Abstract
BackgroundMental syndromes such as anxiety and depression are common comorbidities in patients with chronic insomnia disorder (CID). The locus coeruleus noradrenergic (LC-NE) system is considered to be crucial for modulation of emotion and sleep/wake cycle. LC-NE system is also a critical mediator of the stress-induced anxiety. However, whether the LC-NE system contributes to the underlying mechanism linking insomnia and these comorbidities remain unclear. This study aimed to investigate the LC-NE system alterations in patients with insomnia and its relationship with depression and anxiety symptoms.Materials and MethodsSeventy patients with CID and 63 matched good sleep control (GSC) subjects were recruited and underwent resting-state functional MRI scan. LC-NE functional network was constructed by using seed-based functional connectivity (FC) analysis. The alterations in LC-NE FC network in patients with CID and their clinical significance was explored.ResultsCompared with GSC group, the CID group showed decreased left LC-NE FC in the left inferior frontal gyrus, while they had increased LC-NE FC in the left supramarginal gyrus and the left middle occipital gyrus (MOG). For the right LC-NE FC network, decreased FC was found in left dorsal anterior cingulate cortex (dACC). Interesting, the increased LC-NE FC was located in sensory cortex, while decreased LC-NE FC was located in frontal control cortex. In addition, the FC between the left LC and left MOG was associated with the duration of the disease, while abnormal FC between right LC and left dACC was associated with the anxiety scores in patients with CID.ConclusionThe present study found abnormal LC-NE functional network in patients with CID, and the altered LC-NE function in dACC was associated with anxiety symptoms in CID. The present study substantially extended our understanding of the neuropathological basis of CID and provided the potential treatment target for CID patients who also had anxiety.
Highlights
Insomnia is a prevalent and limiting condition affecting daytime functioning
No significant differences in gender, age, and education were found between good sleep control (GSC) subjects and chronic insomnia disorder (CID) patients
The altered locus coeruleus noradrenergic (LC-NE) function in dorsal anterior cingulate cortex (dACC) was associated with anxiety symptoms in patients with CID
Summary
Insomnia is a prevalent and limiting condition affecting daytime functioning. The chronic insomnia disorder (CID) affects an estimated 10% of the population; in particular during the global lockdown due to the COVID-19 outbreak, insomnia prevalence has doubled to tripled (Kokou-Kpolou et al, 2020; Shi et al, 2020). Numerous groups have used various neuroimaging approaches and demonstrated specific brain structural and functional alterations in patients with CID (Huang et al, 2012; Joo et al, 2013; Li et al, 2018; Yu et al, 2018a,b; Gong et al, 2020c). Investigation of the brain mechanism underlying CID and mental symptom comorbidities is essential for comprehensive understanding of insomnia. Mental syndromes such as anxiety and depression are common comorbidities in patients with chronic insomnia disorder (CID). This study aimed to investigate the LC-NE system alterations in patients with insomnia and its relationship with depression and anxiety symptoms
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