Insomnia-Driven Hippocampal Atrophy: Evidence From Bidirectional Mendelian Randomization

Dandan Han1, Xiang Li2, Shaohua Zhao3

  • 1Medical Imaging Center, Xuchang Central Hospital Affiliated to Henan University of Science and Technology Xuchang P.R. China.

Health Science Reports
|March 10, 2026
PubMed
Abstract

Insights

Genetically proxied insomnia causally reduces hippocampal volumes, suggesting early intervention may preserve brain health. Addressing insomnia is crucial for public health and cognitive well-being.

Area of Science:

  • Neuroscience
  • Genetics
  • Public Health

Background:

  • Observational studies suggest a link between insomnia and hippocampal atrophy.
  • Causal inference is limited by confounding and reverse causality.
  • Bidirectional causality between insomnia and hippocampal subfield volumes remains unaddressed.

Purpose of the Study:

  • To investigate the bidirectional causal relationship between insomnia and hippocampal volumes using Mendelian randomization.
  • To determine if genetic predisposition to insomnia affects hippocampal subfield volumes.
  • To assess if hippocampal volumes influence the risk of insomnia.

Main Methods:

  • Conducted a bidirectional two-sample Mendelian randomization (MR) study.
  • Utilized genome-wide association study (GWAS) summary data for insomnia and eight hippocampal volume imaging-derived phenotypes (IDPs).
  • Employed inverse-variance weighted regression and sensitivity analyses, controlling for multiple testing with Benjamini-Hochberg FDR.

Main Results:

  • Forward MR showed genetically proxied insomnia was inversely associated with six of eight hippocampal phenotypes, indicating reduced volumes.
  • Sensitivity analyses confirmed the robustness of these findings.
  • Reverse MR found no evidence that hippocampal volumes causally affect insomnia.

Conclusions:

  • Insomnia has a causal effect on reducing hippocampal volumes.
  • Early intervention for insomnia, such as cognitive-behavioral therapy, may help preserve hippocampal health.
  • Addressing insomnia is a public health priority, warranting further research into biological mechanisms and generalizability.