title: Gender Differences in Regional Brain Activity in Patients with Chronic Primary Insomnia: Evidence from a Resting-State fMRI Study.
abstract: OBJECTIVE
  To explore the regional brain activities in patients with chronic primary insomnia (PCPIs) and their sex differences.
  
  
  METHODS
  Forty-two PCPIs (27 females, 15 males) and 42 good sleepers (GSs; 24 females, 18 males) were recruited. Six PCPIs (3 males, 3 females) were scanned twice by MRI to examine the test-retest reliability. Amplitude of low frequency fluctuation (ALFF) method was used to assess the local brain features. The mean signal values of the different ALFF areas were analyzed with a receiver operating characteristic (ROC) curve. Simple linear regression analysis was performed to investigate the relationships between clinical features and different brain areas.
  
  
  RESULTS
  Both female and male PCPIs showed higher ALFF in the temporal lobe and occipital lobe, especially in female PCPIs. Female PCPIs had lower ALFF in the bilateral cerebellum posterior lobe, left dorsolateral prefrontal cortex, and bilateral limbic lobe; however, male PCPIs showed lower ALFF in the left occipital gyrus. The mean signal value of the cerebellum in female PCPIs showed negative correlations with negative emotions. Compared with male PCPIs, female PCPIs showed higher ALFF in the bilateral middle temporal gyrus and lower ALFF in the left limbic lobe. The different areas showed high test-retest stability (Clusters of contiguous volumes ≥ 1080 mm(3) with an intraclass correlation coefficient ≥ 0.80) and high degree of sensitivity and specificity.
  
  
  CONCLUSIONS
  Female PCPIs showed more regional brain differences with higher and lower ALFF responses than male PCPIs. However, they shared analogous excessive hyperarousal mechanism and wide variations in aberrant brain areas.
authors.affiliation: Department of Radiology, The First Affiliated Hospital of Nanchang University, Jiangxi, China.|Brain Cognition and Brain Disease Institute, Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen, China.
authors.forename: Xi-Jian
authors.initials: XJ
authors.lastname: Dai
authors.affiliation: Department of Radiology, The First Affiliated Hospital of Nanchang University, Jiangxi, China.
authors.forename: Xiao
authors.initials: X
authors.lastname: Nie
authors.affiliation: Department of Radiology, The Third Clinical Institute Affiliated To Wenzhou Medical University, Zhejiang, China.
authors.forename: Xuming
authors.initials: X
authors.lastname: Liu
authors.affiliation: Department of Radiology, The First Affiliated Hospital of Nanchang University, Jiangxi, China.
authors.forename: Li
authors.initials: L
authors.lastname: Pei
authors.affiliation: Department of Radiology, The First Affiliated Hospital of Nanchang University, Jiangxi, China.
authors.forename: Jian
authors.initials: J
authors.lastname: Jiang
authors.affiliation: Department of Radiology, The First Affiliated Hospital of Nanchang University, Jiangxi, China.
authors.forename: De-chang
authors.initials: DC
authors.lastname: Peng
authors.affiliation: Department of Radiology, The First Affiliated Hospital of Nanchang University, Jiangxi, China.
authors.forename: Hong-Han
authors.initials: HH
authors.lastname: Gong
authors.affiliation: Department of Radiology, The First Affiliated Hospital of Nanchang University, Jiangxi, China.
authors.forename: Xian-Jun
authors.initials: XJ
authors.lastname: Zeng
authors.affiliation: Department of Imaging and Interventional Radiology, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong.
authors.forename: Yì-Xiáng J
authors.initials: YX
authors.lastname: Wáng
authors.affiliation: Brain Cognition and Brain Disease Institute, Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen, China.
authors.forename: Yang
authors.initials: Y
authors.lastname: Zhan
mesh_terms: D001921:Brain / Q000000981:diagnostic imaging* / Q000503:physiopathology*; D002908:Chronic Disease; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D015203:Reproducibility of Results; D012146:Rest; D012737:Sex Factors; D007319:Sleep Initiation and Maintenance Disorders / Q000000981:diagnostic imaging / Q000503:physiopathology*
keywords: amplitude of low frequency fluctuation; blood oxygen level-dependent; functional magnetic resonance imaging; gender difference; insomnia