J Clin Neurol.  2012 Jun;8(2):130-138.

The Relationship between Hippocampal Volume and Cognition in Patients with Chronic Primary Insomnia

• Noh HJ
• Joo EY
• Kim ST
• Yoon SM
• Koo DL
• Kim D
• Lee GH
• Hong SB

Abstract

BACKGROUND AND PURPOSE
Differences in hippocampal volume (HV) were compared between chronic primary insomniacs (PIs) and good sleepers (GSs), and the relationship between HV and memory function in PIs was investigated to clarify the effect of chronic sleep deprivation on brain structure and cognition.
METHODS
Twenty PIs (mean age, 50 years; 18 females) and 20 age-, gender-, and education-matched GSs were enrolled. Brain magnetic resonance imaging (MRI) was performed on a 1.5-T MRI scanner. Left and right HV and intracranial volume (ICV) were measured manually. Nighttime polysomnography and neuropsychological testing were also applied to all subjects. Group differences in HV were analyzed and the relationships between HV and sleep questionnaire data, nighttime polysomnography, and neuropsychological findings were evaluated.
RESULTS
Compared to GSs, PIs exhibited significantly increased sleep latency and arousal index and a decreased percentage of REM sleep in nighttime polysomnography, as well as impaired verbal and visual memory, and frontal lobe function. Absolute HV and ICV did not differ significantly between PIs and GSs. In the PIs, right and left HVs were negatively correlated with the duration of insomnia and the arousal index, and positively correlated with the recognition of visual memory. In addition, free recall in verbal memory was positively correlated with left HV in PIs.
CONCLUSIONS
These findings suggest that chronic sleep deprivation impairs memory and frontal lobe function, and that a long duration of insomnia and poor sleep quality contribute to a bilateral reduction in HV.

Keyword

primary insomnia; hippocampus; volumetry; memory; sleep

MeSH Terms

Arousal
Brain
Cognition
Frontal Lobe
Hippocampus
Humans
Magnetic Resonance Imaging
Memory
Neuropsychological Tests
Polysomnography
Sleep Deprivation
Sleep Initiation and Maintenance Disorders
Sleep, REM
Surveys and Questionnaires

Figure

• 

  Fig. 1 Scatter plots of left or right hippocampal volume and duration of insomnia and arousal index in patients with chronic insomnia. Higher values on the arousal index correspond to poor sleep quality. Left or right hippocampal volume was negatively correlated with the insomnia duration (left: r=-0.872, p<0.001; right: r=-0.868, p<0.001) (A) and with the arousal index in nighttime polysomnography (left: r=-0.435, p=0.045; right: r=-0.409, p=0.026) (B).

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