a Seoul National University College of Medicine , Seoul , Republic of Korea.
b Neuroscience Research Institute, Gachon University , Incheon , Republic of Korea.
Behav Sleep Med. 2019 Sep-Oct;17(5):621-633. doi: 10.1080/15402002.2018.1435546. Epub 2018 Feb 16.
: In the present study, we compared differences in brain activity during the Stroop task between patients with chronic insomnia disorder (CID) and good sleepers (GS). Furthermore, we evaluated changes in Stroop task-related brain activity after cognitivebehavioral therapy for insomnia (CBT-I). : The final analysis included 21 patients with CID and 25 GS. All participants underwent functional magnetic resonance imaging (fMRI) while performing the color-word Stroop task. CBT-I, consisting of 5 sessions, was administered to 14 patients with CID in the absence of medication. After CBT-I, fMRI was repeated in the patients with CID while performing the same task. Sleep-related questionnaires and sleep variables from a sleep diary were also obtained before and after CBT-I. : No significant differences in behavioral performance in the Stroop task or task-related brain activation were observed between the CID and GS groups. No changes in behavioral performance or brain activity were found after CBT-I. However, clinical improvement in the Insomnia Severity Index (ISI) score was significantly associated with changes in the Stroop task-related regional blood oxygen level-dependent signals in the left supramarginal gyrus. : Our findings suggest that cognitive impairment in patients with CID was not detectable by the Stroop task or Stroop task-related brain activation on fMRI. Moreover, there was no altered brain activity during the Stroop task after CBT-I. However, the ISI score reflected changes in the neural correlates of cognitive processes in patients with CID after CBT-I.
在本研究中，我们比较了慢性失眠障碍（CID）患者和睡眠良好者（GS）在 Stroop 任务期间大脑活动的差异。此外，我们评估了失眠认知行为疗法（CBT-I）后 Stroop 任务相关脑活动的变化。
最终分析包括 21 名 CID 患者和 25 名 GS。所有参与者在执行颜色-词 Stroop 任务时接受功能磁共振成像（fMRI）检查。14 名 CID 患者在不服用药物的情况下接受了 5 次 CBT-I。在 CBT-I 后，患者再次执行相同任务时进行 fMRI。在 CBT-I 前后，还获得了与睡眠相关的问卷和睡眠日记中的睡眠变量。
在 Stroop 任务中的行为表现或任务相关的大脑激活方面，CID 和 GS 组之间没有显著差异。CBT-I 后，行为表现或大脑活动没有变化。然而，失眠严重程度指数（ISI）评分的临床改善与左缘上回 Stroop 任务相关区域血氧水平依赖信号的变化显著相关。
我们的发现表明，CID 患者的认知障碍无法通过 Stroop 任务或 fMRI 上的 Stroop 任务相关大脑激活来检测。此外，CBT-I 后，Stroop 任务期间的大脑活动没有改变。然而，ISI 评分反映了 CBT-I 后 CID 患者认知过程神经相关变化。
