The study found that traditional Chinese medicine and benzodiazepines alleviate insomnia differently, with the former easing hyperarousal states and the latter triggering adaptive regulation for quick sedation.
The methodology of this study involved 82 patients with chronic insomnia disorder and 80 healthy controls. The patients with insomnia were split into two groups where one received a traditional Chinese medicine treatment called modified suanzaoren decoction and the other group was given estazolam, a commonly used insomnia treatment, for a total of six weeks. The research team used Granger causality analysis anchored on precuneus subregions to identify changes in effective connectivity before and after treatment. Further, a neuroimaging-transcription association analysis was carried out to identify potential gene linkages with these alterations in brain connectivity.
The results of the analysis showed increased effective connectivity from the precuneus to the right postcentral/precentral gyrus and left lingual gyrus in patients with insomnia compared to healthy controls. Conversely, decreased effective connectivity from certain areas like the bilateral postcentral/precentral gyrus, right cerebellum crus VIIB, and right calcarine cortex to the precuneus were seen. Post-treatment, there were significant changes in connectivity from the bilateral midcingulate cortex to the precuneus, as well as from the bilateral midcingulate cortex, left postcentral gyrus, and right supramarginal gyrus to the precuneus. The researchers found genes associated with these effective connectivities. Overall, the findings suggest that the abnormal connectivity between the precuneus and areas in the sensory-motor and visual networks could be indicative of hyperarousal states and compensatory responses in insomnia. The traditional Chinese medicine appeared to reduce the hyperarousal state, whereas benzodiazepines brought about adaptive regulation due to their immediate sedative effects.
