School of Life Science and Technology, Xidian University, Xi'an, Shanxi, 710071, People's Republic of China.
Engineering Research Center of Molecular and Neuro Imaging Ministry of Education, Xi'an, People's Republic of China.
Brain Imaging Behav. 2019 Oct;13(5):1193-1201. doi: 10.1007/s11682-018-9932-y.
Primary insomnia (PI) is associated with deteriorating attention, memory, physical and mood complaints. Based on the extensive literature demonstrating the critical roles of the thalamus in sleep regulation, we hypothesized that insomnia would be associated with functional and structural changes of the thalamus. This information is needed to better understand the neural mechanisms of insomnia, and would be useful for informing future attempts to alleviate or treat insomnia symptoms. Twenty-seven PI patients and 39 matched healthy controls were included in the present study. Subcortical volume and resting state functional connectivity (RSFC) of thalamus were compared between groups, and the relationships between neuroimaging differences and clinical features, including the Pittsburgh Sleep Quality Index (PSQI), the Insomnia Severity Index Scale (ISI), the Self-Rating Anxiety Scale (SAS) and the Self-Rating Depression Scale (SDS), also be explored. Compared with the control group, the PI group showed significantly reduced volume of thalamus. In addition, several brain regions showed reduced RSFC with thalamus in PI patients, such as anterior cingulate cortex (ACC), orbitofrontal cortex, hippocampus, caudate and putamen. Correlation analyses revealed that, several of these RSFC patterns were negatively correlated with PSQI score among PI patients, including thalamic connections with the putamen, caudate, hippocampus. Negative correlation was also observed between the RSFC strength of right thalamus-right ACC and SDS score in PI patients. This work demonstrates the structural and functional abnormalities of the thalamus in PI patients that were associated with key clinical features of insomnia. These data further highlight the important role of the thalamus in sleep and PI.
原发性失眠（PI）与注意力、记忆力、身体和情绪问题恶化有关。基于大量文献表明丘脑在睡眠调节中的关键作用，我们假设失眠与丘脑的功能和结构变化有关。这些信息对于更好地了解失眠的神经机制很重要，并且对于告知未来减轻或治疗失眠症状的尝试也很有用。本研究纳入了 27 名 PI 患者和 39 名匹配的健康对照者。比较了两组间丘脑的皮质下体积和静息状态功能连接（RSFC），并探讨了神经影像学差异与临床特征（包括匹兹堡睡眠质量指数（PSQI）、失眠严重程度指数量表（ISI）、自评焦虑量表（SAS）和自评抑郁量表（SDS））之间的关系。与对照组相比，PI 组丘脑体积明显减小。此外，PI 患者丘脑与前扣带回皮质（ACC）、眶额皮质、海马、尾状核和壳核等几个脑区的 RSFC 减少。相关分析显示，PI 患者中，这些 RSFC 模式中的几个与 PSQI 评分呈负相关，包括丘脑与壳核、尾状核、海马的连接。PI 患者右丘脑-右 ACC 的 RSFC 强度与 SDS 评分之间也存在负相关。这项工作表明 PI 患者的丘脑存在结构和功能异常，与失眠的关键临床特征有关。这些数据进一步强调了丘脑在睡眠和 PI 中的重要作用。
