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Insomnia disorder is associated with increased amygdala reactivity to insomnia-related stimuli.

ABSTRACT: Alterations in emotional reactivity may play a key role in the pathophysiology of insomnia disorder (ID). However, only few supporting experimental data are currently available. We evaluated in a hypothesis-driven design whether patients with ID present altered amygdale responses to emotional stimuli related and unrelated to the experience of insomnia and, because of chronic hyperarousal, less habituation of amygdala responses.Case-control study.Departments of Psychiatry and Psychotherapy and of Radiology of the University of Freiburg Medical Center.There were 22 patients with ID (15 females; 7 males; age 40.7 ± 12.6 y) and 38 healthy good sleepers (HGS, 21 females; 17 males; age 39.6 ± 8.9 y).N/A.In a functional magnetic resonance imaging session, five different blocks of pictures with varying emotional arousal, valence, and content (insomnia-relatedness) were presented. Pictures were presented twice to test for habituation processes. Results showed that patients with ID, compared to HGS, presented heightened amygdala responses to insomnia-related stimuli. Moreover, habituation of amygdale responses was observed only in HGS, but not in patients with ID who showed a mixed pattern of amygdala responses to the second presentation of the stimuli.The results provide evidence for an insomnia-related emotional bias in patients with ID. Cognitive behavior treatment for ID could benefit from strategies dealing with the emotional charge associated with the disorder. Further studies should clarify the role of ID with respect to habituation of amygdala responses.

SUBMITTER: Baglioni C

PROVIDER: S-EPMC4548513 | biostudies-literature | 2014 Dec

REPOSITORIES: biostudies-literature

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Insomnia disorder is associated with increased amygdala reactivity to insomnia-related stimuli.

Baglioni Chiara C Spiegelhalder Kai K Regen Wolfram W Feige Bernd B Nissen Christoph C Lombardo Caterina C Violani Cristiano C Hennig Jürgen J Riemann Dieter D

Sleep 20141201 12

<h4>Study objectives</h4>Alterations in emotional reactivity may play a key role in the pathophysiology of insomnia disorder (ID). However, only few supporting experimental data are currently available. We evaluated in a hypothesis-driven design whether patients with ID present altered amygdale responses to emotional stimuli related and unrelated to the experience of insomnia and, because of chronic hyperarousal, less habituation of amygdala responses.<h4>Design</h4>Case-control study.<h4>Settin ...[more]

PMID: 25325493

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Project description:AimsPremenstrual dysphoric disorder (PMDD) is a psychiatric condition that is associated with the menstrual cycle. Elucidation of the neural regulation mechanisms of brain reactivity to emotional stimuli among women with PMDD may inform PMDD treatment.MethodsEighty-six women (42 PMDD, 44 healthy controls) were allocated into two groups (anger-induced group: 23 PMDD vs. 23 controls; depression-induced group: 19 PMDD vs. 21 controls). During the luteal phases of the menstrual cycle, all the women were subjected to functional magnetic resonance imaging (fMRI). fMRI resting-state scans were performed before and after the study participants had performed an emotional stimuli task. After the emotional stimuli task, emotional status of the participants were evaluated by Self-Rating Depression Scales (SDS) and Trait Anger Expression Inventory-II (STAXI-II). In addition, all the participants were requested to complete the Eysenck Personality Questionnaire (EPQ) and the Twenty-Item Toronto Alexithymia Scale (TAS-20).ResultsCompared to healthy controls, all women with PMDD exhibited significantly high scores in Tas-20 (p<0.001), higher neuroticism and psychoticism scores as well as significantly low extraversion and social desirability scores (p<0.05). Compared to the controls, f-MRI revealed that PMDD women had elevated ReHo in the middle frontal gyrus (BA10), temporal lobe (BA42), left cerebellum (BA37), as well as decreased activation in the precuneus (BA7), superior frontal gyrus (BA8), lobulus paracentralis (BA6), and right cerebellum (BA48) (p<0.05). Moreover, depression stimuli showed that women with PMDD had elevated ReHo levels in the middle frontal gyrus (BA11), the middle gyrus (BA47) and in the cingulate gyrus (BA23) vs. healthy controls (p<0.05).ConclusionsWomen with more neuroticism and psychoticism, less extraversion and social desirability tend to report PMDD symptoms. Women with this condition experience difficulties in regulating emotions during the luteal phase of the menstrual cycle. Abnormal ReHo levels in the precuneus, superior frontal gyrus, lobulus paracentralis, and right cerebellum may contribute to anger dysregulation. Hypoactivation in the middle frontal gyrus, the middle gyrus and the cingulate gyrus may be generally associated with depression dysregulation in PMDD.

Project description:Background: Insomnia disorder is a highly prevalent health condition, affecting ~10-15% of the adult population worldwide. A central feature of insomnia is hyperarousal characterized as persistent and increased somatic, cognitive and cortical stimulation. Hyperarousal leads to a state of conditioned arousal that disrupts both sleep and daytime function. Research studies have shown increases in body temperature, heart rate, electroencephalographic activity, catecholamines, and oxygen consumption as a measure of metabolic rate. These findings provide evidence of increased physiological activation in insomnia however results are not consistent. The aim of the systematic review was to determine if metabolic rate in patients with insomnia is increased in keeping with the hyperarousal hypothesis. Methods: We searched Pubmed, Web of Science, CINAHL, PsycINFO, EMBASE, and Scopus databases for observational and interventional studies that have measured metabolic rate in insomnia. Study characteristics were extracted and summarized and a risk of bias was performed for each of the studies. Results: Two reviewers screened 963 abstracts with 35 articles of interest for full-text review. Four articles evaluating 75 participants were included in this systematic review. Two studies showed increased oxygen consumption across 24 h in insomnia patients compared with good-sleeping controls. One study which measured oxygen consumption at only a single timepoint showed no difference between insomnia patients and good-sleeping controls. A further study evaluating the effect of lorazepam on oxygen consumption in patients with chronic insomnia showed that lorazepam reduced metabolic rate during the night time only. Conclusions: These findings show that metabolic rate appears to be increased across 24 h in line with the hyperarousal model of insomnia. However, these increases in metabolic rate in insomnia were minor compared to good-sleeping controls and the clinical significance is unclear. Larger, methodologically robust studies are required to confirm these findings and the effect of any increase in metabolic rate on sleep-wake disturbances or pathophysiology.

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Insomnia disorder is associated with increased amygdala reactivity to insomnia-related stimuli.

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Insomnia disorder is associated with increased amygdala reactivity to insomnia-related stimuli.

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