fu
- Department of Medical Imaging, Guangdong Second Provincial General Hospital, Guangzhou, China
| | - Yunfan Wu
- Department of Medical Imaging, Guangdong Second Provincial General Hospital, Guangzhou, China
| | - Guihua Jiang
- Department of Medical Imaging, Guangdong Second Provincial General Hospital, Guangzhou, China
- Department of Medical Imaging, The Affiliated Guangdong Second Provincial General Hospital of Southern Medical University, Guangzhou, China
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31
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Abstract
Previous studies have indicated that sleep plays an important role in emotional memory and decision-making. However, very little attention has been given to emotional memory and decision-making in patients with primary insomnia (PI). We investigated whether PI influences the accuracy of emotional memory and social decision-making.We examined 25 patients with PI and 20 healthy controls (HC) using an emotional picture memory task and the Iowa Gambling Task (IGT). In the emotional picture memory task, participants completed two testing sessions: an emotional picture evaluation and a delayed recognition phase. During the emotional picture evaluation phase, participants were presented with 48 pictures with different valence (16 positive, 16 neutral, and 16 negative), which they had to evaluate for emotional valence and arousal. During the recognition phase, participants were asked to make a yes/no memory assessment of a set of pictures, which contained the 48 target pictures intermingled with 48 non-target pictures.The performance of the participants with PI was the same as that of the HC in the emotional picture evaluation task. However, the PI group showed worse recognition of the positive and neutral pictures than did the HC group, although recognition of negative pictures was similar in the 2 groups. In the IGT, participants in the PI group more frequently selected cards from the risky decks as the game progressed and selected more disadvantageous cards than did participants in the HC group after the first block.Our findings suggest that insomnia had different effects on memory, depending on the valence of the memory. Specifically, memory performance was impaired for positive and neutral items, but the recognition of negative stimuli seemed to be more resistant to the effects of insomnia. Our results also suggest that decision-making, which is known to be mediated by the ventromedial prefrontal cortex, including decision-making under conditions of uncertainty, may be vulnerable in PI.
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Affiliation(s)
- Xi Chunhua
- Department of Neurology, The Third Affiliated Hospital of Anhui Medical University
- Neuropsychology Laboratory, Department of Neurology, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui Province, China
| | - Ding Jiacui
- Department of Psychiatry Six Ward, Mental Health Center of Anhui Province
| | - Li Xue
- Department of Neurology, The Third Affiliated Hospital of Anhui Medical University
| | - Wang Kai
- Neuropsychology Laboratory, Department of Neurology, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui Province, China
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32
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Song P, Lin H, Li S, Wang L, Liu J, Li N, Wang Y. Repetitive transcranial magnetic stimulation (rTMS) modulates time-varying electroencephalography (EEG) network in primary insomnia patients: a TMS-EEG study. Sleep Med 2019; 56:157-163. [DOI: 10.1016/j.sleep.2019.01.007] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/08/2018] [Revised: 12/04/2018] [Accepted: 01/07/2019] [Indexed: 12/11/2022]
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33
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Lan DY, Zhu PW, He Y, Xu QH, Su T, Li B, Shi WQ, Lin Q, Yang YC, Yuan Q, Fang JW, Li QH, Shao Y. Gray Matter Volume Changes in Patients With Acute Eye Pain: A Voxel-Based Morphometry Study. Transl Vis Sci Technol 2019; 8:1. [PMID: 30627476 PMCID: PMC6322711 DOI: 10.1167/tvst.8.1.1] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2018] [Accepted: 10/21/2018] [Indexed: 02/06/2023] Open
Abstract
Purpose The present study was attempted to compare the differences in gray matter volume (GMV) between the acute eye pain (EP) patients and the healthy controls (HCs) using voxel-based morphometry (VBM), and to explore the relationship with clinical features and behavioral performance. Methods A total of 24 patients (17 males, 7 females) with acute EP and 24 (17 males, 7 females) age-, sex-, and education-matched HCs were recruited from the Ophthalmology Department of the First Affiliated Hospital of Nanchang University. Functional magnetic resonance imaging (fMRI) scans were conducted in all subjects. We analyzed the original three-dimensional (3D) T1 brain images by VBM and compared the GMV values with the HCs. The acute EP patients can be distinguished from the HCs by receiver operating characteristic (ROC) curve. Results Compared with HCs, the acute EP patients had significantly lower GMV values in the brain regions of the left cerebellum posterior lobe, the left limbic lobe, the right insula, the left insula, the left thalamus, the left caudate, and the right cuneus. In addition, the WMV values of the whole brain in acute EP patients decreased slightly. Conclusions These results demonstrated that the acute EP patients showed an abnormal reduction in GMV in some brain regions, which might provide valuable information for further exploration of underlying neural mechanisms. These abnormal brain regions may reflect the functional disorders of acute EP patients in somatosensory, motor, cognitive functions, and so on. Translational Relevance The VBM study provides a diagnostic method for identifying the cause of acute EP, additionally, a novel direction was presented for further exploration of underlying neural mechanisms of acute EP.
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Affiliation(s)
- Dong-Yi Lan
- Department of Ophthalmology, The First Affiliated Hospital of Nanchang University, Jiangxi Province Clinical Ophthalmology Institute, Nanchang, Jiangxi, China
| | - Pei-Wen Zhu
- Department of Ophthalmology, The First Affiliated Hospital of Nanchang University, Jiangxi Province Clinical Ophthalmology Institute, Nanchang, Jiangxi, China
| | - Ying He
- Department of Ophthalmology, The First Affiliated Hospital of Nanchang University, Jiangxi Province Clinical Ophthalmology Institute, Nanchang, Jiangxi, China
| | - Qian-Hui Xu
- Department of Ophthalmology, The First Affiliated Hospital of Nanchang University, Jiangxi Province Clinical Ophthalmology Institute, Nanchang, Jiangxi, China
| | - Ting Su
- Department of Ophthalmology, The First Affiliated Hospital of Nanchang University, Jiangxi Province Clinical Ophthalmology Institute, Nanchang, Jiangxi, China.,Eye Institute of Xiamen University, Fujian Provincial Key Laboratory of Ophthalmology and Visual Science, Xiamen, Fujian Province, China
| | - Biao Li
- Department of Ophthalmology, The First Affiliated Hospital of Nanchang University, Jiangxi Province Clinical Ophthalmology Institute, Nanchang, Jiangxi, China
| | - Wen-Qing Shi
- Department of Ophthalmology, The First Affiliated Hospital of Nanchang University, Jiangxi Province Clinical Ophthalmology Institute, Nanchang, Jiangxi, China
| | - Qi Lin
- Department of Ophthalmology, The First Affiliated Hospital of Nanchang University, Jiangxi Province Clinical Ophthalmology Institute, Nanchang, Jiangxi, China
| | - Yan-Chang Yang
- Department of Ophthalmology, The First Affiliated Hospital of Nanchang University, Jiangxi Province Clinical Ophthalmology Institute, Nanchang, Jiangxi, China
| | - Qing Yuan
- Department of Ophthalmology, The First Affiliated Hospital of Nanchang University, Jiangxi Province Clinical Ophthalmology Institute, Nanchang, Jiangxi, China
| | - Jian-Wen Fang
- Department of Ophthalmology, The First Affiliated Hospital of Nanchang University, Jiangxi Province Clinical Ophthalmology Institute, Nanchang, Jiangxi, China
| | - Qing-Hai Li
- Department of Ophthalmology, The First Affiliated Hospital of Nanchang University, Jiangxi Province Clinical Ophthalmology Institute, Nanchang, Jiangxi, China
| | - Yi Shao
- Department of Ophthalmology, The First Affiliated Hospital of Nanchang University, Jiangxi Province Clinical Ophthalmology Institute, Nanchang, Jiangxi, China
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Wu Y, Liu M, Zeng S, Ma X, Yan J, Lin C, Xu G, Li G, Yin Y, Fu S, Hua K, Li C, Wang T, Li C, Jiang G. Abnormal Topology of the Structural Connectome in the Limbic Cortico-Basal-Ganglia Circuit and Default-Mode Network Among Primary Insomnia Patients. Front Neurosci 2018; 12:860. [PMID: 30532688 PMCID: PMC6266325 DOI: 10.3389/fnins.2018.00860] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2018] [Accepted: 11/05/2018] [Indexed: 12/18/2022] Open
Abstract
Purpose: Primary insomnia (PI) is the second most common mental disorder. However, the topologic alterations in structural brain connectome in patients with PI remain largely unknown. Methods: A total of 44 PI patients and 46 age-, gender-, and education level matched healthy control (HC) participants were recruited in this study. Diffusion tensor imaging (DTI) and resting state MRI were used to construct structural connectome for each participant, and the network parameters were employed by non-parametric permutations to evaluate the significant differences between the two groups. Relationships between abnormal network metrics and clinical characteristics, including the disease duration, the Pittsburgh Sleep Quality Index (PSQI), the Insomnia Severity Index (ISI), the Self-Rating Anxiety Scale (SAS), and the Self-Rating Depression Scale (SDS), were investigated with Spearman's correlation analysis in PI patients. Results: PI patients demonstrated small-world architecture with lower global (P = 0.005) and local (P = 0.035) efficiencies compared with the HC group. The unique hub nodal properties in PI patients were mainly in the right limbic cortico-basal-ganglia circuit. Five disrupted subnetworks in PI patients were observed in the limbic cortico-basal-ganglia circuit and left default-mode networks (DMN) (P < 0.05, NBS corrected). Moreover, most unique hub nodal properties in the right limbic cortico-basal-ganglia circuit were significantly correlated with disease duration, and clinical characteristics (SAS, SDS, ISI scores) in PI processing. Conclusion: These findings suggested the abnormal anatomical network architecture may be closely linked to clinical characteristics in PI. The study provided novel insights into the neural substrates underlying symptoms and neurophysiologic mechanisms of PI.
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Affiliation(s)
- Yunfan Wu
- The Second School of Clinical Medicine, Southern Medical University, Guangzhou, China.,Department of Medical Imaging, Guangdong Second Provincial General Hospital, Guangzhou, China
| | - Mengchen Liu
- The Second School of Clinical Medicine, Southern Medical University, Guangzhou, China.,Department of Medical Imaging, Guangdong Second Provincial General Hospital, Guangzhou, China
| | - Shaoqing Zeng
- Department of Medical Imaging, Guangdong Second Provincial General Hospital, Guangzhou, China
| | - Xiaofen Ma
- Department of Medical Imaging, Guangdong Second Provincial General Hospital, Guangzhou, China
| | - Jianhao Yan
- Department of Medical Imaging, Guangdong Second Provincial General Hospital, Guangzhou, China
| | - Chulan Lin
- Department of Medical Imaging, Guangdong Second Provincial General Hospital, Guangzhou, China
| | - Guang Xu
- Department of Medical Imaging, Guangdong Second Provincial General Hospital, Guangzhou, China
| | - Guomin Li
- The Second School of Clinical Medicine, Southern Medical University, Guangzhou, China
| | - Yi Yin
- The Second School of Clinical Medicine, Southern Medical University, Guangzhou, China
| | - Shishun Fu
- The Second School of Clinical Medicine, Southern Medical University, Guangzhou, China
| | - Kelei Hua
- The Second School of Clinical Medicine, Southern Medical University, Guangzhou, China
| | - Chao Li
- Department of Medical Imaging, Guangdong Second Provincial General Hospital, Guangzhou, China
| | - Tianyue Wang
- Department of Medical Imaging, Guangdong Second Provincial General Hospital, Guangzhou, China
| | - Cheng Li
- Department of Medical Imaging, Guangdong Second Provincial General Hospital, Guangzhou, China
| | - Guihua Jiang
- Department of Medical Imaging, Guangdong Second Provincial General Hospital, Guangzhou, China.,The Second School of Clinical Medicine, Southern Medical University, Guangzhou, China
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Yan CQ, Liu CZ, Wang X, Huo JW, Zhou P, Zhang S, Fu QN, Zhang J, Wang ZY, Liu QQ. Abnormal Functional Connectivity of Anterior Cingulate Cortex in Patients With Primary Insomnia: A Resting-State Functional Magnetic Resonance Imaging Study. Front Aging Neurosci 2018; 10:167. [PMID: 29922151 PMCID: PMC5996039 DOI: 10.3389/fnagi.2018.00167] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2018] [Accepted: 05/16/2018] [Indexed: 12/21/2022] Open
Abstract
Background: Recently, there have been many reports about abnormalities regarding structural and functional brain connectivity of the patients with primary insomnia. However, the alterations in functional interaction between the left and right cerebral hemispheres have not been well understood. The resting-state fMRI approach, which reveals spontaneous neural fluctuations in blood-oxygen-level-dependent signals, offers a method to quantify functional interactions between the hemispheres directly. Methods: We compared interhemispheric functional connectivity (FC) between 26 patients with primary insomnia (48.85 ± 12.02 years) and 28 healthy controls (49.07 ± 11.81 years) using a voxel-mirrored homotopic connectivity (VMHC) method. The patients with primary insomnia and healthy controls were matched for age, gender, and education. Brain regions, which had significant differences in VMHC maps between the primary insomnia and healthy control groups, were defined as seed region of interests. A seed-based approach was further used to reveal significant differences of FC between the seeds and the whole contralateral hemisphere. Results: The patients with primary insomnia showed higher VMHC than healthy controls in the anterior cingulate cortex (ACC) bilaterally. The seed-based analyses demonstrated increased FC between the left ACC and right thalamus (and the right ACC and left orbitofrontal cortex) in patients with primary insomnia, revealing abnormal connectivity between the two cerebral hemispheres. The VMHC values in the ACC were positively correlated with the time to fall asleep and Self-Rating Depression Scale scores (SDS). Conclusions: The results demonstrate that there is abnormal interhemispheric resting-state FC in the brain regions of patients with primary insomnia, especially in the ACC. Our finding demonstrates valid evidence that the ACC is an area of interest in the neurobiology of primary insomnia.
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Affiliation(s)
- Chao-Qun Yan
- Department of Acupuncture and Moxibustion, Beijing Hospital of Traditional Chinese Medicine Affiliated to Capital Medical University, Beijing, China
| | - Cun-Zhi Liu
- Department of Acupuncture, Dongfang Hospital, Beijing University of Chinese Medicine, Beijing, China
| | - Xu Wang
- School of Life Sciences, Beijing University of Chinese Medicine, Beijing, China
| | - Jian-Wei Huo
- Department of Radiology, Beijing Hospital of Traditional Chinese Medicine Affiliated to Capital Medical University, Beijing, China
| | - Ping Zhou
- Department of Acupuncture and Moxibustion, Beijing Hospital of Traditional Chinese Medicine Affiliated to Capital Medical University, Beijing, China
| | - Shuai Zhang
- Department of Acupuncture and Moxibustion, Beijing Hospital of Traditional Chinese Medicine Affiliated to Capital Medical University, Beijing, China
| | - Qing-Nan Fu
- Department of Acupuncture and Moxibustion, Beijing Hospital of Traditional Chinese Medicine Affiliated to Capital Medical University, Beijing, China
| | - Jie Zhang
- Department of Acupuncture and Moxibustion, Beijing Hospital of Traditional Chinese Medicine Affiliated to Capital Medical University, Beijing, China
| | - Zhong-Yan Wang
- Department of Radiology, Beijing Hospital of Traditional Chinese Medicine Affiliated to Capital Medical University, Beijing, China
| | - Qing-Quan Liu
- Beijing Key Laboratory of Basic Study on Traditional Chinese Medicine Infectious Diseases, Beijing Hospital of Traditional Chinese Medicine Affiliated to Capital Medical University, Beijing, China
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36
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Li C, Dong M, Yin Y, Hua K, Fu S, Jiang G. Aberrant Effective Connectivity of the Right Anterior Insula in Primary Insomnia. Front Neurol 2018; 9:317. [PMID: 29867727 PMCID: PMC5951943 DOI: 10.3389/fneur.2018.00317] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2018] [Accepted: 04/23/2018] [Indexed: 01/29/2023] Open
Abstract
Objective Daytime cognitive impairment is an essential symptom of primary insomnia (PI). However, the underlying neural substrate remains largely unknown. Many studies have shown that the right anterior insula (rAI) as a key node of salience network (SN) plays a critical role in switching between the executive control network (ECN) and the default mode network (DMN) for better performance of cognitively demanding tasks. Aberrant effective connectivity (directional functional connectivity) of rAI with ECN or DMN may be one reason for daytime cognitive impairment in PI patients. Up to now, no effective connectivity study has been conducted on patients with PI during resting state. Our aim is to investigate the effective connectivity between the rAI and the other voxels in the whole brain in PI. Materials and methods Fifty drug-naive patients with PI and forty age- and sex-matched healthy controls were scanned using resting-state functional MRI. Seed-based Granger causality analysis was used to examine effective connectivity between the rAI, including ventral and dorsal part, and the whole brain. The effective connectivity was compared between the two groups and was correlated with clinical characteristics. Results Compared with controls, patients showed decreased effective connectivity from the rAI to the bilateral precuneus, the left postcentral gyrus (extending to bilateral precuneus) and the bilateral cerebellum posterior lobe, and decreased effective connectivity from the bilateral orbitofrontal cortex (OFC) to the rAI (single voxel P < 0.001, AlphaSim corrected with P < 0.01). In addition, effective connectivity from the ventral rAI to the left postcentral gyrus and from the left OFC to the ventral rAI were significantly negatively correlated with Insomnia Severity Index scores (r = -0.28/P = 0.046 and r = -0.29/P = 0.038, respectively). Conclusion The present study is the first to reveal aberrant effective connectivity between the SN hub (rAI) and the posterior DMN hub (precuneus) as well as decision-making region (OFC) and sensori-motor region in PI. These findings suggest an aberrant salience processing system of the rAI in PI patients.
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Affiliation(s)
- Chao Li
- Department of Medical Imaging, Guangdong Second Provincial General Hospital, Guangzhou, China
| | - Mengshi Dong
- Department of Medical Imaging, Guangdong Second Provincial General Hospital, Guangzhou, China
| | - Yi Yin
- Department of Medical Imaging, Guangdong Second Provincial General Hospital, Guangzhou, China
| | - Kelei Hua
- Department of Medical Imaging, Guangdong Second Provincial General Hospital, Guangzhou, China
| | - Shishun Fu
- Department of Medical Imaging, Guangdong Second Provincial General Hospital, Guangzhou, China
| | - Guihua Jiang
- Department of Medical Imaging, Guangdong Second Provincial General Hospital, Guangzhou, China
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37
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Liu CH, Liu CZ, Zhu XQ, Fang JL, Lu SL, Tang LR, Wang CY, Liu QQ. Increased Posterior Insula-Sensorimotor Connectivity Is Associated with Cognitive Function in Healthy Participants with Sleep Complaints. Front Hum Neurosci 2018; 12:35. [PMID: 29467636 PMCID: PMC5808346 DOI: 10.3389/fnhum.2018.00035] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2017] [Accepted: 01/22/2018] [Indexed: 11/13/2022] Open
Abstract
Insomnia is characterized by sensory hypersensitivity and cognitive impairments. Recent work has identified the insula as a central brain region involved in both bottom-up gating of sensory information and top-down cognitive control. However, the specific relationships between insular subregion connectivity and emotional and cognitive functions remain unclear. In this study, resting-state functional magnetic resonance imaging data were obtained from 25 healthy participants with sleep complaints (HPS) and 25 age-, gender- and educational level-matched healthy participants without insomnia complaints (HP). We performed insular subregion (ventral anterior, dorsal anterior and posterior) functional connectivity (FC) analyses, and cognitive function was measured with several validated test procedures (e.g., the Wisconsin Card Sorting Test [WCST], Continuous Performance Test [CPT] and Trail making Test [TMT]). There were no significant differences between the two groups for WCST, CPT and TMT scores. The HPS group showed enhanced connectivity from the right posterior insula (R-PI) to the left postcentral gyrus (L-postCG) compared to HP group. WCST random errors (RE), sleep disturbance scores and HAMA scores correlated with this connectivity measurement in both HP and HPS groups. Our results provide direct evidence that the posterior insula (PI) synchronizes with sensorimotor areas to detect homeostatic changes and suggest that alteration of the latter is related to executive dysfunction in subjects with insomnia.
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Affiliation(s)
- Chun-Hong Liu
- Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Beijing Institute of Traditional Chinese Medicine, Beijing, China.,Department of Radiology and Psychiatry, Beijing Anding Hospital, Capital Medical University, Beijing, China
| | - Cun-Zhi Liu
- The department of Acupuncture and Moxibustion, Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Beijing Key Laboratory of Acupuncture Neuromodulation, Beijing, China
| | - Xue-Qi Zhu
- Department of Psychosomatic Medicine/Administration of Medical Institution Conducting Clinical Trials for Human Used Drug, Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Beijing, China
| | - Ji-Liang Fang
- Functional Brain Imaging Lab, Department of Radiology, Guang An Men Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Shun-Li Lu
- Department of Radiology and Psychiatry, Beijing Anding Hospital, Capital Medical University, Beijing, China
| | - Li-Rong Tang
- Department of Radiology and Psychiatry, Beijing Anding Hospital, Capital Medical University, Beijing, China
| | - Chuan-Yue Wang
- Department of Radiology and Psychiatry, Beijing Anding Hospital, Capital Medical University, Beijing, China
| | - Qing-Quan Liu
- Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Beijing Institute of Traditional Chinese Medicine, Beijing, China
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Li Z, Chen R, Guan M, Wang E, Qian T, Zhao C, Zou Z, Beck T, Shi D, Wang M, Zhang H, Li Y. Disrupted brain network topology in chronic insomnia disorder: A resting-state fMRI study. NEUROIMAGE-CLINICAL 2018; 18:178-185. [PMID: 29387533 PMCID: PMC5789127 DOI: 10.1016/j.nicl.2018.01.012] [Citation(s) in RCA: 42] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/04/2017] [Revised: 12/26/2017] [Accepted: 01/15/2018] [Indexed: 01/01/2023]
Abstract
This study investigated the topological characteristics of brain functional networks in chronic insomnia disorder (CID) patients. The resting-state functional magnetic resonance imaging and graph theory analysis method were applied to investigate the brain functional connectome patterns among 45 CID patients and 32 healthy controls. The brain functional connectome was constructed by thresholding partial correlation matrices of 90 brain regions from an automated anatomical labeling atlas. The topologic properties of brain functional connectomes at both global and nodal levels were tested. The CID patients had decreased number of module (p = .014) and hierarchy (p = .038), and increased assortativity (p = .035). Furthermore, some brain regions located in the default mode network, dorsal attention network, and sensory-motor network in these patients showed altered nodal centralities. Within these areas, the node betweenness of right central paracentral lobule had positive correlation with the Pittsburgh Sleep Quality Index score (R = 0.319, p = .039). The results imply that functional disruptions of CID patients may be related to disruptions in global and regional topological organization of the brain functional connectome, and provide new and important insights to understand the pathophysiological mechanisms of CID. Chronic insomnia disorder (CID) patients had disrupted global topological properties. Many brain regions of CID patients showed altered nodal centralities involving three different resting networks. Functional disruption of right central paracentral lobule may be a target for therapeutic intervention in pediatric CID. The disruption of topological organization might be explain the mechanism/reason of functional disruptions of CID.
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Affiliation(s)
- Zhonglin Li
- People's Hospital of Zhengzhou University, Department of Radiology, China; Henan Key Laboratory for Medical Imaging of Neurological Diseases, Department of Functional Imaging, China
| | - Rui Chen
- People's Hospital of Zhengzhou University, Department of Radiology, China; Henan Key Laboratory for Medical Imaging of Neurological Diseases, Department of Functional Imaging, China
| | - Min Guan
- People's Hospital of Zhengzhou University, Department of Radiology, China; Henan Key Laboratory for Medical Imaging of Neurological Diseases, Department of Functional Imaging, China
| | - Enfeng Wang
- People's Hospital of Zhengzhou University, Department of Radiology, China; Henan Key Laboratory for Medical Imaging of Neurological Diseases, Department of Functional Imaging, China
| | - Tianyi Qian
- Siemens Healthcare, MR Collaboration, NEA, Beijing, China
| | - Cuihua Zhao
- People's Hospital of Zhengzhou University, Department of Radiology, China; Henan Key Laboratory for Medical Imaging of Neurological Diseases, Department of Functional Imaging, China
| | - Zhi Zou
- People's Hospital of Zhengzhou University, Department of Radiology, China; Henan Key Laboratory for Medical Imaging of Neurological Diseases, Department of Functional Imaging, China
| | - Thomas Beck
- Siemens Healthcare, MR Strategy and Innovation, Erlangen, Germany
| | - Dapeng Shi
- People's Hospital of Zhengzhou University, Department of Radiology, China; Henan Key Laboratory for Medical Imaging of Neurological Diseases, Department of Functional Imaging, China
| | - Meiyun Wang
- People's Hospital of Zhengzhou University, Department of Radiology, China; Henan Key Laboratory for Medical Imaging of Neurological Diseases, Department of Functional Imaging, China
| | - Hongju Zhang
- People's Hospital of Zhengzhou University, Department of Neurology, China.
| | - Yongli Li
- People's Hospital of Zhengzhou University, Department of Radiology, China; Henan Key Laboratory for Medical Imaging of Neurological Diseases, Department of Functional Imaging, China.
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Ma X, Jiang G, Fu S, Fang J, Wu Y, Liu M, Xu G, Wang T. Enhanced Network Efficiency of Functional Brain Networks in Primary Insomnia Patients. Front Psychiatry 2018; 9:46. [PMID: 29515469 PMCID: PMC5826384 DOI: 10.3389/fpsyt.2018.00046] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
Accumulating evidence from neuroimaging studies suggests that primary insomnia (PI) affects interregional neural coordination of multiple interacting functional brain networks. However, a complete understanding of the whole-brain network organization from a system-level perspective in PI is still lacking. To this end, we investigated in topological organization changes in brain functional networks in PI. 36 PI patients and 38 age-, sex-, and education-matched healthy controls were recruited. All participants underwent a series of neuropsychological assessments and resting-state functional magnetic resonance imaging scans. Individual whole-brain functional network were constructed and analyzed using graph theory-based network approaches. There were no significant differences with respect to age, sex, or education between groups (P > 0.05). Graph-based analyses revealed that participants with PI had a significantly higher total number of edges (P = 0.022), global efficiency (P = 0.014), and normalized global efficiency (P = 0.002), and a significantly lower normalized local efficiency (P = 0.042) compared with controls. Locally, several prefrontal and parietal regions, the superior temporal gyrus, and the thalamus exhibited higher nodal efficiency in participants with PI (P < 0.05, false discovery rate corrected). In addition, most of these regions showed increased functional connectivity in PI patients (P < 0.05, corrected). Finally, altered network efficiency was correlated with neuropsychological variables of the Epworth Sleepiness Scale and Insomnia Severity Index in patients with PI. PI is associated with abnormal organization of large-scale functional brain networks, which may account for memory and emotional dysfunction in people with PI. These findings provide novel implications for neural substrates associated with PI.
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Affiliation(s)
- Xiaofen Ma
- Department of Medical Imaging, Guangdong Second Provincial General Hospital, Guangzhou, China
| | - Guihua Jiang
- Department of Medical Imaging, Guangdong Second Provincial General Hospital, Guangzhou, China
| | - Shishun Fu
- Department of Medical Imaging, Guangdong Second Provincial General Hospital, Guangzhou, China
| | - Jin Fang
- Department of Medical Imaging, Guangdong Second Provincial General Hospital, Guangzhou, China
| | - Yunfan Wu
- Department of Medical Imaging, Guangdong Second Provincial General Hospital, Guangzhou, China
| | - Mengchen Liu
- Department of Medical Imaging, Guangdong Second Provincial General Hospital, Guangzhou, China
| | - Guang Xu
- Department of Neurology, Guangdong Second Provincial General Hospital, Guangzhou, China
| | - Tianyue Wang
- Department of Medical Imaging, Guangdong Second Provincial General Hospital, Guangzhou, China
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40
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Pace-Schott EF, Zimmerman JP, Bottary RM, Lee EG, Milad MR, Camprodon JA. Resting state functional connectivity in primary insomnia, generalized anxiety disorder and controls. Psychiatry Res 2017; 265:26-34. [PMID: 28500965 PMCID: PMC5505504 DOI: 10.1016/j.pscychresns.2017.05.003] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2017] [Revised: 05/05/2017] [Accepted: 05/07/2017] [Indexed: 11/17/2022]
Abstract
Sleep abnormalities are extremely common in anxiety disorders and may contribute to their development and persistence. Their shared pathophysiological mechanisms could thus serve as biomarkers or targets for novel therapeutics. Individuals with Primary Insomnia were age- and sex-matched to controls and to persons with Generalized Anxiety Disorder. All underwent fMRI resting-state scans at 3-T. In Primary Insomnia and controls, sleep was recorded for 2 weeks using diaries and actigraphy. All participants completed state-anxiety and neuroticism inventories. Whole-brain connectivity of 6 fear- and extinction-related seeds were compared between the 3 groups using ANOVA. The only significant between-group main effect was seen for connectivity between the left amygdala seed and a bilateral cluster in the rostral anterior cingulate cortex. The latter is believed to exert top-down control over amygdala activity and their interaction may thus constitute an emotion regulatory circuit. This connectivity was significantly greatest in controls while Primary Insomnia was intermediate between that of controls and Generalized Anxiety Disorder. Across Primary Insomnia and control subjects, mean connectivity decreased with poorer sleep. Across all 3 groups, connectivity decreased with greater neuroticism and pre-scan anxiety. Decreased top-down control of the amygdala may increase risk of developing an anxiety disorder with preexisting Primary Insomnia.
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Affiliation(s)
- Edward F Pace-Schott
- Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Charlestown, MA, USA; MGH/HST Martinos Center for Biomedical Imaging, Charlestown, MA, USA.
| | - Jared P Zimmerman
- Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Charlestown, MA, USA; MGH/HST Martinos Center for Biomedical Imaging, Charlestown, MA, USA
| | - Ryan M Bottary
- Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Charlestown, MA, USA; MGH/HST Martinos Center for Biomedical Imaging, Charlestown, MA, USA
| | - Erik G Lee
- Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Charlestown, MA, USA; MGH/HST Martinos Center for Biomedical Imaging, Charlestown, MA, USA
| | - Mohammed R Milad
- Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Charlestown, MA, USA; MGH/HST Martinos Center for Biomedical Imaging, Charlestown, MA, USA
| | - Joan A Camprodon
- Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Charlestown, MA, USA; MGH/HST Martinos Center for Biomedical Imaging, Charlestown, MA, USA
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41
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Li X, Guo S, Wang C, Wang B, Sun H, Zhang X. Increased interhemispheric resting-state functional connectivity in healthy participants with insomnia symptoms: A randomized clinical consort study. Medicine (Baltimore) 2017; 96:e7037. [PMID: 28682863 PMCID: PMC5502136 DOI: 10.1097/md.0000000000007037] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND Abnormalities within the insular cortex of the salience and thalamus of the hyperarousal network have been increasingly reported in healthy participants with insomnia symptoms by recent resting-state functional magnetic resonance imaging (rsfMRI) studies. However, little is known about the changes in functional interaction between the bilateral cerebral hemispheres in healthy participants with insomnia symptoms. METHODS In a randomized trial, 27 healthy participants with insomnia symptoms and 27 age-, gender-, and educational level-matched healthy participants without insomnia symptoms underwent rsfMRI. Voxel-mirrored homotopic connectivity (VMHC) was used to measure functional connectivity between any pair of symmetrical interhemispheric voxels (i.e., functional homotopy). RESULTS The healthy participants with insomnia symptoms displayed significantly increased VMHC compared to healthy participants without insomnia symptoms in the bilateral thalamus/posterior insula (including anterior insula), fusiform, middle cingulate gyrus, inferior parietal lobe, and postcentral gyrus. No regions of decreased VMHC were detected in healthy participants with insomnia symptoms. There were significantly positive correlations between the VMHC values in the anterior cingulate cortex (ACC) and sleep disturbance scores in all healthy participants. CONCLUSIONS Insomnia is associated with substantial impairment of interhemispheric coordination within the default mode (ACC), salience (insula), hyperarousal (thalamus/posterior insula), and visual (fusiform) networks.
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Affiliation(s)
- Xuhua Li
- Department of Neurology, Linyi People's Hospital, Linyi
| | - Shougang Guo
- Department of Neurology, Shandong Provincial Hospital Affiliated to Shandong University, Jinan, China
| | - Chunjuan Wang
- Department of Neurology, Shandong Provincial Hospital Affiliated to Shandong University, Jinan, China
| | - Baojie Wang
- Department of Neurology, Shandong Provincial Hospital Affiliated to Shandong University, Jinan, China
| | - Hao Sun
- Department of Neurology, Shandong Provincial Hospital Affiliated to Shandong University, Jinan, China
| | - Xiaoting Zhang
- Department of Neurology, Shandong Provincial Hospital Affiliated to Shandong University, Jinan, China
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