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Current Neurology and Neuroscience Reports

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01-08-2018 | Sleep (M Thorpy and M Billiard, Section Editors)

Insomnia Disorder and Brain’s Default-Mode Network

Authors: Daniel Ruivo Marques, Ana Allen Gomes, Gina Caetano, Miguel Castelo-Branco

Published in: Current Neurology and Neuroscience Reports | Issue 8/2018

Abstract

Purpose of Review

Insomnia disorder (ID) is a prevalent sleep disorder that significantly compromises the physical and mental health of individuals. This article reviews novel approaches in the study of brain networks and impaired function in ID through the application of modern neuroimaging techniques such as functional magnetic resonance imaging (fMRI).

Recent Findings

The default-mode network (DMN) is presumed to be correlated with self-referential information processing, and it appears to be altered or unbalanced in insomnia.

Summary

A growing body of evidence suggests the lack of deactivation of brain regions comprising the DMN when insomnia patients are at rest. Moreover, core areas of the DMN demonstrate greater activation in insomnia patients when compared to healthy controls in self-referential related tasks. Despite the few studies on the topic, underpinning the correlation between abnormal DMN activity and ID deserves further attention in the future. Implications for therapeutics are briefly outlined.

Lichstein K, Taylor D, McCrae C, Petrov M. Etiology and pathophysiology of insomnia. In: Kryger M, Roth T, Dement W, editors. Principles and practice of sleep medicine (6th ed.) Missouri: Elsevier: Saunders; 2016. p. 769–84.

AASM. International Classification of sleep disorders: diagnostic and coding manual. 3rd ed. American Academy of Sleep Medicine: Westchester; 2014.

American Psychiatric Association. Diagnostic and statistical manual of mental disorders. 5th ed. Washington, DC: American Psychiatric Association; 2013.CrossRef

Marques D, Gomes A, Clemente V, Santos J, Castelo-Branco M. Hyperarousal and failure to inhibit wakefulness in primary insomnia: “birds of a feather”? Sleep Biol Rhythms. 2015;13:219–28. https://doi.org/10.1111/sbr.12115.CrossRef

Riemann D, Spiegelhalder K, Feige B, Voderholzer U, Berger M, Perlis M, et al. The hyperarousal model of insomnia: a review of the concept and its evidence. Sleep Med Rev. 2010;14:19–31. https://doi.org/10.1016/j.smrv.2009.04.002.CrossRefPubMed

• Buysse D, Germain A, Hall M, Monk T, Nofzinger E. A neurobiological model of insomnia. Drug Discov Today: Dis Models. 2011;8:129–37. https://doi.org/10.1016/j.ddmod.2011.07.002. This paper shows a possible way to integrate the DMN within a neurobiological model of insomnia. CrossRef

Spiegelhalder K, Regen W, Baglioni C, Nissen C, Riemann D, Kyle S. Neuroimaging insights into insomnia. Curr Neurol Neurosci Rep. 2015;15(9):9. https://doi.org/10.1007/s11910-015-0527-3. CrossRefPubMed

Nofzinger E. Brain imaging in insomnia. In: Sateia M, Buysse D, editors. Insomnia: diagnosis and treatment, UK: Informa Health Care; 2010. p. 77–83.CrossRef

Nofzinger E. Functional neuroimaging of primary insomnia. In: Nofzinger E, Maquet P, Thorpy M, editors. Neuroimaging of sleep and sleep disorders. Cambridge: Cambridge University Press; 2013. p. 197–208.CrossRef

10.

Nofzinger E, Buysse D, Germain A, Price J, Miewald J, Kupfer D. Functional neuroimaging evidence for hyperarousal in insomnia. Am J Psychiatry. 2004;161:2126–9. https://doi.org/10.1176/appi.ajp.161.11.2126.CrossRefPubMed

11.

O’Byrne JN, Berman Rosa M, Gouin JP, Dang-Vu TT. Neuroimaging findings in primary insomnia. Pathol Biol. 2014;62:262–9. https://doi.org/10.1016/j.patbio.2014.05.013.CrossRefPubMed

12.

• Marques D, Clemente V, Gomes A, Azevedo MH. Profiling insomnia using subjective measures: where are we and where are we going. Sleep Med. 2018; https://doi.org/10.1016/j.sleep.2017.12.006. The authors highlight the importance of profiling insomnia disorder.

13.

van den Heuvel M, Pol H. Exploring the brain network: a review on resting-state fMRI functional connectivity. Eur Neuropsychopharmacol. 2010;20:519–34. https://doi.org/10.1016/j.euroneuro.2010.03.008.CrossRefPubMed

14.

Buckner R, Krienen F, Yeo T. Opportunities and limitations of intrinsic functional connectivity MRI. Nat Neurosci. 2013;16:832–7. https://doi.org/10.1038/nn.3423.CrossRefPubMed

15.

Raichle M, MacLeod A, Snyder A, Powers W, Gusnard D, Schulman G. A default mode of brain function. Proc Natl Acad Sci U S A. 2001;98:676–82. https://doi.org/10.1073/pnas.98.2.676.CrossRefPubMedPubMedCentral

16.

Shi L, Sun J, Xia Y, Ren Z, Chen Q, Wei D, et al. Large-scale brain network connectivity underlying creativity in resting-state and task fMRI: cooperation between default network and frontal-parietal network. Biol Psychol. 2018;135:102–11. https://doi.org/10.1016/j.biopsycho.2018.03.005.CrossRefPubMed

17.

Whitfield-Gabrieli S, Ford J. Default mode network activity and connectivity in psychopathology. Annu Rev Clin Psychol. 2012;8:49–76. https://doi.org/10.1146/annurev-clinpsy-032511-143049.CrossRefPubMed

18.

•• Marques D, Gomes A, Clemente V, Santos J, Castelo-Branco M. Default-mode network activity and its role in comprehension and management of psychophysiological insomnia: a new perspective. New Ideas Psychol. 2015;36:30–7. https://doi.org/10.1016/j.newideapsych.2014.08.001. This is the first structured reflection on the role of DMN for insomnia. Several benefits and caveats are identified. CrossRef

19.

•• Nie X, Shao Y, Liu S-y, Wan A-I, Nie S, Peng D-c, et al. Functional connectivity of paired default mode network subregions in primary insomnia. Neuropsychiatr Dis Treat. 2015;11:3085–93. https://doi.org/10.2147/NDT.S95224. One of the first studies investigating DMN functional connectivity in insomnia. PubMedPubMedCentralCrossRef

20.

•• Regen W, Kyle S, Nissen C, Feige B, Baglioni C, Hennig J, et al. Objective sleep disturbances are associated with greater waking resting-state connectivity between the retrosplenial cortex/hippocampus and various nodes of the default mode network. J Psychiatry Neurosci. 2016;41:295–303. https://doi.org/10.1503/jpn.140290. A recent study showing connectivity impairment in DMN in insomnia. CrossRefPubMedPubMedCentral

21.

•• Zhou F, Huang S, Gao L, Zhuang Y, Ding S, Gong H. Temporal regularity of intrinsic cerebral activity in patients with chronic primary insomnia: a brain entropy study using resting-state fMRI. Brain Behav. 2016;6:e00529. https://doi.org/10.1002/brb3.529. A recent study using a brain entropy approach showing connectivity impairment in DMN in insomnia. CrossRefPubMedPubMedCentral

22.

•• Marques D, Gomes A, Clemente V, Santos J, Duarte I, Caetano G, et al. Self-referential dysfunction and default mode hyperactivation in insomnia patients: a case-control fMRI study. J Psychophysiol. 2017:1–16. https://doi.org/10.1027/0269-8803/a000194. This study reports, among other things, the absence of DMN deactivation when insomnia patients are performing a passive task.

23.

•• Marques D, Gomes A, Clemente V, Santos J, Duarte I, Caetano G, et al. Unbalanced resting-state networks activity in psychophysiological insomnia. Sleep Biol Rhythms. 2017;15:167–77. https://doi.org/10.1007/s41105-017-0096-8. A small albeit relevant case-control fMRI study using functional connectivity technique, which showed various impairments in resting-state networks in insomnia. CrossRef

24.

•• Li C, Dong M, Yin Y, Hua K, Fu S, Jiang G. Abnormal whole-brain functional connectivity in patients with primary insomnia. Neuropsychiatr Dis Treat. 2017;13:427–35. https://doi.org/10.2147/NDT.S128811. A recent study showing connectivity impairment in DMN in insomnia. CrossRefPubMedPubMedCentral

25.

•• Dong X, Qin H, Wu T, Hu T, Liao K, Cheng F, et al. Rest but busy: aberrant resting-state functional connectivity of triple network model in insomnia. Brain Behav. 2018;8:e00876. https://doi.org/10.1002/brb3.876. A recent study showing connectivity impairment in DMN in insomnia. CrossRefPubMedPubMedCentral

26.

•• Marques D, Gomes A, Clemente V, Santos J, Duarte I, Caetano G, Castelo-Branco M. The effect of tailored cognitive-behavioral therapy on neurobiological function in insomnia patients: an fMRI study. 2017: Manuscript submitted for publication. This is a relevant study which investigated the effects of CBT-I on neurobiological function, in particular, on DMN and self-referential cognitive processing.

27.

•• Lee Y-J, Kim S, Kim N, Choi J-W, Park J, Kim S, et al. Changes in subcortical resting-state functional connectivity in patients with psychophysiological insomnia after cognitive–behavioral therapy. Neuroimage Clin. 2018;17:115–23. https://doi.org/10.1016/j.nicl.2017.10.013. This is a recent study which outlines that functional connectivity of insomnia patients differs from good sleepers and changes after CBT-I. CrossRefPubMed

28.

Linden D. How psychotherapy changes the brain: the contribution of functional neuroimaging. Mol Psychiatry. 2006;11:528–38. https://doi.org/10.1038/sj.mp.4001816.CrossRefPubMed

29.

• Marques D, Gomes A, Clemente V, Santos J, Caetano G, Castelo-Branco M. Neurobiological correlates of psychological treatments for insomnia: a review. Eur Psychol. 2016;21:195–205. https://doi.org/10.1027/1016-9040/a000264. A review about the neural correlates of psychotherapeutic interventions for insomnia. CrossRef

30.

Marques D. Do we need neuroimaging to treat insomnia effectively? Sleep Med. 2017; https://doi.org/10.1016/j.sleep.2017.08.005.

Title: Insomnia Disorder and Brain’s Default-Mode Network
Authors: Daniel Ruivo Marques
Ana Allen Gomes
Gina Caetano
Miguel Castelo-Branco
Publication date: 01-08-2018
Publisher: Springer US
Published in: Current Neurology and Neuroscience Reports / Issue 8/2018
Print ISSN: 1528-4042
Electronic ISSN: 1534-6293
DOI: https://doi.org/10.1007/s11910-018-0861-3

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Insomnia Disorder and Brain’s Default-Mode Network

Abstract

Purpose of Review

Recent Findings

Summary

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose of Review

Recent Findings

Summary

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