Jae Myeong Kang1, Sung Woo Joo1, Young-Don Son1, Hyun Kim1, Kwang-Pil Ko1, Jung Sun Lee1, Seung-Gul Kang1. 1. From the Department of Psychiatry, Gil Medical Center, Gachon University, College of Medicine, Incheon, Republic of Korea (Kang, Kang); Department of Psychiatry, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Republic of Korea (Joo, Lee); Department of Biomedical Engineering, College of Health Science, Gachon University, Incheon, Republic of Korea (Son); Department of Psychological and Brain Sciences, Boston University, Boston, MA, United States (Kim); and Department of Preventive Medicine, Gachon University, College of Medicine, Incheon, Republic of Korea (Ko).
Abstract
BACKGROUND: Previous studies have reported functional and structural abnormalities in the thalamus and the pars triangularis of the inferior frontal gyrus in patients with insomnia disorder. However, no studies have been conducted on the white-matter tracts between these 2 brain regions. We aimed to compare the white-matter integrity and structure of the left thalamus-pars triangularis tracts between patients with insomnia and controls, and to characterize the relationship between white-matter integrity and clinical features in patients with insomnia. METHODS: In total, 22 participants with insomnia disorder and 27 controls underwent overnight polysomnography and brain magnetic resonance imaging, and then completed self-report clinical questionnaires and neurocognitive tests for spatial planning. Structural and diffusion measures such as fractional anisotropy, axial diffusivity, radial diffusivity and trace were analyzed in group comparison and correlation analyses. RESULTS: The insomnia group showed significantly lower fractional anisotropy (F = 8.647, p = 0.02) and axial diffusivity (F = 5.895, p = 0.038) in the left thalamus-pars triangularis tracts than controls. In patients with insomnia, fractional anisotropy in the tracts was correlated with the results of the Stockings of Cambridge test (r = 0.451, p = 0.034), and radial diffusivity was correlated with Epworth Sleepiness Scale score (r = 0.437, p = 0.042). LIMITATIONS: Limitations included analyses of limited brain regions and the cross-sectional design. CONCLUSION: The insomnia group showed decreased integrity in the left thalamus-pars triangularis tracts, and integrity was correlated with cognition and daytime sleepiness. These results may imply that insomnia is characterized by disintegration of the white matter tract between the left thalamus and inferior frontal gyrus.
BACKGROUND: Previous studies have reported functional and structural abnormalities in the thalamus and the pars triangularis of the inferior frontal gyrus in patients with insomnia disorder. However, no studies have been conducted on the white-matter tracts between these 2 brain regions. We aimed to compare the white-matter integrity and structure of the left thalamus-pars triangularis tracts between patients with insomnia and controls, and to characterize the relationship between white-matter integrity and clinical features in patients with insomnia. METHODS: In total, 22 participants with insomnia disorder and 27 controls underwent overnight polysomnography and brain magnetic resonance imaging, and then completed self-report clinical questionnaires and neurocognitive tests for spatial planning. Structural and diffusion measures such as fractional anisotropy, axial diffusivity, radial diffusivity and trace were analyzed in group comparison and correlation analyses. RESULTS: The insomnia group showed significantly lower fractional anisotropy (F = 8.647, p = 0.02) and axial diffusivity (F = 5.895, p = 0.038) in the left thalamus-pars triangularis tracts than controls. In patients with insomnia, fractional anisotropy in the tracts was correlated with the results of the Stockings of Cambridge test (r = 0.451, p = 0.034), and radial diffusivity was correlated with Epworth Sleepiness Scale score (r = 0.437, p = 0.042). LIMITATIONS: Limitations included analyses of limited brain regions and the cross-sectional design. CONCLUSION: The insomnia group showed decreased integrity in the left thalamus-pars triangularis tracts, and integrity was correlated with cognition and daytime sleepiness. These results may imply that insomnia is characterized by disintegration of the white matter tract between the left thalamus and inferior frontal gyrus.
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