![]() ![]() using a longitudinal data aimed to explore the changes in brain activities in response to visual sleep-related stimuli and neutral stimuli in 14 drug-free psychophysiological insomnia before and after the CBT for insomnia (CBT-I) ( 20). ![]() However, there is a lack of longitudinal study to explore the brain responses to sleep-related stimuli before and after the CBT for individuals with chronic insomnia symptoms. These findings suggest that the individuals with chronic insomnia symptoms have an overreaction to visual stimuli before the CBT while it was recovered after the CBT. The brain region of the visual area and the amygdala showed an increased functional connectivity before the CBT, whereas the functional connectivity between the two areas was decreased after the CBT ( 19). Previous study found that the prefrontal lobe was hypo-activated during a verbal fluency task and was recovered after the CBT ( 18). Individuals with insomnia symptoms are expected not to have difficulties in initiating and/or maintaining sleep, and are expected not to overreact to sleep-related stimuli as before, due to the positive clinical effect of the CBT. Furthermore, the CBT was also used to manage various psychiatric disorders, such as mild to moderate depression and other disorders, such as anxiety, obsessive compulsive disorder, and panic disorder ( 15- 17). The CBT is a safe and effective treatment approach, and has been gradually accepted for clinical first-line treatment for a large proportion of individuals with chronic insomnia symptoms with longer time effect than hypnotic medications ( 13, 14). However, these studies are too few and diverse in tasks to draw a definitive conclusion.Ĭognitive behavior therapy (CBT) is a structured, didactic and goal-oriented form of therapy ( 12). didn’t find any threat- or craving-related brain reactivity in response to sleep-related words in patients with chronic insomnia compared with good sleepers ( 11). observed increased amygdala activity in response to insomnia-related pictures in insomnia patients ( 10). Recently more and more neurobiological researches have revealed the existence of sleep-related attentional bias, which was defined as the tendency to selectively attend to sleep-related information in comparison to neutral information, and has been suggested to be an important factor for the maintenance in individuals with insomnia symptoms ( 4- 8).įunctional magnetic resonance imaging (fMRI), one of the hot research areas in neuroimaging field, is suitable for the mechanism exploration for central nervous system due to its abilities in detecting the spontaneous neuronal brain activity ( 9), which may help us to elucidate the mechanisms underlying sleep related attentional bias by investigating the brain activation in response to sleep-related and neutral pictures or words. Poor sleep in individuals with insomnia symptoms increases sleep-related anxiety with heightened vigilance to sleep-related stimuli, which further exacerbates hyperarousal and in turn affects sleep. Psychophysiological insomnia, considered to be a learned insomnia, caused by a condition process, whereby hyperarousal and sleep-related condition are paired. The most widely accepted model of the psychophysiological insomnia is hyperarousal theory, which states difficulties in initiating and/or maintaining sleep due to global increases in cortical and physiological arousal across the sleep-wake cycle ( 2, 3). ![]() Accepted for publication Feb 06, 2018.Īlmost half of adult population was reported to have subjective experience of insomnia symptom, making it one of the most common sleep disorders ( 1). Exploration of changes in the brain response to sleep-related pictures after cognitive-behavioral therapy for psychophysiological insomnia. Department of Medical Imaging, Jinling Hospital, Medical School of Nanjing University, 305# Eastern Zhongshan Rd, Nanjing 210002, China. Interviews with Outstanding Guest EditorsĬorrespondence to: Xi-Jian Dai.Policy of Dealing with Allegations of Research Misconduct.Policy of Screening for Plagiarism Process. ![]()
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