Hypogyrification in Generalized Anxiety Disorder and Associated with Insomnia Symptoms

Ting Zhang; Xiaohui Xie; Qianqian Li; Lei Zhang; Yue Chen; Gong-Jun Ji; Qiangqiang Hou; Tianxia Li; Chunyan Zhu; Yanghua Tian; Kai Wang

doi:10.2147/NSS.S358763

Hypogyrification in Generalized Anxiety Disorder and Associated with Insomnia Symptoms

Nat Sci Sleep. 2022 May 25:14:1009-1019. doi: 10.2147/NSS.S358763. eCollection 2022.

Authors

Ting Zhang^#^{1

2

3}, Xiaohui Xie^#^{2

3

4}, Qianqian Li^#^{1

2

3}, Lei Zhang^{2

3

5

6}, Yue Chen^{2

4}, Gong-Jun Ji^{2

3

5}, Qiangqiang Hou^{2

3

4}, Tianxia Li⁷, Chunyan Zhu^{2

3

5

6}, Yanghua Tian^{4

8

9}, Kai Wang^{2

3

4

5

9}

Affiliations

¹ Department of Psychiatry, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui Province, People's Republic of China.
² Collaborative Innovation Center of Neuropsychiatric Disorders and Mental Health, Hefei, Anhui Province, People's Republic of China.
³ Anhui Province Key Laboratory of Cognition and Neuropsychiatric Disorders, Hefei, People's Republic of China.
⁴ Department of Neurology, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui Province, People's Republic of China.
⁵ School of Mental Health and Psychological Sciences, Anhui Medical University, Hefei, Anhui Province, People's Republic of China.
⁶ Department of Psychiatry, The Second Affiliated Hospital of Anhui Medical University, Hefei, Anhui Province, People's Republic of China.
⁷ Anhui Mental Health Center, Hefei, Anhui Province, People's Republic of China.
⁸ Department of Neurology, The Second Affiliated Hospital of Anhui Medical University, Hefei, Anhui Province, People's Republic of China.
⁹ Institute of Artificial Intelligence, Hefei Comprehensive National Science Center, Hefei, People's Republic of China.

^# Contributed equally.

Abstract

Purpose: Insomnia is a recognized feature of generalized anxiety disorder (GAD). The underlying neural substrate of insomnia in GAD is still unclear. Cortical folding is a reliable index and possibly an endophenotype of psychiatric disease. The aim of this study was to explore whether the aberrant cortical morphology was associated with insomnia in GAD.

Patients and methods: We enrolled 73 patients with GAD and 74 matched healthy controls (HCs) to undergo neuropsychiatric assessment and 3.0 T magnetic resonance imaging scanning. Neuropsychiatric batteries included the 14-item Hamilton Anxiety Rating Scale (HAMA) and the Insomnia Severity Index (ISI). Using FreeSurfer7.1.1, we calculated local gyrification index, cortical thickness and surface area and identified group differences in these parameters. Then, we calculated the functional connectivity of these identified regions and determined functional alterations. The relationship between these neuroimaging indicators and clinical measurement was explored.

Results: Compared with HCs, the LGI in the bilateral orbitofrontal cortex (OFC), bilateral insula, left middle frontal gyrus, left temporal pole, and left fusiform area was significantly decreased in GAD. GAD patients had concurrent decreased surface area in the left OFC and thicker right OFC. GAD patients also exhibited increased functional connectivity between the left insula and frontoparietal control network. In addition, a negative relationship was observed between decreased LGI in these limbic regions and ISI score.

Conclusion: GAD patients presented aberrant cortical folding in limbic network. Cortical morphology is a potential endophenotype in GAD, corresponding to an insomnia phenotype.

Keywords: cortical morphology; frontoparietal control network; generalized anxiety disorder; insomnia; limbic network.

Grants and funding

This study was funded by the Natural Science Foundation of China (82090034, 31970979, 91432301, 31571149, 81171273, and 91232717 to K.W.; 81671354, 32071054 and 91732303 to Y.T.) and the Science Fund for Distinguished Young Scholars of Anhui Province (1808085J23 to Y.T.).