Jiang Tongfei, Yin Xuejiao, Zhu Liying, Wang Guiling, Zhang Fan, Guo Jing
Beijing Key Laboratory of Acupuncture Neuromodulation, Department of Acupuncture and Moxibustion, Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Beijing, China.
Graduate School, Beijing University of Chinese Medicine, Beijing, 100029, China.
Brain Imaging Behav. 2025 Feb;19(1):218-239. doi: 10.1007/s11682-024-00949-9. Epub 2024 Oct 10.
Patients with insomnia disorder (ID) usually experience a greater burden of comorbid anxiety symptoms. However, the neural mechanism under the mutual relationship between ID and anxiety remains largely unclear. The meta-analysis aimed to explore the concordance and distinction of regional brain functional activity in patients with ID and those with generalized anxiety disorder (GAD) using coordinate-based activation likelihood estimation approach. Studies using resting-state regional homogeneity, amplitude of low-frequency fluctuations (ALFF), or fractional ALFF in patients with ID or GAD were included by searching multiple databases up to May 24, 2024. Using meta-analytic approach, 21 studies of ID vs. healthy controls (HC) and 16 studies of GAD vs. HC were included to illuminate the common and distinct patterns between the two disorders. Results showed that ID and GAD shared increased brain activities in the left posterior cingulate cortex and left precuneus, as well as decreased brain activity in the left medial prefrontal cortex. Additionally, compared with ID, GAD showed greater increased activities in the left superior frontal gyrus. Our study reveals both common and different activation patterns between ID and GAD, which may provide novel insights for understanding the neural basis of the two disorders and enlighten the possibility of the development of more targeted treatment strategies for ID and GAD.
失眠症(ID)患者通常会承受更重的共病焦虑症状负担。然而,ID与焦虑之间相互关系的神经机制在很大程度上仍不清楚。这项荟萃分析旨在使用基于坐标的激活似然估计方法,探索ID患者与广泛性焦虑障碍(GAD)患者大脑区域功能活动的一致性和差异。通过检索截至2024年5月24日的多个数据库,纳入了使用静息态局部一致性、低频振幅(ALFF)或分数ALFF对ID或GAD患者进行研究的文献。采用荟萃分析方法,纳入了21项ID与健康对照(HC)的研究以及16项GAD与HC的研究,以阐明这两种疾病之间的共同和不同模式。结果显示,ID和GAD在左后扣带回皮质和左楔前叶的大脑活动均增加,以及左内侧前额叶皮质的大脑活动减少。此外,与ID相比,GAD在左额上回的活动增加更为明显。我们的研究揭示了ID和GAD之间共同和不同的激活模式,这可能为理解这两种疾病的神经基础提供新的见解,并为开发针对ID和GAD的更有针对性的治疗策略提供启示。