Department of Sleep & Cognition, Netherlands Institute for Neuroscience, Royal Netherlands Academy of Arts and Sciences, 1105 BA Amsterdam, The Netherlands.
Biol Psychiatry. 2010 Jan 15;67(2):182-5. doi: 10.1016/j.biopsych.2009.08.003.
Brain mechanisms of chronic insomnia, a highly prevalent condition, have barely been investigated. We demonstrate here a decrease in orbitofrontal gray matter (GM) volume that strongly correlates with the severity of complaints.
In a case-control study, optimized voxel-based morphometry was used to compare the regional brain volumes of 24 medication-free chronic primary insomnia patients (age range 52-74 years, 17 women), carefully selected to exclude psychiatric comorbidity, with those of 13 matched control subjects without sleep problems (age range 50-76 years, 9 women). Additionally, the correlation of regional volumes with insomnia severity was investigated.
Patients had a smaller volume of GM in the left orbitofrontal cortex, strongly correlating (r = -.71) with the subjective severity of insomnia. Furthermore, reduced GM volume was found in the anterior and posterior precuneus. Patients did not show increased GM volume in any area. No group differences were found for white matter volume.
This is the first voxel-based morphometry study showing structural brain correlates of insomnia and their relation with insomnia severity. Functional roles of the affected areas in decision-making and stimulus processing might better guide future research into the poorly understood condition of insomnia.
慢性失眠是一种高发疾病，但人们对其大脑机制的研究甚少。我们在此展示了眶额皮质灰质（GM）体积的减少，其与症状严重程度呈强烈相关性。
在一项病例对照研究中，我们使用优化的基于体素的形态测量学方法比较了 24 名未经药物治疗的慢性原发性失眠症患者（年龄 52-74 岁，17 名女性）和 13 名无睡眠问题的匹配对照组受试者（年龄 50-76 岁，9 名女性）的脑区体积。此外，还研究了脑区体积与失眠严重程度的相关性。
患者左眶额皮质 GM 体积较小，与失眠的主观严重程度呈强烈相关性（r = -.71）。此外，在前扣带回和后扣带回也发现了 GM 体积的减少。患者在任何区域均未显示 GM 体积增加。两组在白质体积上无差异。
这是第一项基于体素的形态测量学研究，显示了失眠的结构脑关联及其与失眠严重程度的关系。受影响区域在决策和刺激处理中的功能作用可能更好地指导对失眠这一了解甚少的疾病的未来研究。
