Zhang Haobo, Lv Zhangwei, Chen Hanfei, Tang Zijie, Lei Xu
Sleep and NeuroImaging Center, Faculty of Psychology, Southwest University, Chongqing, 400715, China; Key Laboratory of Cognition and Personality (Southwest University), Ministry of Education, Chongqing, 400715, China.
Sleep and NeuroImaging Center, Faculty of Psychology, Southwest University, Chongqing, 400715, China; Key Laboratory of Cognition and Personality (Southwest University), Ministry of Education, Chongqing, 400715, China.
Behav Res Ther. 2025 Aug;191:104776. doi: 10.1016/j.brat.2025.104776. Epub 2025 May 16.
Inhibitory control (IC) impairment is characteristic of insomnia disorder with short sleep duration (ISSD), but not with normal sleep duration (INSD). IC is critical for sleep-wake regulation. This study evaluates whether computerized IC training can improve sleep in ISSD and explores related neural mechanisms using resting-state fMRI (rs-fMRI).
Twenty ISSD patients participated in a three-week computerized IC training program (15 sessions), alongside a control group of 17 participants. Sleep quality was assessed using the Pittsburgh Sleep Quality Index (PSQI) and the Insomnia Severity Index (ISI), complemented by objective measures from overnight EEG recordings. Neuroimaging analyses focused on changes in regional homogeneity (ReHo), fractional amplitude of low-frequency fluctuations (fALFF), and functional connectivity (FC) in brain regions associated with IC.
Computerized IC training led to significant improvements in both subjective and objective sleep quality, demonstrated by reductions in PSQI and ISI scores, as well as decreased wake time during sleep. Neuroimaging revealed increased ReHo in the left medial orbitofrontal cortex (MOFC), elevated fALFF in the right middle frontal gyrus (MFG), and enhanced FC between the MOFC and the right rectus gyrus (RG), which correlated with improvements in sleep measures.
Computerized IC training appears to be an effective intervention for improving sleep in ISSD, likely by inducing functional changes in prefrontal cortex regions. These findings underscore the potential of IC-targeted treatments for ISSD and highlight the need for future research to evaluate the long-term effects of such interventions.
The study was prospectively registered on May 30, 2024, in Chinese Clinical Trials registry (ChiCTR2400085063).
抑制控制（IC）受损是短睡眠时长失眠症（ISSD）的特征，但正常睡眠时长失眠症（INSD）并非如此。IC对睡眠 - 觉醒调节至关重要。本研究评估计算机化IC训练是否能改善ISSD患者的睡眠，并使用静息态功能磁共振成像（rs - fMRI）探索相关神经机制。
20名ISSD患者参加了为期三周的计算机化IC训练项目（共15节课程），同时有17名参与者作为对照组。使用匹兹堡睡眠质量指数（PSQI）和失眠严重程度指数（ISI）评估睡眠质量，并辅以夜间脑电图记录的客观测量。神经影像学分析重点关注与IC相关脑区的局部一致性（ReHo）、低频振幅分数（fALFF）和功能连接（FC）的变化。
计算机化IC训练使主观和客观睡眠质量均有显著改善，表现为PSQI和ISI评分降低，以及睡眠期间觉醒时间减少。神经影像学显示，左侧内侧眶额皮质（MOFC）的ReHo增加，右侧额中回（MFG）的fALFF升高，且MOFC与右侧直回（RG）之间的FC增强，这些变化与睡眠指标的改善相关。
计算机化IC训练似乎是改善ISSD患者睡眠的有效干预措施，可能是通过诱导前额叶皮质区域的功能变化实现的。这些发现强调了针对ISSD进行IC靶向治疗的潜力，并突出了未来研究评估此类干预措施长期效果的必要性。
该研究于2024年5月30日在中国临床试验注册中心（ChiCTR2400085063）进行了前瞻性注册。
