Altered neurovascular-cerebrospinal fluid synergy in chronic insomnia disorder
Shaoxiang Zhong1, Yuan He2, Kang Chen3
1Department of Neurology, The affiliated Hospital of Southwest Medical University, Chengdu Second People's Hospital, Luzhou, Sichuan, 646000, China; Department of Neurology, West China School of Medicine, Sichuan University, Sichuan University affiliated Chengdu Second People's Hospital, Chengdu, Sichuan 610017, China.
Background:
Chronic insomnia disorder (CID) is associated with neurophysiological dysfunction; however, its effects on neurovascular and glymphatic interactions remain inadequately understood.
Methods:
This study examined the coupling strength between global blood-oxygen-level-dependent (gBOLD) signals and cerebrospinal fluid (CSF) inflow dynamics in CID patients (n = 137) and healthy controls (HC, n = 72) using resting state functional magnetic resonance imaging.
Results:
Results demonstrated significantly diminished gBOLD-CSF coupling in CID patients compared to HC. Across all participants, coupling strength exhibited a negative correlation with age and a positive correlation with educational attainment. Counterintuitively, higher Pittsburgh Sleep Quality Index (PSQI) scores, indicative of poorer sleep quality, were associated with stronger BOLD-CSF coupling, potentially reflecting compensatory mechanisms during infrequent deep sleep episodes.
Conclusion:
These findings underscore disrupted neurovascular-glymphatic communication in chronic insomnia, which may predispose individuals to neurodegenerative risks. This study highlights the necessity for reevaluating insomnia as a systemic threat to brain health, necessitating longitudinal investigations and therapeutic strategies targeting glymphatic preservation.
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