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Unbalanced resting-state networks activity in psychophysiological insomnia

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Abstract

Psychophysiological insomnia (PI) is a clinical condition characterized by sleep-related disturbing cognitive activity and biased self-related information processing. This hypothetical cognitive arousal has been hypothesized to be associated with overactivation within different brain areas and networks, especially when individuals are at rest, e.g., in the absence of any attention-demanding task. In this study, we carried out a resting-state fMRI experiment aimed at investigating activity of the different resting-state networks in PI. Our pool of participants was compound of 5 PI patients and 5 sex- and age-matched healthy controls recruited from the community. Participants from both groups also completed a set of self-report measures, including the sleep diary, Insomnia Severity Index (ISI), dysfunctional beliefs and attitudes about sleep (DBAS-30), and the World Health Organization Quality of Life Measure (WHOQOL-Bref). Our results showed that insomnia patients presented altered activation in the default-mode network (DMN), visual and auditory networks, and bilateral fronto-parietal networks. In the DMN, the patients presented a pattern of both decreased (right superior frontal gyrus, left medial frontal gyrus, and right middle temporal gyrus) and increased activation (left superior frontal gyrus, left anterior and posterior cingulate, right precuneus, left cingulate gyrus, and left middle temporal gyrus). Our findings on unbalanced resting-state networks in PI, with special emphasis on the DMN, may lay grounds to better understanding of the cognitive arousal experienced by PI patients and might help to further improve the clinical management of insomnia.

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Acknowledgements

Ph.D. Grant (SFRH/BD/77557/2011) from FCT (Fundação para a Ciência e Tecnologia) provided to the first author; this work was also supported by FCTUID/NEU/04539/2013 provided to CNC.IBILI (Institute for Biomedical Imaging and Life Sciences, Faculty of Medicine, University of Coimbra, Portugal), Programa Ciência 2008 and Project Grant PTDC/SAU-BEB/100147/2008 (Fundação para a Ciência e Tecnologia), and BIAL Fellowship 170/10 (BIAL Foundation). We are also grateful to ICNAS (Institute for Nuclear Sciences Applied to Health), to Sleep Medicine Centre of CHUC, and to DE-UA (Department of Education, University of Aveiro) for the technical support. We would like to acknowledge the support of BIN (the Brain Imaging Network of Portugal). Furthermore, we acknowledge the contribution of Carlos Ferreira and João Marques for technical help in fMRI data acquisition.

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Author notes

  1. Gina Caetano

    Present address: ISR-Lisboa/LARSyS and Department of Bioengineering, Instituto Superior Técnico, Universidade de Lisboa, Lisbon, Portugal

Authors and Affiliations

  1. Department of Education and Psychology, University of Aveiro, Campus Universitário de Santiago, 3810-193, Aveiro, Portugal

    Daniel Ruivo Marques

  2. Institute for Biomedical Imaging and Life Sciences, IBILI, Azinhaga de Santa Comba, 3000-548, Coimbra, Portugal

    Daniel Ruivo Marques, Gina Caetano & Miguel Castelo-Branco

  3. Faculty of Psychology and Educational Sciences, University of Coimbra, Rua do Colégio Novo, 3000-115, Coimbra, Portugal

    Ana Allen Gomes

  4. Centro de Investigação do Núcleo de Estudos e Intervenção Cognitivo-Comportamental/Research and Development Unit (FCT), Cognitive and Behavioral Center for Research and Intervention, CINEICC, Coimbra, Portugal

    Ana Allen Gomes

  5. Sleep Medicine Centre, Coimbra University Hospital Centre (CHUC), Coimbra, Portugal

    Vanda Clemente & José Moutinho dos Santos

  6. Brain Imaging Network, ICNAS, Azinhaga de Santa Comba, 3000-058, Coimbra, Portugal

    Isabel Catarina Duarte, Gina Caetano & Miguel Castelo-Branco

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  1. Daniel Ruivo Marques
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Correspondence to Daniel Ruivo Marques.

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Conflict of interest

Daniel Ruivo Marques, Ana Allen Gomes, Vanda Clemente, José Moutinho dos Santos, Isabel Catarina Duarte, Gina Caetano, and Miguel Castelo-Branco declare that they have no conflict of interest.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. This article does not contain any studies with animals performed by any of the authors.

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Informed consent was obtained from all individual participants included in the study.

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Marques, D.R., Gomes, A.A., Clemente, V. et al. Unbalanced resting-state networks activity in psychophysiological insomnia. Sleep Biol. Rhythms 15, 167–177 (2017). https://doi.org/10.1007/s41105-017-0096-8

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