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Does Cognitive–Behavioral Therapy for Insomnia Change the Brain? A Case Series Study

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Abstract

Purpose

In this study, our aim was to examine neural correlates of cognitive–behavioral therapy for insomnia (CBT-I).

Methods

It was investigated to what extent successfully tailored CBT-I modified the neural activity pattern observed before the intervention, when two insomnia patients were exposed to idiosyncratic stimuli pertaining to past/present and future concerns in an fMRI experiment.

Results

Our findings suggested that successful CBT-I seems to normalize brain overactivity. This finding is enhanced by the visible attenuation of activity in brain regions implicated in self-referential processing and by the significant activation within visual areas across all experimental conditions.

Conclusion

It is likely that psychological treatment changes the brain’s function in insomnia. However, studies with larger sample sizes are needed to establish solid evidence.

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Acknowledgements

We are grateful to FCT (Fundação para a Ciência e Tecnologia) for a PhD Grant (SFRH/BD/77557/2011) provided to the first author; to IBILI (Institute for Biomedical Imaging and Life Sciences, Faculty of Medicine, University of Coimbra), to ICNAS (Institute for Nuclear Sciences Applied to Health, University of Coimbra, Portugal), to Sleep Medicine Center of CHUC, and to DE-UA (Department of Education, University of Aveiro) for all the support. We would like to acknowledge the support of BIN (the Brain Imaging Network of Portugal). Furthermore, we acknowledge the contribution of Carlos Ferreira, João Marques and Sónia Afonso for fMRI data acquisition and Gregor Phillipiak for programming the presentation of fMRI stimuli.

Funding

PhD 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), BIAL Foundation Grant 170/10, Programa Ciência 2008 and project Grant PTDC/SAU-BEB/100147/2008 (Fundação para a Ciência e Tecnologia).

Author information

Authors and Affiliations

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

    Daniel Ruivo Marques

  2. CINEICC, Center for Research in Neuropsychology and Cognitive Behavioral Intervention, Faculty of Psychology and Educational Sciences, University of Coimbra, Coimbra, Portugal

    Daniel Ruivo Marques & Ana Allen Gomes

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

    Ana Allen Gomes

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

    Vanda Clemente & José Moutinho dos Santos

  5. Coimbra Institute for Biomedical Imaging and Translational Research (CIBIT, ICNAS), Faculty of Medicine, University of Coimbra, Coimbra, Portugal

    Isabel Catarina Duarte & Miguel Castelo-Branco

  6. ISR‑Lisboa/LARSyS and Department of Bioengineering, Instituto Superior Técnico, Universidade de Lisboa, Lisbon, Portugal

    Gina Caetano

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  1. Daniel Ruivo Marques
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  2. Ana Allen Gomes
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  3. Vanda Clemente
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Corresponding author

Correspondence to Daniel Ruivo Marques.

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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. Does Cognitive–Behavioral Therapy for Insomnia Change the Brain? A Case Series Study. Sleep Vigilance 4, 35–42 (2020). https://doi.org/10.1007/s41782-019-00081-5

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