Functional Brain Neuroimaging Characteristics Of Insomnia Disorder Patients With Diferent Sleeping Time

Objective Insomnia disorder is a disease that affects people’s physical and mental health.Several studies indicate consistently that short sleep duration insomnia disorder is a more severe subtype.Unfortunately,there are few studies on the neuroimaging mechanism of patients with insomnia disorder at different sleep durations,and more and more study tend to use functional magnetic resonance imaging technology to study the law of neuron activity in the resting state.To verify whether the insomnia patients with different sleep durations differ in brain imaging characteristics,and hopefully,shed light on the future studies concerning mechanisms and treatments of insomnia disorders,our study chooses functional magnetic resonance imaging technology to present activities of different brain regions in insomnia patients with different sleep durations respectively,and analyses possible correlation between imaging characteristics and clinical features.Methods A total of 31 patients,meeting the diagnostic criteria of DSM-5 for insomnia disorder,and 27 healthy controls were included in the current study.All participants gave written informed consents.general demographic survey,sleep related questionnaires and other clinical evaluation were administered to all subjects.sleep diaries were recorded for two consecutive weeks.Then the subjects received two consecutive nights of polysomnography(PSG)to exclude those who do not meet our requirement.Then taking 6 hours as the cut off point,21 cases with insomnia disorder with a total subjective sleep time in the past month < 6 h were defined as the subjective short sleep duration insomnia group(s ID-S group),and 10 cases ≥6h were defined as the subjective long sleep duration insomnia group(s ID-L group);8 cases with insomnia disorder with PSG total sleep time < 6 h were defined as the objective short sleep duration insomnia group(o ID-S group),and 23 cases ≥6h were defined as the objective long sleep duration insomnia group(o ID-L group).Then,MRI equipment were used to collect functional magnetic resonance imaging(f MRI)data of all eligible subjects.We chose three methods-regional homogeneity(Re Ho),amplitude low frequency(ALFF)and fractional amplitude low frequency(f ALFF)-to reveal the brain activity patterns.Results In the brain region of left angular,bilateral precuneus,etc.show significant differences between the the s ID-S group,s ID-L group and HC group.In the brain region of right caudate,the right cerebellum＿Crus1 and the left precuneus,brain functional activities show significant differences between the the o ID-S group,o ID-L group and HC group.Besides,the ALFF values of the right thalamus in the s ID-S group was significantly negatively correlated with PSQI score and ISI score(r =-0.45,P = 0.040;r =-0.45,P = 0.041);The ALFF values of the left anterior wedge in the s ID-L group was significantly negatively correlated with sleep efficiency(r =-0.91,P <0.001);The ALFF values of the right caudate in the o ID-L group was significantly negatively correlated with FSS score(r =-0.44,P = 0.035).2.After post-hoc analyses,the Re Ho analysis found that the activation of left middle occipital gyrus in s ID-L group was significantly lower than that in s ID-S group and HC group.The ALFF analysis found that the activation of right thalamus and other brain areas in s ID-S group was significantly higher than that in s ID-L group and HC group,the activation of left precuneus in s ID-L group was significantly lower than that in s ID-S group and HC group.The f ALFF analysis found that the activation of left medial superior frontal and other brain areas in s ID-S group was significantly lower than that in s ID-L group and HC group,the activation of right precuneus and right hippocampus in s ID-S group was significantly higher than that in s ID-L group and HC group.Conclusion 1.Two group of insomnia disorder patients with different sleep durations show different activity patterns in the brain areas of left angular,precuneus and others.2.The insomnia disorder patients with short sleep duration shows different activity patterns in the brain areas of left angular,right precuneus,left medial superior frontal and others.The difference suggests that short sleep duration insomnia disorder is a more serious subtype of insomnia disorder.