Advertisement

Sleep and Breathing

, Volume 22, Issue 2, pp 487–493 | Cite as

fMRI brain activation in patients with insomnia disorder during a working memory task

  • Young-Don Son
  • Jae Myeong Kang
  • Seong-Jin Cho
  • Jung-Sun Lee
  • Hee Young Hwang
  • Seung-Gul Kang
Neurology • Original Article
  • 259 Downloads

Abstract

Purpose

This study used functional magnetic resonance imaging (fMRI) to investigate differences in the functional brain activation of patients with insomnia disorder (n = 21, mean age = 36.6) and of good sleepers (n = 26, mean age = 33.2) without other comorbidities or structural brain abnormalities during a working memory task.

Methods

All participants completed a clinical questionnaire, were subjected to portable polysomnography (PSG), and performed the working memory task during an fMRI scan. The subjects who were suspected of major sleep disorder and comorbid psychiatric disorders except insomnia disorder were excluded. To compare the brain activation on working memory from the insomnia group with those from the good-sleeper group, a two-sample t test was performed. Statistical significance was determined using 3DClustSim with the updated algorithm to obtain a reasonable cluster size and p value for each analysis.

Results

We observed higher levels of brain activation in the right lateral inferior frontal cortex and the right superior temporal pole in the insomnia group compared to good sleepers (cluster-based multiple comparison correction, p < 0.001, k = 34 @ α = 0.01).

Conclusion

Thus, patients with insomnia disorder showed increased brain activation during working memory relative to good sleepers, and this may be indicative of compensatory brain activation to maintain cognitive performance in patients with insomnia disorder without other comorbidities.

Keywords

Insomnia disorder fMRI Working memory Brain activation 

Notes

Acknowledgements

This work was supported by the Gachon University Gil Medical Center (Grant number: 2013-43).

Compliance with ethical standards

Ethical approval

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.

Financial disclosures

The authors have indicated no financial conflicts of interest.

Supplementary material

11325_2017_1575_MOESM1_ESM.docx (320 kb)
ESM 1 (DOCX 320 kb)
11325_2017_1575_MOESM2_ESM.docx (18 kb)
ESM 2 (DOCX 18.1 kb)

References

  1. 1.
    Blank M, Zhang J, Lamers F, Taylor AD, Hickie IB, Merikangas KR (2015) Health correlates of insomnia symptoms and comorbid mental disorders in a nationally representative sample of US adolescents. Sleep 38(2):197–204CrossRefPubMedPubMedCentralGoogle Scholar
  2. 2.
    Tononi G, Cirelli C (2014) Sleep and the price of plasticity: from synaptic and cellular homeostasis to memory consolidation and integration. Neuron 81(1):12–34CrossRefPubMedPubMedCentralGoogle Scholar
  3. 3.
    Lim J, Dinges DF (2010) A meta-analysis of the impact of short-term sleep deprivation on cognitive variables. Psychol Bull 136(3):375–389CrossRefPubMedPubMedCentralGoogle Scholar
  4. 4.
    Fortier-Brochu E, Beaulieu-Bonneau S, Ivers H, Morin CM (2012) Insomnia and daytime cognitive performance: a meta-analysis. Sleep Med Rev 16(1):83–94CrossRefPubMedGoogle Scholar
  5. 5.
    Haimov I, Hanuka E, Horowitz Y (2008) Chronic insomnia and cognitive functioning among older adults. Behav Sleep Med 6(1):32–54CrossRefPubMedGoogle Scholar
  6. 6.
    Orff HJ, Drummond SP, Nowakowski S, Perils ML (2007) Discrepancy between subjective symptomatology and objective neuropsychological performance in insomnia. Sleep 30(9):1205–1211CrossRefPubMedPubMedCentralGoogle Scholar
  7. 7.
    Varkevisser M, Van Dongen HP, Van Amsterdam JG, Kerkhof GA (2007) Chronic insomnia and daytime functioning: an ambulatory assessment. Behav Sleep Med 5(4):279–296CrossRefPubMedGoogle Scholar
  8. 8.
    Drummond SP, Walker M, Almklov E, Campos M, Anderson DE, Straus LD (2013) Neural correlates of working memory performance in primary insomnia. Sleep 36(9):1307–1316PubMedPubMedCentralGoogle Scholar
  9. 9.
    Altena E, Van Der Werf YD, Sanz-Arigita EJ, Voorn TA, Rombouts SA, Kuijer JP et al (2008) Prefrontal hypoactivation and recovery in insomnia. Sleep 31(9):1271–1276PubMedPubMedCentralGoogle Scholar
  10. 10.
    Li Y, Liu L, Wang E, Zhang H, Dou S, Tong L et al (2016) Abnormal neural network of primary insomnia: evidence from spatial working memory task fMRI. Eur Neurol 75(1–2):48–57CrossRefPubMedGoogle Scholar
  11. 11.
    American Psychiatric Association (2013) Diagnostic and statistical manual of mental disorders (DSM-5®) American Psychiatric PubGoogle Scholar
  12. 12.
    Sohn SI, Kim DH, Lee MY, Cho YW (2012) The reliability and validity of the Korean version of the Pittsburgh Sleep Quality Index. Sleep and Breathing 16(3):803–812CrossRefPubMedGoogle Scholar
  13. 13.
    Kang K, Park KS, Kim JE, Kim SW, Kim YT, Kim JS et al (2013) Usefulness of the Berlin Questionnaire to identify patients at high risk for obstructive sleep apnea: a population-based door-to-door study. Sleep Breath 17(2):803–810CrossRefPubMedGoogle Scholar
  14. 14.
    Cho YW, Lee JH, Son HK, Lee SH, Shin C, Johns MW (2011) The reliability and validity of the Korean version of the Epworth sleepiness scale. Sleep Breath 15(3):377–384CrossRefPubMedGoogle Scholar
  15. 15.
    Hahn H, Yum T, Shin Y, Kim K, Yoon D, Chung K (1986) A standardization study of Beck Depression Inventory in Korea. J Korean Neuropsychiatr Assoc 25(3):487–500Google Scholar
  16. 16.
    Cho YW, Song ML, Morin CM (2014) Validation of a Korean version of the insomnia severity index. J Clin Neurol 10(3):210–215CrossRefPubMedPubMedCentralGoogle Scholar
  17. 17.
    Berry R, Brooks R, Gamaldo C, Harding S, Lloyd R, Marcus C (2013) The AASM manual for the scoring of sleep and associated events: rules, terminology and technical specifications, version 2.0. 2. Darien, Illinois: American Academy of. Sleep MedGoogle Scholar
  18. 18.
    Eklund A, Nichols TE, Knutsson H (2016) Cluster failure: Why fMRI inferences for spatial extent have inflated false-positive rates. Proc Natl Acad Sci U S A 113(28):7900–7905CrossRefPubMedPubMedCentralGoogle Scholar
  19. 19.
    Smith EE, Jonides J (1999) Storage and executive processes in the frontal lobes. Science 283(5408):1657–1661CrossRefPubMedGoogle Scholar
  20. 20.
    Smith EE, Jonides J, Marshuetz C, Koeppe RA (1998) Components of verbal working memory: evidence from neuroimaging. Proc Natl Acad Sci U S A 95(3):876–882CrossRefPubMedPubMedCentralGoogle Scholar
  21. 21.
    Ranganath C (2006) Working memory for visual objects: complementary roles of inferior temporal, medial temporal, and prefrontal cortex. Neuroscience 139(1):277–289CrossRefPubMedGoogle Scholar
  22. 22.
    Drummond SP, Smith MT, Orff HJ, Chengazi V, Perlis ML (2004) Functional imaging of the sleeping brain: review of findings and implications for the study of insomnia. Sleep Med Rev 8(3):227–242CrossRefPubMedGoogle Scholar
  23. 23.
    Yetkin FZ, Rosenberg RN, Weiner MF, Purdy PD, Cullum CM (2006) FMRI of working memory in patients with mild cognitive impairment and probable Alzheimer's disease. Eur Radiol 16(1):193–206CrossRefPubMedGoogle Scholar
  24. 24.
    Burggren AC, Small GW, Sabb FW, Bookheimer SY (2002) Specificity of brain activation patterns in people at genetic risk for Alzheimer disease. Am J Geriatric Psychiatry 10(1):44–51CrossRefGoogle Scholar
  25. 25.
    Ayalon L, Ancoli-Israel S, Klemfuss Z, Shalauta MD, Drummond SP (2006) Increased brain activation during verbal learning in obstructive sleep apnea. NeuroImage 31(4):1817–1825CrossRefPubMedGoogle Scholar
  26. 26.
    Castronovo V, Canessa N, Strambi LF, Aloia MS, Consonni M, Marelli S et al (2009) Brain activation changes before and after PAP treatment in obstructive sleep apnea. Sleep 32(9):1161–1172CrossRefPubMedPubMedCentralGoogle Scholar
  27. 27.
    Nofzinger EA, Buysse DJ, Germain A, Price JC, Miewald JM, Kupfer DJ (2004) Functional neuroimaging evidence for hyperarousal in insomnia. Am J Psychiatry 161(11):2126–2128CrossRefPubMedGoogle Scholar
  28. 28.
    van der Werf YD, Altena E, van Dijk KD, Strijers RL, De Rijke W, Stam CJ et al (2010) Is disturbed intracortical excitability a stable trait of chronic insomnia? A study using transcranial magnetic stimulation before and after multimodal sleep therapy. Biol Psychiatry 68(10):950–955CrossRefPubMedGoogle Scholar
  29. 29.
    Stoffers D, Altena E, van der Werf YD, Sanz-Arigita EJ, Voorn TA, Astill RG et al (2014) The caudate: a key node in the neuronal network imbalance of insomnia? Brain 137(Pt 2):610–620CrossRefPubMedGoogle Scholar

Copyright information

© Springer International Publishing AG 2017

Authors and Affiliations

  1. 1.Department of Biomedical Engineering, College of Health ScienceGachon UniversityIncheonRepublic of Korea
  2. 2.Department of Psychiatry, Gil Medical Center, College of MedicineGachon UniversityIncheonRepublic of Korea
  3. 3.Department of PsychiatryUniversity of Ulsan College of MedicineSeoulRepublic of Korea
  4. 4.Department of RadiologyGachon University Gil Medical CenterIncheonRepublic of Korea

Personalised recommendations