Event-related current density in primary insomnia

Using Low Resolution Electromagnetic Tomography (LORETA), event-related current density was investigated in 14 patients with primary insomnia and 14 controls matched for age, gender and education level. All subjects were rated on the Athens Insomnia Scale, the Hyperarousal Scale, the Hamilton Depression Rating Scale and the Beck Depression Inventory. They also completed the Selective Reminding Test and the Continuous Attention Test. Only minor elevations on depression scales were found in patients. The Continuous Attention Test did not reveal any between group differences. However, insomniacs required more trials before all the Selective Reminding Test items were learned. Insomniacs showed less event-related current density in orbitofrontal, medial prefrontal and anterior cingulate cortex, i.e. brain regions of relevance for cognition and affect. Earliest group differences appeared in the P1 time range and then were observed at the N1, N2 and P3 stages of stimulus processing. These stimulus processing differences correlated most consistently with severity of insomnia. Neuropsychological impairment correlated most strongly with less current density in Brodmann area 10.