title: Increased insular connectivity with emotional regions in primary insomnia patients: a resting-state fMRI study.
abstract: OBJECTIVE
  To explore the abnormal connectivity patterns between the insular and the voxels of the brain in primary insomnia (PI) with insular-based functional connectivity (FC).
  
  
  METHODS
  With the resting-state fMRI data acquired from 57 PI patients and 46 healthy controls, a two-sample t test was performed on individual FC correlation maps from two groups. The person correlation analysis was used to evaluate the relationship between the abnormal FC and clinical features.
  
  
  RESULTS
  PI patients show enhanced connectivity between the left insula with the right anterior cingulate cortex (p < 0.05 and p < 0.001, AlphaSim-corrected), right frontal sup orb, bilateral thalamus and left precuneus,as well as decreased connectivity with the left middle temporal gyrus and right fusiform (p < 0.05, AlphaSim-corrected). Correlation analysis indicated the enhanced connectivities in the PI patients have significant negative correlations with Self-Rating Depression Scale(SDS)and Self-Rating Anxiety Scale(SAS)scores. In addition, the decreased functional connectivities showed positive correlations with SDS and SAS scores.
  
  
  CONCLUSIONS
  Our study showed the increased connectivity regions with insula were mainly in the emotional circle and decreased connectivity was in cognitive-related regions. These provide additional evidence from functional integration view to understand the possible underlying neural- mechanisms of PI.
  
  
  CONCLUSIONS
  • The aberrant insular-based connectivity pattern of PI patients was detected. • Regions showing increased connectivity with left insular were mainly in emotional circle. • Significant correlations between changed FC and SDS and SAS score were found.
authors.affiliation: Guangdong No. 2 Provincial People's Hospital, Guangzhou, China.
authors.forename: Tianyue
authors.initials: T
authors.lastname: Wang
authors.affiliation: Guangdong No. 2 Provincial People's Hospital, Guangzhou, China.
authors.forename: Jianhao
authors.initials: J
authors.lastname: Yan
authors.affiliation: Guangdong No. 2 Provincial People's Hospital, Guangzhou, China.
authors.forename: Shumei
authors.initials: S
authors.lastname: Li
authors.affiliation: Guangdong No. 2 Provincial People's Hospital, Guangzhou, China.
authors.forename: Wenfeng
authors.initials: W
authors.lastname: Zhan
authors.affiliation: Guangdong No. 2 Provincial People's Hospital, Guangzhou, China.
authors.forename: Xiaofen
authors.initials: X
authors.lastname: Ma
authors.affiliation: People's Hospital of Yuxi City, Yuxi, China.
authors.forename: Likun
authors.initials: L
authors.lastname: Xia
authors.affiliation: Guangdong No. 2 Provincial People's Hospital, Guangzhou, China.
authors.forename: Meng
authors.initials: M
authors.lastname: Li
authors.affiliation: Guangdong No. 2 Provincial People's Hospital, Guangzhou, China.
authors.forename: Chulan
authors.initials: C
authors.lastname: Lin
authors.affiliation: Guangdong No. 2 Provincial People's Hospital, Guangzhou, China.
authors.forename: Junzhang
authors.initials: J
authors.lastname: Tian
authors.affiliation: Guangdong No. 2 Provincial People's Hospital, Guangzhou, China.
authors.forename: Cheng
authors.initials: C
authors.lastname: Li
authors.affiliation: Guangdong No. 2 Provincial People's Hospital, Guangzhou, China. GH.jiang2002@163.com.
authors.forename: Guihua
authors.initials: G
authors.lastname: Jiang
mesh_terms: D000328:Adult; D001921:Brain / Q000000981:diagnostic imaging* / Q000503:physiopathology; D001931:Brain Mapping / Q000379:methods*; D016022:Case-Control Studies; D063132:Connectome; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009434:Neural Pathways / Q000503:physiopathology; D007319:Sleep Initiation and Maintenance Disorders / Q000000981:diagnostic imaging*
keywords: Functional connectivity; Functional integration; Insular; Primary insomnia; Resting-state fMRI