Journal Article

Dual roles of the amygdala–hippocampus circuit in the regulation of rapid eye movement sleep and depression symptoms by repetitive transcranial magnetic stimulation in patients with insomnia

Zhu, Yifei, Yuan, Kai, Zhao, Xumeng, Liu, Xiaoyang, Shao, Ziqiang, Yu, Dahua, Yue, Lirong, Guo, Yongjian, Sheng, Xiaona, Liu, Jiayi

2024

Overview

Exclusion criteria for both groups are as follows: other comorbid mental disorders; serious neurological or medical conditions; other sleep disorders; body mass index score >30; frequent jet lag; contraindications for 3 Tesla magnetic resonance imaging (MRI) or transcranial magnetic stimulation. 60 patients with insomnia were enrolled (38 were female), alongside 30 age-matched, gender-matched and education-matched healthy controls. For each subject, a T1-weighted sequence was acquired with the parameters as follows: repetition time (TR)=6.3 ms; echo time (TE)=2.8 ms; inversion time=844.2 ms; data matrix=256×256; slices=176; field of view (FOV)=256×256 mm2; slice thickness=1 mm. The resting-state functional images were acquired with a single echo using the following parameters: TR=2000 ms; TE=30 ms; flip angle=90°; FOV=240×240 mm2; slice thickness=5 mm; slices=30; matrix size=64×64 and total volumes=185. The hyper-RSFC within the left amygdala–hippocampus circuit (p<0.05, family-wise error corrected) in patients with insomnia was restored after active rTMS treatment (figure 1B). [...]the RSFC changes were significantly correlated with the improvement of REM duration (r=0.46, p=0.024) and BDI scores (r=0.70, p=0.004) (figure 1C). Table 1 Demographic and clinical characteristics of the participants Characteristics Active rTMS (n=30) Sham rTMS (n=30) HC (n=30) P value Mean (SD) Mean (SD) Mean (SD) Active-sham Active-HC Sham-HC Age (years） 43.31 (8.98) 43.15 (10.20) 41.50 (11.25) ns ns ns Gender (M/F) 12/18 10/20 12/18 ns ns ns Education (years) 13.25 (3.85) 12.61 (3.88) 13.79 (4.22) ns ns ns PSQI 13.17 (2.78) 13.77 (3.23) 3.23 (1.46) ns <0.001 <0.001 ISI 16.53 (3.81) 17.31 (5.84) 1.40 (1.16) ns <0.001 <0.001 BDI 13.12 (2.62) 16.40 (5.14) 3.50 (4.11) ns <0.001 <0.001 BAI 35.22 (8.28) 36.72 (6.23) 26.10 (2.26) ns <0.001 <0.001 REM duration (min) 75.10 (36.58) 66.23 (21.92) 50.05 (25.72) ns 0.005 0.021 RSFC (amy–hippo) 0.14 (0.11) 0.16 (0.10) 0.03 (0.03) ns <0.001 <0.001 amy-hippo, amygdala-hippocampus; BAI, Beck Anxiety Inventory; BDI, Beck Depression Inventory; HC, healthy control; ISI, Insomnia Severity Index; ns, not significant; PSQI, Pittsburgh Sleep Quality Index; REM, rapid eye movement; RSFC,

• Publisher: BMJ Publishing Group Ltd,BMJ Publishing Group LTD,BMJ Publishing Group
• Subject: Anxiety / Brain research / Clinical Trials, Phase I as Topic / Comorbidity / Double-Blind Method / Emotional Adjustment / Eye movements / Homeostasis / Insomnia / Letter / Magnetic resonance imaging / Mental depression / Mental disorders / Sleep disorders / Time series / Transcranial magnetic stimulation / Variance analysis