Changes in resting-state brain connectivity following computerized cognitive behavioral therapy for insomnia in dialysis patients: A pilot study.

Abstract

OBJECTIVE:

Insomnia is prevalent among dialysis patients and affects their mortality. Although cognitive behavioral therapy for insomnia (CBTi) is recommended, attending regular face-to-face CBTi sessions is a major challenge for patients. We evaluated the effectiveness of a self-directed computerized CBTi (cCBTi) in dialysis patients, and investigated changes in resting-state brain connectivity and inflammatory cytokines following cCBTi.

METHOD:

Thirty-five patients undergoing maintenance hemodialysis or peritoneal dialysis who had insomnia were screened for participation in the study, with 17 participants included in the final analyses. A self-directed cCBTi protocol accessed via tablet computer during dialysis or at home was developed and applied. Information about sleep, anxiety, depression, laboratory data, and resting-state functional magnetic resonance imaging data was obtained 3-5 days before and after cCBTi.

RESULTS:

cCBTi improved sleep quality, and this was correlated with increased resting-state brain connectivity between the default-mode network and the premotor/dorsolateral prefrontal cortex. The decrement of interleukin-1β levels were correlated with improved sleep quality and increased brain connectivity after cCBTi.

CONCLUSION:

Our pilot study findings suggest that cCBTi is effective for dialysis patients with insomnia, and the therapeutic effects of cCBTi are related to changes in brain functional connectivity and inflammatory cytokines.

• Authors: Hye Yoon Park, Hyeongrae Lee, Jong Hyun Jhee, Kyung Mee Park, Eun Chae Choi, Suk Kyoon An, Kee Namkoong, Eun Lee, Jung Tak Park
• Journal: General hospital psychiatry (Gen Hosp Psychiatry) 2020 Sep - Oct Vol. 66 Pg. 24-29 ISSN: 1873-7714 [Electronic] United States
• PMID: 32615333 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
• Copyright: Copyright © 2020 The Authors. Published by Elsevier Inc. All rights reserved.

Chemical References

• IL1B protein, human
• Interleukin-1beta

Topics

• Adult
• Cognitive Behavioral Therapy
• Connectome
• Default Mode Network (diagnostic imaging, physiopathology)
• Female
• Humans
• Interleukin-1beta (blood)
• Magnetic Resonance Imaging
• Male
• Middle Aged
• Nerve Net (diagnostic imaging, physiopathology)
• Pilot Projects
• Renal Dialysis
• Sleep Initiation and Maintenance Disorders (blood, diagnostic imaging, physiopathology, therapy)
• Therapy, Computer-Assisted