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

PURPOSE: This study aimed to investigate the sensorimotor network (SMN) alterations in chronic insomnia disorder (CID) following treatment with Suanzaoren decoction (SZRD) or estazolam, and to explore their associations with clinical variables and genetic variations.

PATIENTS AND

METHODS

SMN functional connectivity (FC), effective connectivity (EC) and transcription-neuroimaging association analyses were conducted in 82 CID patients and 54 healthy controls (HCs). CID patients received either Suanzaoren decoction (SZRD), or estazolam treatment for six weeks. Subsequently, transcriptome-neuroimaging correlation analysis utilizing the Allen Human Brain Atlas was performed to identify gene profiles and neurotransmitter distributions linked to changes in FC/EC values.

RESULTS

SZRD treatment effectively improved sleep quality. Significant differences were found in the FC and EC of SMN in patients with CID compared with HCs at baseline. The FC and EC values in the CID were associated with multiple neurotransmitter systems, including dopaminergic (DAT), cholinergic (VAChT, α4β2), and glutamatergic (NMDA) systems. Patients showed altered EC from the right fusiform gyrus to the left lateral SMN after estazolam treatment. Furthermore, we identified genes associated with FC and EC in CID, which were enriched in biological processes such as synaptic and ion transmission.

CONCLUSION

Our findings indicate that CID patients exhibit abnormal SMN-related intrinsic function and associated biological correlates. Aberrant SMN activity is a distinctive neuroimaging feature of CID. While estazolam affects SMN activity, SZRD has little influence on SMN-related alterations.