Effects of sleep quality on the default mode network and on anxiety- depression symptoms in premenstrual syndrome

  1. Haixia Qin
  2. Yan Zhang
  3. Shanshan Li
  4. Yuanyuan Ou
  5. Shihuan Lin
  6. YinQi Lai
  7. Qingping Zhang
  8. Kaixuan Zhou
  9. Ruijing Sun
  10. Yuejuan Wu
  11. Zhen Liu
  12. Ziyan Lai
  13. Ya Chen
  14. Rongcai Wu
  15. Zhizhong Chen
  16. Hui Zhang
  17. Gaoxiong Duan
  18. Demao Deng
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Abstract

Background Neuroimaging evidence suggests existence of an association between the aberrant default mode network (DMN) and anxiety-depression severity in premenstrual syndrome (PMS); however, ignoring the effects of sleep prevents understanding the pathophysiology of PMS. Methods Seventy-seven PMS patients and sixty-six healthy controls (HCs) underwent resting-state functional MRI, and clinical assessment included the Pittsburgh Sleep Quality Index (PSQI), the Self-Rating Anxiety Scale, and the Self-Rating Depression Scale. PSQI scores classified PMS patients into normal sleep quality (PMS-NSQ) and poor sleep quality (PMS-PSQ) groups. Resting-state functional connectivity (rsFC) and regional homogeneity (ReHo) within the DMN were compared among the three groups. Correlation and mediation analyses examined potential associations relating sleep quality, changes in brain function, and clinical variables. Results Compared to HCs, both PMS groups exhibited increased rsFC between left inferior parietal lobule (IPL) and right middle occipital gyrus. Additionally, the PMS-NSQ group presented decreased FC of right ventromedial prefrontal cortex (VMPFC) and right posterior cingulate/precuneus, decreased ReHo in right VMPFC, and increased ReHo value in left IPL. Combined correlation and mediation analyses showed that the altered functional activity within the DMN and anxiety-depression symptoms were mediated by sleep quality in PMS patients, mainly involving the right VMPFC and left IPL regions of the brain. Conclusions The findings reveal the potential neuropathology of sleep problems in PMS, which sleep quality may mediate the association between functional connectivity within DMN and anxiety-depression severity. The right VMPFC and the left IPL may prospectively serve as potential intervention targets for the treatment of sleep disturbances in PMS. Trial registration: Chinese Clinical Trial Registry (ChiCTR1900020642)

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  1. Version published to 10.21203/rs.3.rs-6028422/v1 on Research Square