Prediction of treatment efficacy in the suanzaoren decoction and estazolam for chronic insomnia disorder, along with brain function and cognitive changes before and after treatment, and potential gene expression profiles
Li T, Han Y, Yan H, Lv D, Yao P, Chen L, Yuan Y, Zhao J, Guo W, Guo Z, Lang B · Asian Journal of Psychiatry · 2025 August
DOI 10.1016/j.ajp.2025.104563
Objective
To investigate the effects of suanzaoren decoction and estazolam on brain function changes in chronic insomnia disorder and explore the potential genetic basis underlying these changes.
Conclusions
The study found that both suanzaoren decoction and estazolam improved sleep duration and efficiency in patients with chronic insomnia disorder. Suanzaoren decoction showed decreased ReHo values in certain brain regions, while estazolam did not produce significant changes. Machine learning models successfully predicted changes in sleep quality scores, and genes associated with the imaging results were identified.
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Insights
Suanzaoren decoction, a traditional Chinese medicine, enhances cognitive function and improves Chronic Insomnia Disorder symptoms by adjusting brain functions.
In the methodology, 82 patients diagnosed with Chronic Insomnia Disorder and 54 healthy controls were examined using fMRI scans before and after a six-week treatment with either suanzaoren decoction or estazolam. Changes in brain function were evaluated with a mixed-effects model analysis. Machine learning and transcriptome-neuroimaging spatial correlation analysis were employed to predict the effectiveness of the treatment and to understand its connection with specific genetic profiles.
In discussing the results, it was noted that the Chronic Insomnia Disorder patients exhibited differences in certain parts of the brain compared to the healthy controls. Both treatment groups saw improvements in their sleep duration and efficiency. However, only the group treated with suanzaoren decoction exhibited distinct changes in specific areas of the brain, with the researchers concluding that these abnormal ReHo changes might serve as imaging markers for Chronic Insomnia Disorder and help predict both drug efficacy and related gene expression profiles.
