title: Sleep-Wake Differences in Relative Regional Cerebral Metabolic Rate for Glucose among Patients with Insomnia Compared with Good Sleepers.
abstract: The neurobiological mechanisms of insomnia may involve altered patterns of activation across sleep-wake states in brain regions associated with cognition, self-referential processes, affect, and sleep-wake promotion. The objective of this study was to compare relative regional cerebral metabolic rate for glucose (rCMRglc) in these brain regions across wake and nonrapid eye movement (NREM) sleep states in patients with primary insomnia (PI) and good sleeper controls (GS).
  
  
  
  Participants included 44 PI and 40 GS matched for age (mean = 37 y old, range 21-60), sex, and race. We conducted [18F]fluoro-2-deoxy-D-glucose positron emission tomography scans in PI and GS during both morning wakefulness and NREM sleep at night. Repeated measures analysis of variance was used to test for group (PI vs. GS) by state (wake vs. NREM sleep) interactions in relative rCMRglc.
  
  
  
  Significant group-by-state interactions in relative rCMRglcwere found in the precuneus/posterior cingulate cortex, left middle frontal gyrus, left inferior/superior parietal lobules, left lingual/fusiform/occipital gyri, and right lingual gyrus. All clusters were significant at Pcorrected< 0.05.
  
  
  
  Insomnia was characterized by regional alterations in relative glucose metabolism across NREM sleep and wakefulness. Significant group-by-state interactions in relative rCMRglcsuggest that insomnia is associated with impaired disengagement of brain regions involved in cognition (left frontoparietal), self-referential processes (precuneus/posterior cingulate), and affect (left middle frontal, fusiform/lingual gyri) during NREM sleep, or alternatively, to impaired engagement of these regions during wakefulness.
authors: Department of Psychiatry, Sleep and Chronobiology Center, University of Pittsburgh School of Medicine, Pittsburgh, PA.
authors: Daniel B
authors: DB
authors: Kay
authors: Department of Bioengineering, University of Pittsburgh, Pittsburgh, PA.
authors: Helmet T
authors: HT
authors: Karim
authors: Department of Psychiatry, Sleep and Chronobiology Center, University of Pittsburgh School of Medicine, Pittsburgh, PA.
authors: Adriane M
authors: AM
authors: Soehner
authors: Department of Psychiatry, Sleep and Chronobiology Center, University of Pittsburgh School of Medicine, Pittsburgh, PA.
authors: Brant P
authors: BP
authors: Hasler
authors: Department of Psychiatry, Sleep and Chronobiology Center, University of Pittsburgh School of Medicine, Pittsburgh, PA.
authors: Kristine A
authors: KA
authors: Wilckens
authors: Department of Radiology, University of Pittsburgh, Pittsburgh, PA.
authors: Jeffrey A
authors: JA
authors: James
authors: Department of Psychiatry, Sleep and Chronobiology Center, University of Pittsburgh School of Medicine, Pittsburgh, PA.
authors: Howard J
authors: HJ
authors: Aizenstein
authors: Department of Radiology, University of Pittsburgh, Pittsburgh, PA.
authors: Julie C
authors: JC
authors: Price
authors: Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA.
authors: Bedda L
authors: BL
authors: Rosario
authors: Department of Psychiatry, Sleep and Chronobiology Center, University of Pittsburgh School of Medicine, Pittsburgh, PA.
authors: David J
authors: DJ
authors: Kupfer
authors: Department of Psychiatry, Sleep and Chronobiology Center, University of Pittsburgh School of Medicine, Pittsburgh, PA.
authors: Anne
authors: A
authors: Germain
authors: Department of Psychiatry, Sleep and Chronobiology Center, University of Pittsburgh School of Medicine, Pittsburgh, PA.
authors: Martica H
authors: MH
authors: Hall
authors: Department of Psychiatry, Sleep and Chronobiology Center, University of Pittsburgh School of Medicine, Pittsburgh, PA.
authors: Peter L
authors: PL
authors: Franzen
authors: Department of Psychiatry, Sleep and Chronobiology Center, University of Pittsburgh School of Medicine, Pittsburgh, PA.|Cerêve Inc. Oakmont, PA.
authors: Eric A
authors: EA
authors: Nofzinger
authors: Department of Psychiatry, Sleep and Chronobiology Center, University of Pittsburgh School of Medicine, Pittsburgh, PA.
authors: Daniel J
authors: DJ
authors: Buysse
mesh_terms: D000328:Adult; D001921:Brain / Q000000981:diagnostic imaging / Q000378:metabolism*; D004734:Energy Metabolism / Q000502:physiology*; D005260:Female; D019788:Fluorodeoxyglucose F18 / Q000378:metabolism; D005947:Glucose / Q000378:metabolism*; D006801:Humans; D008297:Male; D008875:Middle Aged; D049268:Positron-Emission Tomography / Q000379:methods*; D012890:Sleep / Q000502:physiology*; D007319:Sleep Initiation and Maintenance Disorders / Q000175:diagnosis / Q000378:metabolism*; D014851:Wakefulness / Q000502:physiology; D055815:Young Adult
chemical_list: D019788:Fluorodeoxyglucose F18; D005947:Glucose
keywords: FDG; PET; insomnia; neuroimaging