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• Clinical Article •
A preliminary comparative study on the characteristics of resting-state brain functional networks in patients with comorbid insomnia in first-episode and recurrent depression
CHEN Limei  LI Mengyao  HUANG Yingxin  HUANG Yihua  XIE Wang  YAN Luda  LI Jingjing  LI Zhongxian  PENG Min  ZHOU Yifu  FANG Jiliang  ZHOU Peng 

Cite this article as: CHEN L M, LI M Y, HUANG Y X, et al. A preliminary comparative study on the characteristics of resting-state brain functional networks in patients with comorbid insomnia in first-episode and recurrent depression[J]. Chin J Magn Reson Imaging, 2025, 16(1): 89-94, 110. DOI:10.12015/issn.1674-8034.2025.01.014.


[Abstract] Objective To investigate the disparities in brain functional connectivity (FC) among patients with first-episode depression comorbid with insomnia (FEDCI) and those with recurrent depression comorbid with insomnia (RDCI), and to assess its association with clinical manifestations.Materials and Methods A cohort of 53 patients with depression comorbid with insomnia was studied. The participants were categorized into two groups: 32 patients with FEDCI and 21 patients with RDCI. Additionally, 21 healthy controls (HC) served as a control group. The 17-item Hamilton Depression Scale (HAMD-17) was used to assess the degree of depression, Pittsburgh Sleep Quality Index (PSQI), Insomnia Severity Index (ISI) to assess the degree of depression and sleep status. The PSQI and ISI were used to assess sleep status. Resting-state blood oxygen level-dependent functional magnetic resonance imaging (fMRI) data were acquired from all participants. Using SPSS software, we employed univariate analysis of variance to compare FC differences based on the bilateral rostral anterior cingulate cortex (rACC) as seed regions across the three groups, and analyzed its correlation with clinical scales. fMRI data underwent GRF correction with voxel-level P < 0.001 and cluster-level P < 0.05.Results The differences in demographics and clinical symptom scores between the two groups were not statistically significant (P > 0.05). The difference in FC based on bilateral rACC between the FEDCI and RDCI groups and the HC group was not statistically significant (P > 0.05). However, with the left rACC as a seed region, the RDCI group exhibited lower FC values in the left angular gyrus and right middle frontal gyrus compared to the HC group. In comparison to the FEDCI group, the RDCI group had higher FC values in the left angular gyrus and left inferior frontal gyrus (P < 0.05). Utilizing the right rACC as a seed region, the FEDCI group displayed a higher FC value in the left thalamus, while showing lower FC values in the left posterior central gyrus and right insula compared to the HC group (P < 0.05). Furthermore, the FEDCI group exhibited lower FC values in the left posterior central gyrus and right insula compared to the RDCI group (P < 0.05). Correlation analysis revealed a positive association between the FC values of the left anterior cingulate gyrus and left angular gyrus in the FEDCI group with the HAMD-17 (P = 0.012, r = 0.439). Additionally, the number of depression episodes in the RDCI group positively correlated with the FC value between the left rACC and left inferior frontal gyrus (P = 0.002, r = 0.654).Conclusions There exist significant differences in prefrontal, the emotional and somatosensory motor network brain functional networks between patients with FEDCI and RDCI, which correlate with clinical symptoms and the number of depressive episodes.
[Keywords] functional magnetic resonance imaging；first-episode depression comorbid insomnia；recurrent depression comorbid insomnia；functional connectivity；rostral anterior cingulate cortex

CHEN Limei1   LI Mengyao1   HUANG Yingxin1   HUANG Yihua2   XIE Wang2   YAN Luda1   LI Jingjing1, 3   LI Zhongxian1   PENG Min1   ZHOU Yifu1   FANG Jiliang4*   ZHOU Peng1, 3*  

1 Department of Acupuncture, Seventh Clinical Medical College, Guangzhou University of Chinese Medicine, Shenzhen 518100, China

2 Department of Radiology, Bao'an District Traditional Chinese Medicine Hospital, Shenzhen 518100, China

3 Acupuncture Clinical Research Center, Bao'an District Traditional Chinese Medicine Hospital, Shenzhen 518100, China

4 Department of Radiology, Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing 100053, China

Corresponding author: FANG J L, E-mail: fangmgh@163.com ZHOU P, E-mail: zhoupeng80@gzucm.edu.cn

Conflicts of interest   None.

Received  2024-06-29
Accepted  2025-01-10
DOI: 10.12015/issn.1674-8034.2025.01.014
Cite this article as: CHEN L M, LI M Y, HUANG Y X, et al. A preliminary comparative study on the characteristics of resting-state brain functional networks in patients with comorbid insomnia in first-episode and recurrent depression[J]. Chin J Magn Reson Imaging, 2025, 16(1): 89-94, 110. DOI:10.12015/issn.1674-8034.2025.01.014.

[1]
The Lancet. Waking up to the importance of sleep[J/OL]. Lancet, 2022, 400(10357): 973 [2024-06-28]. https://pubmed.ncbi.nlm.nih.gov/36115369/. DOI: 10.1016/S0140-6736(22)01774-3.
[2]
SIMON G E, MOISE N, MOHR D C. Management of depression in adults: a review[J]. JAMA, 2024, 332(2): 141-152. DOI: 10.1001/jama.2024.5756.
[3]
HUANG Y Q, WANG Y, WANG H, et al. Prevalence of mental disorders in China: a cross-sectional epidemiological study[J]. Lancet Psychiatry, 2019, 6(3): 211-224. DOI: 10.1016/S2215-0366(18)30511-X.
[4]
HERRMAN H, PATEL V, KIELING C, et al. Time for united action on depression: a lancet-world psychiatric association commission[J]. Lancet, 2022, 399(10328): 957-1022. DOI: 10.1016/S0140-6736(21)02141-3.
[5]
RIEMANN D, BAGLIONI C, BASSETTI C, et al. European guideline for the diagnosis and treatment of insomnia[J]. J Sleep Res, 2017, 26(6): 675-700. DOI: 10.1111/jsr.12594.
[6]
FENG Y, XIAO L, WANG W W, et al. Guidelines for the diagnosis and treatment of depressive disorders in China: The second edition[J/OL]. J Affect Disord, 2019, 253: 352-356 [2024-06-28]. https://pubmed.ncbi.nlm.nih.gov/31078835/. DOI: 10.1016/j.jad.2019.04.104.
[7]
YAO Y, GUO D, LIU F L, et al. An overview of mechanisms underlying the comorbidity of sleep and depression disorders in the elderly[J]. Stress Brain, 2024, 4(1): 31-45. DOI: 10.26599/sab.2023.9060007.
[8]
HIDAKA S, IKEJIMA C, KODAMA C, et al. Prevalence of depression and depressive symptoms among older Japanese people: comorbidity of mild cognitive impairment and depression[J]. Int J Geriatr Psychiatry, 2012, 27(3): 271-279. DOI: 10.1002/gps.2715.
[9]
WANG X F, CHENG S X, XU H L. Systematic review and meta-analysis of the relationship between sleep disorders and suicidal behaviour in patients with depression[J/OL]. BMC Psychiatry, 2019, 19(1): 303 [2024-06-28]. https://pubmed.ncbi.nlm.nih.gov/31623600/. DOI: 10.1186/s12888-019-2302-5.
[10]
HUANG C Y, ZHAO Y F, ZHANG Z X, et al. Psychotherapeutic and pharmacological agents for post-traumatic stress disorder with sleep disorder: network meta-analysis[J/OL]. Ann Med, 2024, 56(1): 2381696 [2024-06-28]. https://pubmed.ncbi.nlm.nih.gov/39061119/. DOI: 10.1080/07853890.2024.2381696.
[11]
RAJA A, AHMED S, BASIT ALI SIDDIQUI M, et al. Evaluating the safety and efficacy of zuranolone in the management of major depressive disorder and postpartum depression, with or without concurrent insomnia: a rigorous systematic review and meta-analysis[J/OL]. Front Psychiatry, 2024, 15: 1425295 [2024-06-28]. https://pubmed.ncbi.nlm.nih.gov/39035602/. DOI: 10.3389/fpsyt.2024.1425295.
[12]
SATEIA M J, BUYSSE D J, KRYSTAL A D, et al. Clinical practice guideline for the pharmacologic treatment of chronic insomnia in adults: an American academy of sleep medicine clinical practice guideline[J]. J Clin Sleep Med, 2017, 13(2): 307-349. DOI: 10.5664/jcsm.6470.
[13]
CANARIO E, CHEN D, BISWAL B. A review of resting-state fMRI and its use to examine psychiatric disorders[J]. Psychoradiology, 2021, 1(1): 42-53. DOI: 10.1093/psyrad/kkab003.
[14]
FENG J J, MA L Y, XU L L, et al. Research progress of MRI in major depressive disorder with insomnia[J]. Chin J Magn Reson Imag, 2022, 13(12): 141-145. DOI: 10.12015/issn.1674-8034.2022.12.026.
[15]
SCHNEIDER I, SCHMITGEN M M, BACH C, et al. Cognitive remediation therapy modulates intrinsic neural activity in patients with major depression[J]. Psychol Med, 2020, 50(14): 2335-2345. DOI: 10.1017/S003329171900240X.
[16]
YANG H, CHEN X, CHEN Z B, et al. Disrupted intrinsic functional brain topology in patients with major depressive disorder[J]. Mol Psychiatry, 2021, 26(12): 7363-7371. DOI: 10.1038/s41380-021-01247-2.
[17]
IRONSIDE M, DUDA J M, MOSER A D, et al. Association of lower rostral anterior cingulate GABA+ and dysregulated cortisol stress response with altered functional connectivity in young adults with lifetime depression: a multimodal imaging investigation of trait and state effects[J]. Am J Psychiatry, 2024, 181(7): 639-650. DOI: 10.1176/appi.ajp.20230382.
[18]
FAIR D A, COHEN A L, POWER J D, et al. Functional brain networks develop from a "local to distributed" organization[J/OL]. PLoS Comput Biol, 2009, 5(5): e1000381 [2024-06-28]. https://pubmed.ncbi.nlm.nih.gov/19412534/. DOI: 10.1371/journal.pcbi.1000381.
[19]
YAN C G, WANG X D, ZUO X N, et al. DPABI: data processing & analysis for (resting-state) brain imaging[J]. Neuroinformatics, 2016, 14(3): 339-351. DOI: 10.1007/s12021-016-9299-4.
[20]
ASHBURNER J, FRISTON K J. Unified segmentation[J]. NeuroImage, 2005, 26(3): 839-851. DOI: 10.1016/j.neuroimage.2005.02.018.
[21]
FRODL T, JÄGER M, BORN C, et al. Anterior cingulate cortex does not differ between patients with major depression and healthy controls, but relatively large anterior cingulate cortex predicts a good clinical course[J]. Psychiatry Res, 2008, 163(1): 76-83. DOI: 10.1016/j.pscychresns.2007.04.012.
[22]
MANOLIU A, MENG C, BRANDL F, et al. Insular dysfunction within the salience network is associated with severity of symptoms and aberrant inter-network connectivity in major depressive disorder[J/OL]. Front Hum Neurosci, 2014, 7: 930 [2024-06-28]. https://pubmed.ncbi.nlm.nih.gov/24478665/. DOI: 10.3389/fnhum.2013.00930.
[23]
HABER S N, KNUTSON B. The reward circuit: linking primate anatomy and human imaging[J]. Neuropsychopharmacology, 2010, 35(1): 4-26. DOI: 10.1038/npp.2009.129.
[24]
HU Y X, SHI J Y, XIA G Y, et al. Analysis of functional connectivity changes in attention networks and default mode networks in patients with depression and insomnia[J]. Sleep Breath, 2024, 28(4): 1731-1742. DOI: 10.1007/s11325-024-03064-7.
[25]
SCHMAAL L, HIBAR D P, SÄMANN P G, et al. Cortical abnormalities in adults and adolescents with major depression based on brain scans from 20 cohorts worldwide in the ENIGMA Major Depressive Disorder Working Group[J]. Mol Psychiatry, 2017, 22(6): 900-909. DOI: 10.1038/mp.2016.60.
[26]
CHENG W, ROLLS E T, RUAN H T, et al. Functional connectivities in the brain that mediate the association between depressive problems and sleep quality[J]. JAMA Psychiatry, 2018, 75(10): 1052-1061. DOI: 10.1001/jamapsychiatry.2018.1941.
[27]
CHEN L M. Clinical study of percutaneous auricular nerve stimulation in the treatment of refractory depression and its brain mechanism BOLD/MRS multimodal fMRI study[D]. Beijing: China Academy of Chinese Medical Sciences, 2021. DOI: 10.27658/d.cnki.gzzyy.2021.000078.
[28]
YAN C G, CHEN X, LI L, et al. Reduced default mode network functional connectivity in patients with recurrent major depressive disorder[J]. Proc Natl Acad Sci USA, 2019, 116(18): 9078-9083. DOI: 10.1073/pnas.1900390116.
[29]
BRIGGS R G, KHAN A B, CHAKRABORTY A R, et al. Anatomy and white matter connections of the superior frontal gyrus[J]. Clin Anat, 2020, 33(6): 823-832. DOI: 10.1002/ca.23523.
[30]
QIN H, LIU B, YU D H. Changes of gray matter structure of patients with chronic insomnia in magnetic resonance imaging[J]. Chin J Neurol, 2021, 54(2): 125-130. DOI: 10.3760/cma.j.cn113694-20200505-00328.
[31]
SU T, CHEN B, YANG M F, et al. Disrupted functional connectivity of the habenula links psychomotor retardation and deficit of verbal fluency and working memory in late-life depression[J/OL]. CNS Neurosci Ther, 2024, 30(4): e14490 [2024-06-28]. https://pubmed.ncbi.nlm.nih.gov/37804094/. DOI: 10.1111/cns.14490.
[32]
LEONARDS C A, HARRISON B J, JAMIESON A J, et al. Altered task-related decoupling of the rostral anterior cingulate cortex in depression[J/OL]. Neuroimage Clin, 2024, 41: 103564 [2024-06-28]. https://pubmed.ncbi.nlm.nih.gov/38218081/. DOI: 10.1016/j.nicl.2024.103564.
[33]
DAVEY C G, CEARNS M, JAMIESON A, et al. Suppressed activity of the rostral anterior cingulate cortex as a biomarker for depression remission[J]. Psychol Med, 2021, 53(6): 1-8. DOI: 10.1017/S0033291721004323.
[34]
CHEN Z Y, JIANG T F, YIN X J, et al. The increased functional connectivity between the locus coeruleus and supramarginal gyrus in insomnia disorder with acupuncture modulation[J/OL]. Front Neurosci, 2023, 17: 1131916 [2024-06-28]. https://pubmed.ncbi.nlm.nih.gov/37152608/. DOI: 10.3389/fnins.2023.1131916.
[35]
WU Y, ZHONG Y, ZHANG G, et al. Distinct functional patterns in child and adolescent bipolar and unipolar depression during emotional processing[J/OL]. Cereb Cortex, 2024, 34(1): bhad461 [2024-06-28]. https://pubmed.ncbi.nlm.nih.gov/38044479/. DOI: 10.1093/cercor/bhad461.
[36]
SUN X Y, SUN J R, LU X W, et al. Mapping neurophysiological subtypes of major depressive disorder using normative models of the functional connectome[J]. Biol Psychiatry, 2023, 94(12): 936-947. DOI: 10.1016/j.biopsych.2023.05.021.
[37]
YANG C Y, ZHOU Z L, BAO W J, et al. Sex differences in aberrant functional connectivity of three core networks and subcortical networks in medication-free adolescent-onset major depressive disorder[J/OL]. Cereb Cortex, 2024, 34(6): bhae225 [2024-06-28]. https://pubmed.ncbi.nlm.nih.gov/38836288/. DOI: 10.1093/cercor/bhae225.
[38]
MO Y T, WEI Q, BAI T J, et al. Bifrontal electroconvulsive therapy changed regional homogeneity and functional connectivity of left angular gyrus in major depressive disorder[J/OL]. Psychiatry Res, 2020, 294: 113461 [2024-06-28]. https://pubmed.ncbi.nlm.nih.gov/33038791/. DOI: 10.1016/j.psychres.2020.113461.
[39]
AQUINO G, BENZ F, DRESSLE R J, et al. Towards the neurobiology of insomnia: a systematic review of neuroimaging studies[J/OL]. Sleep Med Rev, 2024, 73: 101878 [2024-06-28]. https://pubmed.ncbi.nlm.nih.gov/38056381/. DOI: 10.1016/j.smrv.2023.101878.
[40]
ZHANG Y J, LIN P, WANG R M, et al. Insula-medial prefrontal cortex functional connectivity modulated by transcutaneous auricular vagus nerve stimulation: an fMRI study[J]. IEEE J Biomed Health Inform, 2024, 28(10): 5962-5970. DOI: 10.1109/JBHI.2024.3423019.

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