Reconfigurations of dynamic functional network connectivity after 1HZ repetitive transcranial magnetic stimulation in insomnia disorder.

AIMS: The objective of the current study was to investigate the dynamic functional connectivity among large-scale brain networks in patients with insomnia, and to assess the efficacy of repetitive transcranial magnetic stimulation (rTMS) treatment in these individuals.

METHODS

Resting-state functional magnetic resonance imaging (rs-fMRI) data from 62 insomnia patients and 69 healthy controls were used to compare differences in dynamic functional connectivity between the two groups. A total of 26 insomnia patients underwent rTMS for four weeks. Changes in dynamic functional network connectivity was observed in insomnia patients following treatment. Additionally, the relationship between clinical symptoms and insomnia was analyzed using topological and correlation analyses.

RESULTS

Our findings demonstrated that insomnia patients exhibited a significantly lower fraction rate of negative connectivity between the dorsal default mode network (dDMN) and the visual network (VN) compared to healthy controls, while showing strong positive connectivity within the VN and the auditory network (AUN). It may be attributed to the restoration of normal dynamic functional connectivity between the dDMN and VN in insomnia patients following rTMS. Furthermore, the dynamic functional connectivity between the dDMN and VN was found to predict sleep quality and treatment outcome in insomnia patients.

CONCLUSION

Abnormal dynamic functional network connectivity between the dDMN and VN is a hallmark of insomnia, and may serve as a biomarker to assess the effects of rTMS treatment in insomnia patients.