Abstract：
OBJECTIVE: Insomnia disorder is the most common sleep disorder. A better understanding of insomnia-related deviations in the brain could inspire better treatment. Insufficiently recognized heterogeneity within the insomnia population could obscure detection of involved brain circuits. The present study investigated whether structural brain connectivity deviations differ between recently discovered and validated insomnia subtypes.
METHODS: Structural and diffusion weighted 3-Tesla MRI data of four independent studies were harmonized. The sample consisted of 73 controls without sleep complaints and 204 participants with insomnia grouped into five subtypes based on their fingerprint of mood and personality traits assessed with the Insomnia Type Questionnaire. Linear regression correcting for age and sex evaluated group differences in structural connectivity strength, indicated by fractional anisotropy, streamline volume density and mean diffusivity, and evaluated within three different atlases.
RESULTS: Insomnia subtypes showed differentiating profiles of deviating structural connectivity which concentrated in different functional networks. Permutation testing against randomly drawn heterogeneous subsamples indicated significant specificity of deviation profiles in four of the five subtypes: highly distressed, moderately distressed reward sensitive, slightly distressed low reactive and slightly distressed high reactive. Connectivity deviation profile significance ranged from p= 0.001 to p=0.049 for different resolutions of brain parcellation and connectivity weight.
CONCLUSIONS: Our results provide a first indication that different insomnia subtypes exhibit distinct profiles of deviations in structural brain connectivity. Subtyping of insomnia could be essential for a better understanding of brain mechanisms that contribute to insomnia vulnerability.
METHODS: Structural and diffusion weighted 3-Tesla MRI data of four independent studies were harmonized. The sample consisted of 73 controls without sleep complaints and 204 participants with insomnia grouped into five subtypes based on their fingerprint of mood and personality traits assessed with the Insomnia Type Questionnaire. Linear regression correcting for age and sex evaluated group differences in structural connectivity strength, indicated by fractional anisotropy, streamline volume density and mean diffusivity, and evaluated within three different atlases.
RESULTS: Insomnia subtypes showed differentiating profiles of deviating structural connectivity which concentrated in different functional networks. Permutation testing against randomly drawn heterogeneous subsamples indicated significant specificity of deviation profiles in four of the five subtypes: highly distressed, moderately distressed reward sensitive, slightly distressed low reactive and slightly distressed high reactive. Connectivity deviation profile significance ranged from p= 0.001 to p=0.049 for different resolutions of brain parcellation and connectivity weight.
CONCLUSIONS: Our results provide a first indication that different insomnia subtypes exhibit distinct profiles of deviations in structural brain connectivity. Subtyping of insomnia could be essential for a better understanding of brain mechanisms that contribute to insomnia vulnerability.
摘要：
目的：失眠障碍是最常见的睡眠障碍。更好地了解大脑中与失眠相关的偏差可以激发更好的治疗方法。失眠症人群中认识不足的异质性可能会掩盖对涉及的大脑回路的检测。本研究调查了最近发现的和经过验证的失眠亚型之间的结构性脑连接偏差是否不同。
方法：对4项独立研究的结构和扩散加权3特斯拉MRI数据进行了统一。样本由73名没有睡眠投诉的对照和204名失眠参与者组成，根据他们的情绪指纹和人格特征，将他们分为五个亚型。校正年龄和性别的线性回归评估了结构连接强度的组差异，由分数各向异性表示，流线体积密度和平均扩散系数，并在三个不同的地图集中进行了评估。
结果：失眠亚型显示出不同的结构连通性分布，这些连通性分布集中在不同的功能网络中。针对随机绘制的异质子样本的置换测试表明，在五种亚型中的四种中，偏差谱具有显着的特异性：高度困扰，适度痛苦的奖励敏感，轻微困扰的低反应性和轻微困扰的高反应性。对于不同分辨率的脑分裂和连通性权重，连通性偏差曲线的显著性范围为p=0.001至p=0.049。
结论：我们的研究结果首次表明不同的失眠亚型表现出不同的脑结构性连接偏差。失眠的亚型可能对于更好地了解导致失眠脆弱性的大脑机制至关重要。
方法：对4项独立研究的结构和扩散加权3特斯拉MRI数据进行了统一。样本由73名没有睡眠投诉的对照和204名失眠参与者组成，根据他们的情绪指纹和人格特征，将他们分为五个亚型。校正年龄和性别的线性回归评估了结构连接强度的组差异，由分数各向异性表示，流线体积密度和平均扩散系数，并在三个不同的地图集中进行了评估。
结果：失眠亚型显示出不同的结构连通性分布，这些连通性分布集中在不同的功能网络中。针对随机绘制的异质子样本的置换测试表明，在五种亚型中的四种中，偏差谱具有显着的特异性：高度困扰，适度痛苦的奖励敏感，轻微困扰的低反应性和轻微困扰的高反应性。对于不同分辨率的脑分裂和连通性权重，连通性偏差曲线的显著性范围为p=0.001至p=0.049。
结论：我们的研究结果首次表明不同的失眠亚型表现出不同的脑结构性连接偏差。失眠的亚型可能对于更好地了解导致失眠脆弱性的大脑机制至关重要。
