No abstract

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

Addiction is characterized by a persistent cycle of drug seeking and taking as well as high relapse rate. Neuroimaging technology offers an opportunity to elucidate the brain neurobiology in addiction, with particular attention to those circuits implicated in reward processing, memory and cognitive control etc. Here, we summarized the neuroimaging evidence in addiction to reveal the brain structural and functional plasticity changes and recovery with prolonged abstinence. Moreover, neuroimaging combined with machine learning may allow a prediction of relapse risk. Repeated transcranial magnetic stimulation (rTMS) has been proved to be effective in drug addiction by modulating the brain region and circuits. We further proposed neuronavigated rTMS may provide a scientific and advanced strategy to improve the therapy by promoting accurate individualized stimulation targets. In conclusion, combination of neuroimaging with multimodal fusion, machine learning and neurostimulation has the potential to extend our understanding of the brain neuroplasticity and therapy in addiction. We expected this paper would promote the translation and treatment in addiction and propound recommendations for the urgent challenges to mitigate the addiction relapse rate in future.