Insomnia subtypes have differentiating deviations in brain structural connectivity

Abstract

ObjectiveInsomnia disorder is the most common sleep disorder. A better understanding of insomnia-related deviations in the brain could inspire better treatment. Insufficiently recognized heterogeneity within the insomnia population could obscure involved brain circuits. The present study investigated whether structural brain connectivity deviations differ between recently discovered and validated insomnia subtypes. MethodsStructural and diffusion weighted 3-Tesla MRI data of four independent studies were harmonized. The sample consisted of 73 controls without sleep complaints and 204 participants with insomnia grouped into five subtypes based on their fingerprint of personality and mood traits assessed with the Insomnia Type Questionnaire. Linear regression correcting for age, sex, and brain volume evaluated group differences in structural connectivity strength, indicated by fractional anisotropy and mean diffusivity, and evaluated within two different atlases. ResultsInsomnia subtypes showed differentiating profiles of deviating structural connectivity which moreover concentrated in different functional networks. Permutation testing against randomly drawn heterogeneous subsamples indicated significant specificity of deviation profiles in four of the five subtypes: highly distressed (p=0.019), moderately distressed reward insensitive (p=0.014), slightly distressed low reactive (p=0.006) and slightly distressed high reactive (p=0.006). ConclusionsOur results provide a first indication that different insomnia subtypes exhibit distinct profiles of deviations in structural brain connectivity. Subtyping of insomnia could be essential for a better understanding of brain mechanisms that contribute to insomnia vulnerability.