Aberrant intra-network resting-state functional connectivity in chronic insomnia with or without cognitive impairment

Chronic insomnia (CI) is a common sleep disorder in middle-aged and elderly individuals. Long-term sleep deprivation can lead to physical, mental, and cognitive damage. Resting-state networks (RSNs) in the brain are closely linked to cognition and behavior. Therefore, we investigated changes in RSNs to explore behavioral and cognitive abnormalities in middle-aged and elderly CI patients. Resting state functional magnetic resonance imaging (rs-fMRI) and independent component analysis were used to study the intrinsic functional connectivity (FC) of the RSNs in 36 CI patients (20 CI with cognitive impairment (CI-I) patients and 16 CI without cognitive impairment (CI-N) patients) and 20 healthy controls (HC). Two-sample t-tests were used to compare RSNs differences between CI and HC groups, as well as between CI-I and CI-N groups. Partial correlation analysis was used to explore the relationship between the significant abnormal brain regions in RSN and clinical scales. Compared with HCs, CI patients showed significant differences in multiple RSNs, and FC values in two brain regions within RSNs were correlated with clinical scales. Furthermore, compared with CI-N group, CI-I group also showed significantly altered FC in multiple RSNs. Moreover, FC values in the right middle frontal gyrus within right frontal parietal network of CI-I patients were negatively correlated with the Mini-Mental State Examination scores. These results may explain hyperarousal, attention deficit and motor impairments in CI patients. Furthermore, the aberrant alterations of RSNs in CI-I patients may play a crucial role in the onset and progression of cognitive impairment in CI patients.