Increased interhemispheric resting-state functional connectivity in healthy participants with insomnia symptoms: A randomized clinical consort study

BACKGROUND: Abnormalities within the insular cortex of the salience and thalamus of the hyperarousal network have been increasingly reported in healthy participants with insomnia symptoms by recent resting-state functional magnetic resonance imaging (rsfMRI) studies. However, little is known about the changes in functional interaction between the bilateral cerebral hemispheres in healthy participants with insomnia symptoms. METHODS: In a randomized trial, 27 healthy participants with insomnia symptoms and 27 age-, gender-, and educational level-matched healthy participants without insomnia symptoms underwent rsfMRI. Voxel-mirrored homotopic connectivity (VMHC) was used to measure functional connectivity between any pair of symmetrical interhemispheric voxels (i.e., functional homotopy). RESULTS: The healthy participants with insomnia symptoms displayed significantly increased VMHC compared to healthy participants without insomnia symptoms in the bilateral thalamus/posterior insula (including anterior insula), fusiform, middle cingulate gyrus, inferior parietal lobe, and postcentral gyrus. No regions of decreased VMHC were detected in healthy participants with insomnia symptoms. There were significantly positive correlations between the VMHC values in the anterior cingulate cortex (ACC) and sleep disturbance scores in all healthy participants. CONCLUSIONS: Insomnia is associated with substantial impairment of interhemispheric coordination within the default mode (ACC), salience (insula), hyperarousal (thalamus/posterior insula), and visual (fusiform) networks.