1. Changes in resting-state brain connectivity following computerized cognitive behavioral therapy for insomnia in dialysis patients: A pilot study.
- Author
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Park HY, Lee H, Jhee JH, Park KM, Choi EC, An SK, Namkoong K, Lee E, and Park JT
- Subjects
- Adult, Default Mode Network diagnostic imaging, Female, Humans, Magnetic Resonance Imaging, Male, Middle Aged, Nerve Net diagnostic imaging, Pilot Projects, Sleep Initiation and Maintenance Disorders diagnostic imaging, Therapy, Computer-Assisted, Cognitive Behavioral Therapy, Connectome, Default Mode Network physiopathology, Interleukin-1beta blood, Nerve Net physiopathology, Renal Dialysis, Sleep Initiation and Maintenance Disorders blood, Sleep Initiation and Maintenance Disorders physiopathology, Sleep Initiation and Maintenance Disorders therapy
- 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., Competing Interests: Declaration of competing interest The authors have no conflicts of interest to declare., (Copyright © 2020 The Authors. Published by Elsevier Inc. All rights reserved.)
- Published
- 2020
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