title: Reduced Integrity of Right Lateralized White Matter in Patients with Primary Insomnia: A Diffusion-Tensor Imaging Study.
abstract: Purpose To analyze the integrity of white matter (WM) tracts in primary insomnia patients and provide better characterization of abnormal WM integrity and its relationship with disease duration and clinical features of primary insomnia. Materials and Methods This prospective study was approved by the ethics committee of the Guangdong No. 2 Provincial People's Hospital. Tract-based spatial statistics were used to compare changes in diffusion parameters of WM tracts from 23 primary insomnia patients and 30 healthy control (HC) participants, and the accuracy of these changes in distinguishing insomnia patients from HC participants was evaluated. Voxel-wise statistics across subjects was performed by using a 5000-permutation set with family-wise error correction (family-wise error, P < .05). Multiple regressions were used to analyze the associations between the abnormal fractional anisotropy (FA) in WM with disease duration, Pittsburgh Sleep Quality Index, insomnia severity index, self-rating anxiety scale, and the self-rating depression scale in primary insomnia. Characteristics for abnormal WM were also investigated in tract-level analyses. Results Primary insomnia patients had lower FA values mainly in the right anterior limb of the internal capsule, right posterior limb of the internal capsule, right anterior corona radiata, right superior corona radiata, right superior longitudinal fasciculus, body of the corpus callosum, and right thalamus (P < .05, family-wise error correction). The receiver operating characteristic areas for the seven regions were acceptable (range, 0.60-0.74; 60%-74%). Multiple regression models showed abnormal FA values in the thalamus and body corpus callosum were associated with the disease duration, self-rating depression scale, and Pittsburgh Sleep Quality Index scores. Tract-level analysis suggested that the reduced FA values might be related to greater radial diffusivity. Conclusion This study showed that WM tracts related to regulation of sleep and wakefulness, and limbic cognitive and sensorimotor regions, are disrupted in the right brain in patients with primary insomnia. The reduced integrity of these WM tracts may be because of loss of myelination. (©) RSNA, 2016.
authors.affiliation: From the Department of Medical Imaging, Guangdong No. 2 Provincial People's Hospital, 1 Shiliugang Rd, Haizhu District, Guangzhou 510317, P. R. China (S.L., J.T., H.W., M.L., T.W., G.J.); Institute of Neuroscience and Medicine (INM-2), Forschungszentrum Jülich, Jülich, Germany (A.B.); Neurologic Department, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany (A.B.); Center for the Study of Applied Psychology, Key Laboratory of Mental Health and Cognitive Science of Guangdong Province, Guangzhou, P. R. China (R.H.); School of Psychology, South China Normal University, Guangzhou, P. R. China (R.H.); and Department of Magnetic Resonance Imaging, People's Hospital of YuXi City, YuXi, P. R. China (L.X.).
authors.forename: Shumei
authors.initials: S
authors.lastname: Li
authors.affiliation: From the Department of Medical Imaging, Guangdong No. 2 Provincial People's Hospital, 1 Shiliugang Rd, Haizhu District, Guangzhou 510317, P. R. China (S.L., J.T., H.W., M.L., T.W., G.J.); Institute of Neuroscience and Medicine (INM-2), Forschungszentrum Jülich, Jülich, Germany (A.B.); Neurologic Department, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany (A.B.); Center for the Study of Applied Psychology, Key Laboratory of Mental Health and Cognitive Science of Guangdong Province, Guangzhou, P. R. China (R.H.); School of Psychology, South China Normal University, Guangzhou, P. R. China (R.H.); and Department of Magnetic Resonance Imaging, People's Hospital of YuXi City, YuXi, P. R. China (L.X.).
authors.forename: Junzhang
authors.initials: J
authors.lastname: Tian
authors.affiliation: From the Department of Medical Imaging, Guangdong No. 2 Provincial People's Hospital, 1 Shiliugang Rd, Haizhu District, Guangzhou 510317, P. R. China (S.L., J.T., H.W., M.L., T.W., G.J.); Institute of Neuroscience and Medicine (INM-2), Forschungszentrum Jülich, Jülich, Germany (A.B.); Neurologic Department, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany (A.B.); Center for the Study of Applied Psychology, Key Laboratory of Mental Health and Cognitive Science of Guangdong Province, Guangzhou, P. R. China (R.H.); School of Psychology, South China Normal University, Guangzhou, P. R. China (R.H.); and Department of Magnetic Resonance Imaging, People's Hospital of YuXi City, YuXi, P. R. China (L.X.).
authors.forename: Andreas
authors.initials: A
authors.lastname: Bauer
authors.affiliation: From the Department of Medical Imaging, Guangdong No. 2 Provincial People's Hospital, 1 Shiliugang Rd, Haizhu District, Guangzhou 510317, P. R. China (S.L., J.T., H.W., M.L., T.W., G.J.); Institute of Neuroscience and Medicine (INM-2), Forschungszentrum Jülich, Jülich, Germany (A.B.); Neurologic Department, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany (A.B.); Center for the Study of Applied Psychology, Key Laboratory of Mental Health and Cognitive Science of Guangdong Province, Guangzhou, P. R. China (R.H.); School of Psychology, South China Normal University, Guangzhou, P. R. China (R.H.); and Department of Magnetic Resonance Imaging, People's Hospital of YuXi City, YuXi, P. R. China (L.X.).
authors.forename: Ruiwang
authors.initials: R
authors.lastname: Huang
authors.affiliation: From the Department of Medical Imaging, Guangdong No. 2 Provincial People's Hospital, 1 Shiliugang Rd, Haizhu District, Guangzhou 510317, P. R. China (S.L., J.T., H.W., M.L., T.W., G.J.); Institute of Neuroscience and Medicine (INM-2), Forschungszentrum Jülich, Jülich, Germany (A.B.); Neurologic Department, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany (A.B.); Center for the Study of Applied Psychology, Key Laboratory of Mental Health and Cognitive Science of Guangdong Province, Guangzhou, P. R. China (R.H.); School of Psychology, South China Normal University, Guangzhou, P. R. China (R.H.); and Department of Magnetic Resonance Imaging, People's Hospital of YuXi City, YuXi, P. R. China (L.X.).
authors.forename: Hua
authors.initials: H
authors.lastname: Wen
authors.affiliation: From the Department of Medical Imaging, Guangdong No. 2 Provincial People's Hospital, 1 Shiliugang Rd, Haizhu District, Guangzhou 510317, P. R. China (S.L., J.T., H.W., M.L., T.W., G.J.); Institute of Neuroscience and Medicine (INM-2), Forschungszentrum Jülich, Jülich, Germany (A.B.); Neurologic Department, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany (A.B.); Center for the Study of Applied Psychology, Key Laboratory of Mental Health and Cognitive Science of Guangdong Province, Guangzhou, P. R. China (R.H.); School of Psychology, South China Normal University, Guangzhou, P. R. China (R.H.); and Department of Magnetic Resonance Imaging, People's Hospital of YuXi City, YuXi, P. R. China (L.X.).
authors.forename: Meng
authors.initials: M
authors.lastname: Li
authors.affiliation: From the Department of Medical Imaging, Guangdong No. 2 Provincial People's Hospital, 1 Shiliugang Rd, Haizhu District, Guangzhou 510317, P. R. China (S.L., J.T., H.W., M.L., T.W., G.J.); Institute of Neuroscience and Medicine (INM-2), Forschungszentrum Jülich, Jülich, Germany (A.B.); Neurologic Department, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany (A.B.); Center for the Study of Applied Psychology, Key Laboratory of Mental Health and Cognitive Science of Guangdong Province, Guangzhou, P. R. China (R.H.); School of Psychology, South China Normal University, Guangzhou, P. R. China (R.H.); and Department of Magnetic Resonance Imaging, People's Hospital of YuXi City, YuXi, P. R. China (L.X.).
authors.forename: Tianyue
authors.initials: T
authors.lastname: Wang
authors.affiliation: From the Department of Medical Imaging, Guangdong No. 2 Provincial People's Hospital, 1 Shiliugang Rd, Haizhu District, Guangzhou 510317, P. R. China (S.L., J.T., H.W., M.L., T.W., G.J.); Institute of Neuroscience and Medicine (INM-2), Forschungszentrum Jülich, Jülich, Germany (A.B.); Neurologic Department, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany (A.B.); Center for the Study of Applied Psychology, Key Laboratory of Mental Health and Cognitive Science of Guangdong Province, Guangzhou, P. R. China (R.H.); School of Psychology, South China Normal University, Guangzhou, P. R. China (R.H.); and Department of Magnetic Resonance Imaging, People's Hospital of YuXi City, YuXi, P. R. China (L.X.).
authors.forename: Likun
authors.initials: L
authors.lastname: Xia
authors.affiliation: From the Department of Medical Imaging, Guangdong No. 2 Provincial People's Hospital, 1 Shiliugang Rd, Haizhu District, Guangzhou 510317, P. R. China (S.L., J.T., H.W., M.L., T.W., G.J.); Institute of Neuroscience and Medicine (INM-2), Forschungszentrum Jülich, Jülich, Germany (A.B.); Neurologic Department, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany (A.B.); Center for the Study of Applied Psychology, Key Laboratory of Mental Health and Cognitive Science of Guangdong Province, Guangzhou, P. R. China (R.H.); School of Psychology, South China Normal University, Guangzhou, P. R. China (R.H.); and Department of Magnetic Resonance Imaging, People's Hospital of YuXi City, YuXi, P. R. China (L.X.).
authors.forename: Guihua
authors.initials: G
authors.lastname: Jiang
mesh_terms: D000328:Adult; D056324:Diffusion Tensor Imaging; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D011446:Prospective Studies; D007319:Sleep Initiation and Maintenance Disorders / Q000000981:diagnostic imaging* / Q000473:pathology*; D066127:White Matter / Q000000981:diagnostic imaging* / Q000473:pathology*