Suanzaoren decoction improving chronic insomnia with little effects on functional connectivity within the sensorimotor network

Yao P, Guo Z, Han Y, Yan H, Lin W, Han Z, Liu M, Chen M, Li J, Guo X, Cui LB, Guo W, Lv D · Brain Research · 2026 January

DOI 10.1016/j.brainres.2025.150037

Objective

To investigate SMN alterations in chronic insomnia disorder following treatment with Suanzaoren decoction or estazolam and explore their associations with clinical variables and genetic variations.

Conclusions

CID patients exhibited abnormal SMN-related intrinsic function and associated biological correlates, with aberrant SMN activity being a distinctive neuroimaging feature of CID. Estazolam affected SMN activity, while SZRD had little influence on SMN-related alterations.

Critical Appraisal

Published research can offer valuable insights, but a paper’s conclusions may go beyond what its results support. Critical appraisal examines the methods, findings and limitations to clarify what can reasonably be concluded—and what remains uncertain.

This article has not yet been critically appraised by the Research Hub.

Learn more about Critical Appraisal

Insights

Suanzaoren decoction improves sleep quality in chronic insomnia disorder patients, who showed altered sensorimotor network function linked to multiple neurotransmitter systems.

In the methodology, two groups of chronic insomnia disorder (CID) patients, totaling 82 individuals, and 54 healthy controls were studied. One group of CID patients received Suanzaoren decoction (SZRD) while the other received estazolam, both over a span of six weeks. The groups were analyzed for functional connectivity (FC) and effective connectivity (EC) in the sensorimotor network (SMN). Transcriptome-neuroimaging correlation analysis was also utilized to identify the associated gene profile and neurotransmitter distributions in relation to the changes in FC and EC values. In the discussions of the results, the study found that SZRD treatment effectively improved sleep quality in the CID patients. Additionally, it was seen that CID patients showed significant differences in the FC and EC of SMN compared to healthy controls. Interestingly, these differences were related to multiple neurotransmitter systems. Moreover, specific genes linked to FC and EC among CID patients were identified and these were mainly involved in the biological processes like synaptic and ion transmission. It was also found that estazolam somehow altered the EC from the right fusiform gyrus to the left lateral SMN among CID patients, while SZRD treatment had minimal influence on SMN-related changes.