Alterations in coupling between global brain activity and cerebrospinal fluid flow in patients with insomnia disorder before and after transcranial direct current stimulation - A resting-state functional MRI study

Q: What relationship did the study examine between global brain activity and CSF flow in insomnia disorder?

It examined gBOLD-CSF coupling strength as an indicator of glymphatic system function, hypothesizing dysfunction in insomnia disorder and links to clinical symptoms.

Q: How did gBOLD-CSF coupling differ between insomnia patients and healthy controls?

Insomnia patients showed significantly weaker gBOLD–CSF coupling than healthy controls.

Q: What effects did transcranial direct current stimulation (tDCS) have in the study?

After tDCS, patients had reduced PSQI, GAD-7, and PHQ-9 scores and increased gBOLD-CSF coupling strength, indicating improved symptoms and enhanced glymphatic activity.

Sep 28, 2026

Uploaded by supergirl

The coupling between global blood-oxygen-level-dependent (gBOLD) signals and cerebrospinal fluid (CSF) flow is linked to glymphatic system function, but its role in insomnia disorder (ID) and symptom severity remains unclear. This study compared gBOLD-CSF coupling in 33 insomnia patients and 27 healthy controls, including a subgroup receiving 2-week transcranial direct current stimulation (tDCS). ID showed reduced coupling versus controls, associated with insomnia and anxiety severity, while tDCS increased coupling and improved PSQI, GAD-7, and PHQ-9 scores.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages12

Reading Time30 min

AccessFree to download

Background

Methods

Results

Conclusion

TYPE Original Research PUBLISHED 18 December 2025 DOI 10.3389/fpsyt.2025.1705101 OPEN ACCESS EDITED BY Jason H. Huang, Baylor Scott and White Health, United States REVIEWED BY Zhen Yuan, University of Macau, China Liang Gong, Chengdu Second People ’s Hospital, China *CORRESPONDENCE Wenjing Lan [lanwj@jlu.edu.cn](lanwj@jlu.edu.cn) RECEIVED 14 September 2025 REVISED 01 November 2025 ACCEPTED 25 November 2025 PUBLISHED 18 December 2025 CITATION Liu D, Chen X, Zhang X, Peng J, Zhou H and Lan W (2025) Alterations in coupling between global brain activity and cerebrospinal ﬂuid ﬂow in patients with insomnia disorder before and after transcranial direct current stimulation: a resting-state functional MRI study. Front. Psychiatry 16:1705101 . doi: 10.3389/fpsyt.2025.1705101 COPYRIGHT © 2025 Liu, Chen, Zhang, Peng, Zhou and Lan. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY) . The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms. Alterations in coupling between global brain activity and cerebrospinal ﬂuid ﬂowin patients with insomnia disorder before and after transcranial direct current stimulation: a resting-state functional MRI study Dehong Liu 1, Xin Chen 1, Xiaotong Zhang 2, Jiaqi Peng 1, Hongwei Zhou 1 and Wenjing Lan 1* 1 Radiology Department, The First Hospital of Jilin University, Changchun, Jilin, China, 2 Neurology Department, The First Hospital of Jilin University, Changchun, Jilin, China Background: The coupling between global blood-oxygen-level-dependent (gBOLD) signals and cerebrospinal ﬂuid (CSF) ﬂow has been established in humans and is thought to reﬂect the function of the brain’s glymphatic system. This study aimed to investigate glymphatic system dysfunction in insomnia disorder (ID) and its correlation with clinical symptoms, and to evaluate whether transcranial direct current stimulation (tDCS) can modulate glymphatic system and alleviate insomnia. Methods: We totally enrolled 33 IDs (20 females, 42.3±15.0 years) and 27 healthy controls (HCs, 15 females, 53 . 6±17 .7 years) . Among them, 19 IDs (9 females, 38 .4 ±16 . 1 years) received 2-week tDCS treatment. gBOLD-CSF coupling strength was compared between groups and correlated with clinical scale scores (PSQI, PHQ-9, GAD-7) . Changes in gBOLD-CSF coupling strength and clinical scores after tDCS were also examined. Results: IDs showed signiﬁcantly weaker gBOLD–CSF coupling than HCs (p=0 . 003) . Coupling strength was negatively correlated with PSQI score (r=-0.363, p=0.045) and GAD-7 score (r=-0 .435, p=0 . 014), but not with PHQ-9 . After tDCS, patients exhibited signiﬁcantly reducing in PSQI score(p=0 . 014), GAD-7 score (p=0 . 0001) and PHQ-9 score (p<0.0001), along with increasing in gBOLD-CSF coupling strength (p=0 . 002) . Frontiers in Psychiatry 01 [frontiersin.org](frontiersin.org) Conclusion: Our results indicate that IDs exhibit impaired glymphatic system function, as reﬂected by reduced gBOLD–CSF coupling strength. This reduction was correlated with the severity of both insomnia and anxiety symptoms. Moreover, we demonstrated that tDCS can not only improve symptoms of insomnia, anxiety, and depression but also enhance glymphatic activity in IDs. KEYWORDS insomnia, anxiety, depression, cerebrospinal ﬂuid, global blood-oxygen-leveldependent signal, glymphatic system, transcranial direct current stimulation 1 Introduction Insomnia disorder (ID) is a prevalent health problem affecting asigniﬁcant portion of the global population. A systematic literature analysis involving over 260,000 participants revealed that the average prevalence of insomnia diso

FAQs

What relationship did the study examine between global brain activity and CSF flow in insomnia disorder?

It examined gBOLD-CSF coupling strength as an indicator of glymphatic system function, hypothesizing dysfunction in insomnia disorder and links to clinical symptoms.

How did gBOLD-CSF coupling differ between insomnia patients and healthy controls?

Insomnia patients showed significantly weaker gBOLD–CSF coupling than healthy controls.

What effects did transcranial direct current stimulation (tDCS) have in the study?

After tDCS, patients had reduced PSQI, GAD-7, and PHQ-9 scores and increased gBOLD-CSF coupling strength, indicating improved symptoms and enhanced glymphatic activity.

Sep 28, 2026

Uploaded by supergirl