A Resting-state Functional Magnetic Resonance Imaging Regional Homogeneity Study On Patients With Insomnia Disorder:A Case-control Study

Objective:Our aim is to evaluate the difference in encephalic regional homogeneity between patients with insomnia and controls by resting state-functional Magnetic Resonance Imaging analysis. The relationship of abnormal encephalic ReHo with sleep parameters as measured by polysomnography and the Pittsburgh Sleep Quality Index(PSQI), emotional symptoms, adverse cognitive behavior patterns and daytime function impairment impaired will also be calculated. Methods:A total of 23 people diagnosed with insomnia disorder according to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition(DSM-5), and 18 healthy controls were recruited. Both two groups are instructed to completegenerally information scale, diagnostic interview for sleep patterns and sleep disorders(DISP), Pittsburgh Sleep Quality Index(PSQI), Self-Rating Anxiety Scale(SAS), Self-rating Depression Scale(SDS), Hamilton Anxiety Scale(HAMA), Hamilton Depression Scale(HAMD), Epworth Sleepiness Scale(ESS), State-Trait Anxiety Inventory(STAI), Beck Depression Rating Scale(BDI), Dysfunctional Beliefs and Attitudes about Sleep(DBAS-10), Hyperarousal Scale(HAS), Flinders Fatigue Scale(FFS),and Insomnia Severity Index(ISI), they also need to have the PSG and rs-fMRI test. Independent-sample t-test was performed to assess the difference in general information, DISP, PSQI, SAS, SDS, HAMA, HAMD, ESS, STAI, BDI, BDI-10, HAS, FFS and ISI scores between cases and controls. The association between ReHo and clinical characteristics were calculated by multiple linear regressions. We used the SPSS16.0 for all statistical analyses. Results:1.The subjective and objective symptoms of insomnia in case group were more serious than control group, and the people in case group are more prone to affect anxiety, depression, fatigue and adverse cognitive behavior patterns.2.Compared with the matched group,the brain areas with significant higher ReHo value in insomnia disorder patients were as follow: orbitofrontal cortex; right superior parietal lobule;left precuneus;left superior temporal gyrus;left thalamus and caudate nucleus head;left posterior lobe of cerebellum; right posterior lobe of cerebellum and cerebellar tonsil and ReHo value was significantly decreased in bilateral cuneus;left superior parietal lobule.3.We also found a significant positive correlation in insomnia disorder patients between : left superior temporal gyrus and PSQI total points; right superior parietal lobule and PSQI total points;and a significant negative correlation in insomnia disorder patients between:right posterior lobe of cerebellum as well as cerebellar tonsil and N3 sleep phase proportion;left superior parietal lobule and N1 sleep phase proportion. Conclusion:1. The subjective and objective sleep disorder and daytime impaired are existed in case group people that made them deal with adverse cognitive behavior patterns.2. The ReHo value in case group in such areas as cognitive system, ascending reticular activating system and epencephalon has changed which suggest that insomnia disorder may associated with functional structure obstacle of these three areas.3. The changes of Partial cerebral regions' Re Ho value in sleep disorders may associated with some specific clinical manifestations.