Functional neuroimaging evidence for hyperarousal in insomnia. Am J Psychiatry

Department of Psychiatry, University of Pittsburgh, Pittsburgh, Pennsylvania, United States
American Journal of Psychiatry (Impact Factor: 12.3). 11/2004; 161(11):2126-8. DOI: 10.1176/appi.ajp.161.11.2126
Source: PubMed


The authors investigated the neurobiological basis of poor sleep and daytime fatigue in insomnia.
[(18)F]Fluorodeoxyglucose positron emission tomography was used to assess regional cerebral glucose metabolism of seven patients with insomnia and 20 healthy subjects.
Compared with healthy subjects, patients with insomnia showed greater global cerebral glucose metabolism during sleep and while awake, a smaller decline in relative metabolism from waking to sleep states in wake-promoting regions, and reduced relative metabolism in the prefrontal cortex while awake.
Subjectively disturbed sleep in patients with insomnia is associated with greater brain metabolism. The inability to fall asleep may be related to a failure of arousal mechanisms to decline in activity from waking to sleep states. Further, daytime fatigue may reflect decreased activity in the prefrontal cortex resulting from inefficient sleep.

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    • "Sleep research indicates that insomnia is highly associated with abnormal brain activity. Patients with insomnia have been found to exhibit hyperarousal [84] or greater global brain metabolism while awake, as compared to sleep state [85]. In particular, their resting EEG activity in both the alpha band and the nonalpha band is higher than that of normal subjects, and there is a significant positive correlation between hyperarousal scores and alpha activity on the left side when patients' eyes are open [86]. "

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    • "Furthermore , altered function in fronto - subcortical circuits has been suggested to be involved in the pathophysiology of insomnia [ Cano et al . , 2008 ; Nofzinger et al . , 2004 ] . While the exact neurobiological mechanisms underlying insomnia remain unclear , it seems reasonable to assume that reduced white matter integrity in the anterior internal capsule may contribute to disturbed sleep - specific fronto - subcortical neuronal synchronization and , thus , to the experience of insomnia . It has also been su"
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    ABSTRACT: Chronic insomnia is one of the most prevalent central nervous system diseases, however, its neurobiology is poorly understood. Up to now, nothing is known about the integrity of white matter tracts in insomnia patients. In this study, diffusion tensor imaging (DTI) was used in a well-characterized sample of primary insomnia (PI) patients and good sleeper controls to fill this void. Voxelwise between-group comparisons of fractional anisotropy (FA) were performed in 24 PI patients (10 males; 14 females; 42.7 ± 14.5 years) and 35 healthy good sleepers (15 males; 20 females; 40.1 ± 9.1 years) with age and sex as covariates. PI patients showed reduced FA values within the right anterior internal capsule and a trend for reduced FA values in the left anterior internal capsule. The results suggest that insomnia is associated with a reduced integrity of white matter tracts in the anterior internal capsule indicating that disturbed fronto-subcortical connectivity may be a cause or consequence of the disorder. Hum Brain Mapp, 2013. © 2013 Wiley Periodicals, Inc.
    Full-text · Article · Jul 2014 · Human Brain Mapping
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    • "Neuroimaging findings in people with insomnia also support a hyperarousal hypothesis. In PET studies primary insomniacs, relative to healthy controls, showed greater cerebral glucose metabolism during sleep, while awake, and at the transition from wake to sleep and particularly in the ascending reticular activation system (ARAS) (Nofzinger et al. 2004). The hypothalamus, thalamus, amygdala, hippocampus , and prefrontal cortices were also activated during sleep. "
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    ABSTRACT: Insomnia is a prevalent sleep disorder that is typically comorbid with medical, psychiatric, and other sleep disorders. Yet, it is a disorder with its own course and morbidity that can persist if untreated. This chapter describes the physiological correlates of insomnia expressed during sleep and during the daytime. Together, the data from nighttime and daytime electrophysiologyelectrophysiology , event-related brain potential recordingevent-related brain potential recording , neuroimaging studiesneuroimaging studies , sympathetic nervous systemsympathetic nervous system , and HPA axis monitoringHPA axis monitoring all suggest that insomnia is a 24 h disorder of hyperarousaldisorder of hyperarousal .
    Full-text · Article · Jun 2014 · Current Topics in Behavioral Neurosciences
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