Role of real-time functional magnetic resonance imaging neurofeedback in treating insomnia disorder via regulating amygdala activity
Objective To observe the amygdala activity in patients with insomnia disorder(ID),and to explore the role of real-time functional magnetic resonance imaging neurofeedback(rtfMRI-NF)in treating insomnia by regulating the amygdala activity.Methods Thirty-eight ID patients were diagnosed and treated in Henan Provincial People's Hospital from June 2020 to December 2022.The rtfMRI-NF technique was used to regulate the activity of the left amygdala once a week for 3 consecutive weeks.The resting function MRI data and scores of clinical scales[Pittsburgh Sleep Quality Index(PSQI),Insomnia Severity Index Scale(ISI),Hamilton Depression Scale(HAMD),and Hamilton Anxiety Scale(HAMA)]were collected before and after intervention.Regional homogeneity(ReHo)was used to analyze the brain functional activities before and after intervention,and the differential brain region was selected.The Pearson correlation method was used to assess the correlation between the ReHo value of the differential brain region after the intervention and the scores of HAMA and HAMD.Functional connectivity(FC)of the whole brain voxels was analyzed using the differential brain region as seed point,and the FC value was calculated.Results The scores of PSQI,ISI,HAMA and HAMD were lower after intervention(11.81±3.40,14.81±6.16,16.56±11.52,17.22±7.21)than those before intervention(14.25±3.11,18.09±5.52,20.94±11.58,20.91±8.42)(t=3.652,P=0.001;t=3.479,P=0.002;t=2.739,P=0.010;t=3.539,P=0.001),and the ReHo value of the right precuneus was lower after intervention than that before intervention(FWE-adjusted,voxel level P＜0.005,mass level P＜0.05).With the right precuneus as the seed point,the FC values of the right middle temporal gyrus,right gyrus rectus and left supraorbital frontal gyrus were all lower than those before intervention(GRF-adjusted,voxel level P＜0.005,mass level P＜0.05).After intervention,the ReHo value of the right precuneus was negatively correlated with the scores of HAMA and HAMD(r=-0.426,P=0.015;r=-0.424,P=0.016).Conclusion rtfMRI-NF can relieve anxiety and depression by regulating left amygdala activity in ID patients,reshape the function of brain regions related to emotion and cognition in the default mode network and limbic network,so as to treat insomnia.
insomnia disorderreal-time functional magnetic resonance imaging neurofeedbacklocal consistencyfunctional connectivityresting-state functional magnetic resonance imaging
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