Primary insomnia (PI) is associated with deteriorating attention, memory, physical and mood complaints. Based on the extensive literature demonstrating the critical roles of the thalamus in sleep regulation, we hypothesized that insomnia would be associated with functional and structural changes of the thalamus. This information is needed to better understand the neural mechanisms of insomnia, and would be useful for informing future attempts to alleviate or treat insomnia symptoms. Twenty-seven PI patients and 39 matched healthy controls were included in the present study. Subcortical volume and resting state functional connectivity (RSFC) of thalamus were compared between groups, and the relationships between neuroimaging differences and clinical features, including the Pittsburgh Sleep Quality Index (PSQI), the Insomnia Severity Index Scale (ISI), the Self-Rating Anxiety Scale (SAS) and the Self-Rating Depression Scale (SDS), also be explored. Compared with the control group, the PI group showed significantly reduced volume of thalamus. In addition, several brain regions showed reduced RSFC with thalamus in PI patients, such as anterior cingulate cortex (ACC), orbitofrontal cortex, hippocampus, caudate and putamen. Correlation analyses revealed that, several of these RSFC patterns were negatively correlated with PSQI score among PI patients, including thalamic connections with the putamen, caudate, hippocampus. Negative correlation was also observed between the RSFC strength of right thalamus–right ACC and SDS score in PI patients. This work demonstrates the structural and functional abnormalities of the thalamus in PI patients that were associated with key clinical features of insomnia. These data further highlight the important role of the thalamus in sleep and PI.
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This work is supported by the National Natural Science Foundation of China under Grant Nos. 81571751, 81571753, 61771266, 81701780, the Fundamental Research Funds for the Central Universities under the Grant No. JB151204, the program for Young Talents of Science and Technology in Universities of Inner Mongolia Autonomous Region NJYT-17-B11, the Natural Science Foundation of Inner Mongolia under Grant No. 2017MS(LH)0814, 2018LH08079, the program of Science and Technology in Universities of Inner Mongolia Autonomous Region NJZY17262, the Innovation Fund Project of Inner Mongolia University of Science and Technology No. 2015QNGG03, National Natural Science Foundation of Shaanxi Province under Grant No. 2017JM6051, 2018JM7075. The funding agencies played no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; and preparation, review, or approval of the manuscript. The authors report no biomedical financial interests or potential conflicts of interest.
Informed consent was obtained from all individual participants included in the study.
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.
Conflict of interest
The authors report no biomedical financial interests or potential conflicts of interest.
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Li, M., Wang, R., Zhao, M. et al. Abnormalities of thalamus volume and resting state functional connectivity in primary insomnia patients. Brain Imaging and Behavior 13, 1193–1201 (2019). https://doi.org/10.1007/s11682-018-9932-y
- Resting state functional connectivity
- Pittsburgh sleep quality index