College of Nursing, University of South Florida, Tampa, Florida.
Department of Psychiatry, University of Missouri-Columbia, Columbia, Missouri.
J Clin Sleep Med. 2024 Feb 1;20(2):293-302. doi: 10.5664/jcsm.10860.
Brain regions involved in insomnia and chronic pain are overlapping and diffuse. The interactive role of physiological arousal in associations between insomnia symptoms and neural regions is unknown. This preliminary study examined whether arousal interacted with sleep in associations with gray matter volume of frontal (dorsolateral prefrontal cortex, anterior cingulate cortex) and temporal (right/left hippocampus) regions in adults with chronic widespread pain and insomnia complaints.
Forty-seven adults with chronic widespread pain and insomnia (mean age = 46.00, standard deviation = 13.88, 89% women) completed 14 daily diaries measuring sleep onset latency (SOL), wake time after sleep onset, and total sleep time (TST), as well as Holter monitor assessments of heart rate variability (measuring physiological arousal), and magnetic resonance imaging. Multiple regressions examined whether average SOL, wake time after sleep onset, or TST were independently or interactively (with arousal/heart rate variability) associated with dorsolateral prefrontal cortex, anterior cingulate cortex, and left/right hippocampus gray matter volumes.
Shorter TST was associated with lower right hippocampus volume. TST also interacted with arousal in its association with right hippocampal volume, Specifically, shorter TST was associated with lower volume at highest and average arousal levels. SOL interacted with arousal in its association with anterior cingulate cortex volume, such that, among individuals with lowest arousal, longer SOL was associated with lower volume.
Preliminary findings highlight the interactive roles of physiological arousal and insomnia symptoms in associations with neural structure in chronic widespread pain and insomnia. Individuals with the highest physiological arousal may be particularly vulnerable to the impact of shorter TST on hippocampal volume loss. Reducing SOL may only impact anterior cingulate cortex volume in those with lower physiological arousal.
Curtis AF, Nair N, Hayse B, et al. Preliminary investigation of the interactive role of physiological arousal and insomnia complaints in gray matter volume alterations in chronic widespread pain. 2024;20(2):293-302.
失眠和慢性疼痛涉及的大脑区域既有重叠也有弥散。生理唤醒在失眠症状与神经区域之间的关联中的交互作用尚不清楚。本初步研究旨在探讨在患有慢性广泛性疼痛和失眠主诉的成年人中，唤醒是否与睡眠相互作用，从而影响额（背外侧前额叶皮质、前扣带回皮质）和颞（右/左海马体）区域的灰质体积。
47 名患有慢性广泛性疼痛和失眠的成年人（平均年龄=46.00，标准差=13.88，89%为女性）完成了 14 天的睡眠日记，记录入睡潜伏期（SOL）、睡眠后醒来时间和总睡眠时间（TST），以及动态心电图监测心率变异性（测量生理唤醒）和磁共振成像。多元回归检验了平均 SOL、睡眠后醒来时间或 TST 是否与背外侧前额叶皮质、前扣带回皮质和左/右海马体灰质体积独立或交互（与唤醒/心率变异性）相关。
TST 较短与右侧海马体体积较低有关。TST 与唤醒之间也存在交互作用，影响其与右侧海马体体积的关联，具体而言，TST 较短与最高和平均唤醒水平的体积较低有关。SOL 与唤醒在与前扣带回皮质体积的关联中存在交互作用，即，在唤醒最低的个体中，较长的 SOL 与较低的体积有关。
初步研究结果强调了生理唤醒和失眠症状在慢性广泛性疼痛和失眠患者的神经结构关联中的交互作用。生理唤醒水平最高的个体可能特别容易受到 TST 缩短对海马体体积损失的影响。降低 SOL 可能仅在前扣带回皮质体积较低的个体中影响前扣带回皮质体积。
Curtis AF, Nair N, Hayse B, et al. 初步研究生理唤醒和失眠主诉在慢性广泛性疼痛中的交互作用对灰质体积改变的影响。 2024;20(2):293-302.
