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• Reviews •
Multimodal magnetic resonance imaging findings in depression with comorbid insomnia
CHENG Zixuan  HU Liangbo 

Cite this article as: CHENG Z X, HU L B. Multimodal magnetic resonance imaging findings in depression with comorbid insomnia[J]. Chin J Magn Reson Imaging, 2026, 17(3): 110-116. DOI:10.12015/issn.1674-8034.2026.03.016.


[Abstract] Depression is a common mental disorder that imposes a substantial burden on individuals and society. Insomnia is one of the most prevalent and clinically persistent symptoms in depression and shows a close bidirectional relationship with its onset, progression, and outcome, often indicating greater symptom severity, poorer treatment response, and a higher risk of relapse. Accumulating evidence suggests that depression and insomnia may, at least in part, share overlapping neurobiological mechanisms. In recent years, the application of multimodal MRI has substantially advanced the investigation of the neural underpinnings of depression comorbid with insomnia. This review systematically summarizes recent findings from structural MRI (sMRI), diffusion tensor imaging (DTI), functional MRI (fMRI), arterial spin labeling (ASL), and magnetic resonance spectroscopy (MRS) studies in this field. We highlight converging evidence of alterations in gray matter structure, white matter microstructure, glymphatic system function, brain activity, functional connectivity, and neurochemical profiles in individuals with depression and comorbid insomnia. In addition, we discuss the limitations of the existing literature and outline directions for future research, with the goal of facilitating the identification of imaging-based biomarkers and informing precision medicine approaches in clinical practice.
[Keywords] depression；insomnia；multimodal imaging；magnetic resonance imaging；diffusion tensor imaging；magnetic resonance spectroscopy；glymphatic system

CHENG Zixuan   HU Liangbo*  

Department of Radiology, the Affiliated Yongchuan Hospital of Chongqing Medical University, Chongqing 402160, China

Corresponding author: HU L B, E-mail: 700056@hospital.cqmu.edu.cn

Conflicts of interest   None.

Received  2025-12-30
Accepted  2026-02-14
DOI: 10.12015/issn.1674-8034.2026.03.016
Cite this article as: CHENG Z X, HU L B. Multimodal magnetic resonance imaging findings in depression with comorbid insomnia[J]. Chin J Magn Reson Imaging, 2026, 17(3): 110-116. DOI:10.12015/issn.1674-8034.2026.03.016.

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