Neuroimaging Insights into Insomnia

Spiegelhalder, Kai; Regen, Wolfram; Baglioni, Chiara; Nissen, Christoph; Riemann, Dieter; Kyle, Simon D.

doi:10.1007/s11910-015-0527-3

Cited by 63 publications

(68 citation statements)

References 86 publications

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“…25 A meta-analysis of subjective and objective measures in primary insomnia revealed a disproportionate increase of PSQI-reported disturbance relative to PSG findings. 26 A previous evaluation of TMD patients reported largely normal PSG findings in the context of elevated prevalence of primary insomnia diagnosis. 17,18 The present study provides further evidence for subjectively poor sleep without clear objective findings in TMD cases, a pattern consistent with chronic insomnia.…”

Section: Discussionmentioning

confidence: 92%

Depressive symptoms account for differences between self‐reported versus polysomnographic assessment of sleep quality in women with myofascial TMD

Dubrovsky

Janal

Lavigne

et al. 2017

J of Oral Rehabilitation

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Background Temporomandibular disorder (TMD) patients report poor sleep quality on the Pittsburgh Sleep Quality Index (PSQI). However, polysomnographic (PSG) studies show meager evidence of sleep disturbance on standard physiological measures. Objective The present aim was to analyze self-reported sleep quality in TMD as a function of myofascial pain, PSG parameters, and depressive symptomatology. Methods PSQI scores from 124 women with myofascial TMD and 46 matched controls were hierarchically regressed onto TMD presence, ratings of pain intensity and pain-related disability, in-lab PSG variables, and depressive symptoms (Symptoms Checklist-90). Results Relative to controls, TMD cases had higher PSQI scores, representing poorer subjective sleep, and more depressive symptoms (both P < 0.001). Higher PSQI scores were strongly predicted by more depressive symptoms (P < 0.001, R2 = 26%). Of 19 PSG variables, two had modest contributions to higher PSQI scores: longer REM latency in TMD cases (P = 0.01, R2 = 3%) and more awakenings in all participants (P = 0.03, R2 = 2%). After accounting for these factors, TMD presence and pain ratings were not significantly related to PSQI scores. Conclusion These results show that reported poor sleep quality in TMD is better explained by depressive symptoms than by PSG-assessed sleep disturbances or myofascial pain. As TMD cases lacked typical PSG features of clinical depression, the results suggest a negative cognitive bias in TMD and caution against interpreting self-report sleep measures as accurate indicators of PSG sleep disturbance. Future investigations should take account of depressive symptomatology when interpreting reports of poor sleep.

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Section: Discussionmentioning

confidence: 92%

Depressive symptoms account for differences between self‐reported versus polysomnographic assessment of sleep quality in women with myofascial TMD

Dubrovsky

Janal

Lavigne

et al. 2017

J of Oral Rehabilitation

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“…The prefrontal cortex has demonstrated its important roles in alertness, attention, and higher-order cognitive processes for insomnia (Thomas et al, 2000; Spiegelhalder et al, 2015). Recently, Li et al demonstrated reduced ALFF values in the left IFG and right MFG in primary insomnia (PI) patients.…”

Section: Discussionmentioning

confidence: 99%

“…Moreover, the thalamus is a complex association of central nuclei that are closely correlated and interposed with the arousal and frontal systems, thus linking to the levels of vigilance and wakefulness of sleep (Bridoux et al, 2015). Overall, the insula of the salience network and the thalamus of the hyperarousal system are essential for insomnia, which indicates the hub of the insula and thalamus in sleep-related activity (Spiegelhalder et al, 2015). Using task-based fMRI, Bell-McGinty et al also discovered increased activation in the right putamen in subjects after total sleep deprivation (TSD), which revealed that changes in the arousal levels may affect performance following TSD (Bell-McGinty et al, 2004).…”

Section: Discussionmentioning

confidence: 99%

“…Recently, numerous structural and functional neuroimaging studies have examined widespread dysfunctions in the fronto-striato-limbic-thalamic regions in insomnia (Drummond et al, 2004; Spiegelhalder et al, 2013, 2015; Riemann et al, 2015). For example, using high-resolution 3D T1-weighted magnetic resonance imaging (MRI), Altena et al discovered that the gray matter volume (GMV) in the left orbitofrontal cortex (OFC) was decreased in 24 insomnia patients, and the GMV of the OFC was strongly positively associated with insomnia scores (Altena et al, 2010).…”

Section: Introductionmentioning

confidence: 99%

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Disrupted Topology of Frontostriatal Circuits Is Linked to the Severity of Insomnia

Lu¹,

Liu

et al. 2017

Front. Neurosci.

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Insomnia is one of the most common health complaints, with a high prevalence of 30~50% in the general population. In particular, neuroimaging research has revealed that widespread dysfunctions in brain regions involved in hyperarousal are strongly correlated with insomnia. However, whether the topology of the intrinsic connectivity is aberrant in insomnia remains largely unknown. In this study, resting-state functional magnetic resonance imaging (rsfMRI) in conjunction with graph theoretical analysis, was used to construct functional connectivity matrices and to extract the attribute features of the small-world networks in insomnia. We examined the alterations in global and local small-world network properties of the distributed brain regions that are predominantly implicated in the frontostriatal network between 30 healthy subjects with insomnia symptoms (IS) and 62 healthy subjects without insomnia symptoms (NIS). Correlations between the small-world properties and clinical measurements were also generated to identify the differences between the two groups. Both the IS group and the NIS group exhibited a small-worldness topology. Meanwhile, the global topological properties didn't show significant difference between the two groups. By contrast, participants in the IS group showed decreased regional degree and efficiency in the left inferior frontal gyrus (IFG) compared with subjects in the NIS group. More specifically, significantly decreased nodal efficiency in the IFG was found to be negatively associated with insomnia scores, whereas the abnormal changes in nodal betweenness centrality of the right putamen were positively correlated with insomnia scores. Our findings suggested that the aberrant topology of the salience network and frontostriatal connectivity is linked to insomnia, which can serve as an important biomarker for insomnia.

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“…A recent review focused on the neural mechanisms of insomnia points out that the alteration of the hyperarousal system (i.e., hypothalamus and brainstem), the reward and salience system (i.e., amygdala, hippocampus, and insula), and the cognitive control system can result in malfunctioning during the wake to sleep transition, sustained sleep difficulties, and cognitive impairment in insomnia. [14] In addition, converging evidence suggests that various core intrinsic connectivity networks are related to insomnia symptoms. Using optimized voxel-based morphometry, Altena et al [15] demonstrate that reduced gray matter volume in the left orbitofrontal cortex is positively associated with insomnia scores in insomnia patients, supporting the reward network as a plausible substrate for the insufficient problem-solving abilities of insomnia.…”

Section: Introductionmentioning

confidence: 99%

Increased interhemispheric resting-state functional connectivity in healthy participants with insomnia symptoms

Guo²,

Wang³

et al. 2017

Medicine

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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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Neuroimaging Insights into Insomnia

Cited by 63 publications

References 86 publications

Depressive symptoms account for differences between self‐reported versus polysomnographic assessment of sleep quality in women with myofascial TMD

Depressive symptoms account for differences between self‐reported versus polysomnographic assessment of sleep quality in women with myofascial TMD

Disrupted Topology of Frontostriatal Circuits Is Linked to the Severity of Insomnia

Increased interhemispheric resting-state functional connectivity in healthy participants with insomnia symptoms

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