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Improved Functional Organization in Patients With Primary Insomnia After Individually-Targeted Transcranial Magnetic Stimulation

Primary insomnia (PI) is among the most prevalent sleep-related disorders and has a far-reaching impact on daytime functioning. Repetitive transcranial magnetic stimulation (rTMS) has drawn attention because of its effectiveness and safety. The purpose of the current study was to detect changes in t...

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Autores principales: Qi, Shun, Zhang, Yao, Li, Xiang, Sun, Chuanzhu, Ma, Xiaowei, Li, Sanzhong, Li, Li, Ren, Kai, Xi, Min, Huang, Zi-Gang
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8960275/
https://www.ncbi.nlm.nih.gov/pubmed/35360154
http://dx.doi.org/10.3389/fnins.2022.859440
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author Qi, Shun
Zhang, Yao
Li, Xiang
Sun, Chuanzhu
Ma, Xiaowei
Li, Sanzhong
Li, Li
Ren, Kai
Xi, Min
Huang, Zi-Gang
author_facet Qi, Shun
Zhang, Yao
Li, Xiang
Sun, Chuanzhu
Ma, Xiaowei
Li, Sanzhong
Li, Li
Ren, Kai
Xi, Min
Huang, Zi-Gang
author_sort Qi, Shun
collection PubMed
description Primary insomnia (PI) is among the most prevalent sleep-related disorders and has a far-reaching impact on daytime functioning. Repetitive transcranial magnetic stimulation (rTMS) has drawn attention because of its effectiveness and safety. The purpose of the current study was to detect changes in the topological organization of whole-brain functional networks and to determine their associations with the clinical treatment effects of rTMS. Resting-state functional magnetic resonance imaging (rsfMRI) data from 32 patients with PI were collected and compared with findings from 32 age- and gender-matched healthy controls (HCs). The patients were treated with Stanford accelerated intelligent neuromodulation therapy, which is a recently validated neuroscience-informed accelerated intermittent theta-burst stimulation protocol. Graph theoretical analysis was used to construct functional connectivity matrices and to extract the attribute features of small-world networks in insomnia. Scores on the Insomnia Severity Index (ISI), Pittsburgh Sleep Quality Index, Self-Rating Anxiety Scale, Self-Rating Depression Scale, and the associations between these clinical characteristics and functional metrics, were the primary outcomes. At baseline, the patients with PI showed inefficient small-world property and aberrant functional segregation and functional integration compared with the HCs. These properties showed renormalization after individualized rTMS treatment. Furthermore, low functional connectivity between the right insula and left medial frontal gyrus correlated with improvement in ISI scores. We highlight functional network dysfunctions in PI patients and provide evidence into the pathophysiological mechanisms involved and the possible mode of action of rTMS.
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spelling pubmed-89602752022-03-30 Improved Functional Organization in Patients With Primary Insomnia After Individually-Targeted Transcranial Magnetic Stimulation Qi, Shun Zhang, Yao Li, Xiang Sun, Chuanzhu Ma, Xiaowei Li, Sanzhong Li, Li Ren, Kai Xi, Min Huang, Zi-Gang Front Neurosci Neuroscience Primary insomnia (PI) is among the most prevalent sleep-related disorders and has a far-reaching impact on daytime functioning. Repetitive transcranial magnetic stimulation (rTMS) has drawn attention because of its effectiveness and safety. The purpose of the current study was to detect changes in the topological organization of whole-brain functional networks and to determine their associations with the clinical treatment effects of rTMS. Resting-state functional magnetic resonance imaging (rsfMRI) data from 32 patients with PI were collected and compared with findings from 32 age- and gender-matched healthy controls (HCs). The patients were treated with Stanford accelerated intelligent neuromodulation therapy, which is a recently validated neuroscience-informed accelerated intermittent theta-burst stimulation protocol. Graph theoretical analysis was used to construct functional connectivity matrices and to extract the attribute features of small-world networks in insomnia. Scores on the Insomnia Severity Index (ISI), Pittsburgh Sleep Quality Index, Self-Rating Anxiety Scale, Self-Rating Depression Scale, and the associations between these clinical characteristics and functional metrics, were the primary outcomes. At baseline, the patients with PI showed inefficient small-world property and aberrant functional segregation and functional integration compared with the HCs. These properties showed renormalization after individualized rTMS treatment. Furthermore, low functional connectivity between the right insula and left medial frontal gyrus correlated with improvement in ISI scores. We highlight functional network dysfunctions in PI patients and provide evidence into the pathophysiological mechanisms involved and the possible mode of action of rTMS. Frontiers Media S.A. 2022-03-10 /pmc/articles/PMC8960275/ /pubmed/35360154 http://dx.doi.org/10.3389/fnins.2022.859440 Text en Copyright © 2022 Qi, Zhang, Li, Sun, Ma, Li, Li, Ren, Xi and Huang. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Neuroscience
Qi, Shun
Zhang, Yao
Li, Xiang
Sun, Chuanzhu
Ma, Xiaowei
Li, Sanzhong
Li, Li
Ren, Kai
Xi, Min
Huang, Zi-Gang
Improved Functional Organization in Patients With Primary Insomnia After Individually-Targeted Transcranial Magnetic Stimulation
title Improved Functional Organization in Patients With Primary Insomnia After Individually-Targeted Transcranial Magnetic Stimulation
title_full Improved Functional Organization in Patients With Primary Insomnia After Individually-Targeted Transcranial Magnetic Stimulation
title_fullStr Improved Functional Organization in Patients With Primary Insomnia After Individually-Targeted Transcranial Magnetic Stimulation
title_full_unstemmed Improved Functional Organization in Patients With Primary Insomnia After Individually-Targeted Transcranial Magnetic Stimulation
title_short Improved Functional Organization in Patients With Primary Insomnia After Individually-Targeted Transcranial Magnetic Stimulation
title_sort improved functional organization in patients with primary insomnia after individually-targeted transcranial magnetic stimulation
topic Neuroscience
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8960275/
https://www.ncbi.nlm.nih.gov/pubmed/35360154
http://dx.doi.org/10.3389/fnins.2022.859440
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