Abnormalities of thalamus volume and resting state functional connectivity in primary insomnia patients

Primary insomnia(PI) is associated with deteriorating attention, memory, physical and mood complaints. Based on the extensive literature demonstrating the critical roles of the thalamusin sleep regulation, we hypothesized that insomniawould be associated with functional and structural changes of the thalamus. This information is needed to better understand the neural mechanisms of insomnia, and would be useful for informing future attempts to alleviate or treat insomniasymptoms. Twenty-seven PI patients and 39 matched healthy controls were included in the present study. Subcortical volume and resting state functionalconnectivity (RSFC) of thalamuswere compared between groups, and the relationships between neuroimaging differences and clinical features, including the Pittsburgh Sleep Quality Index(PSQI), the InsomniaSeverity Index Scale (ISI), the Self-Rating Anxiety Scale (SAS) and the Self-Rating Depression Scale (SDS), also be explored. Compared with the control group, the PI group showed significantly reduced volume of thalamus. In addition, several brain regions showed reduced RSFC with thalamusin PI patients, such as anterior cingulate cortex(ACC), orbitofrontal cortex, hippocampus, caudate and putamen. Correlation analyses revealed that, several of these RSFC patterns were negatively correlated with PSQI score among PI patients, including thalamic connections with the putamen, caudate, hippocampus. Negative correlation was also observed between the RSFC strength of right thalamus–right ACC and SDS score in PI patients. This work demonstrates the structural and functional abnormalities of the thalamusin PI patients that were associated with key clinical features of insomnia. These data further highlight the important role of the thalamusin sleep and PI.