Abstract
Insomnia is one of the main symptom correlates of major depressive disorder (MDD), but the neural mechanisms underlying the multifaceted interplay between insomnia and depression are not fully understood. Patients with MDD and high insomnia (MDD-HI, n = 24), patients with MDD and low insomnia (MDD-LI, n = 37), and healthy controls (HCs, n = 51) were recruited to participate in the present study. The amplitude of low-frequency fluctuations (ALFF) during the resting state were compared among the three groups. We observed ALFF differences between the three groups in the right inferior frontal gyrus/anterior insula (IFG/AI), right middle temporal gyrus, left calcarine, and bilateral dorsolateral prefrontal cortex (dlPFC). Further region of interest (ROI) comparisons showed that the increases in the right IFG/AI reflected an abnormality specific to insomnia in MDD, while increases in the bilateral dlPFC reflected an abnormality specific to MDD generally. Increased ALFF in the right IFG/AI was also found to be correlated with sleep disturbance scores when regressing out the influence of the severity of anxiety and depression. Our findings suggest that increased resting state ALLF in IFG/AI may be specifically related to hyperarousal state of insomnia in patients with MDD, independently of the effects of anxiety and depression.
Highlights
Major depressive disorder (MDD) is characterized by a sustained depressive mood, anhedonia, and sleep abnormalities, alongside a number of motivational and social behaviors [1]
Insomnia, which is a disorder that is independent of depression [9], has a prognostic value as a risk factor for subsequent depressive episodes [3, 10]
As there appears to be an interplay between insomnia and depression that is multifaceted, examining the specific underlying brain abnormalities associated with insomnia in patients with MDD, could produce data that may lead to the availability of individualized therapies for patients with MDD
Summary
Major depressive disorder (MDD) is characterized by a sustained depressive mood, anhedonia, and sleep abnormalities, alongside a number of motivational and social behaviors [1]. It is a major cause of disability [2]. In longitudinal studies of adults with MDD, insomnia has been shown to increase the risk of recurrence of new depressive episodes twofold to fourfold [11, 12]. Insomnia is one of the main symptom correlates of major depressive disorder (MDD), but the neural mechanisms underlying the multifaceted interplay between insomnia and depression are not fully understood
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