Gray matter changes following cognitive behavioral therapy for patients with comorbid fibromyalgia and insomnia: A pilot study

Christina S. McCrae*, Jennifer Marie Mundt, Ashley F. Curtis, Jason G. Craggs, Andrew M. O’Shea, Roland Staud, Richard B. Berry, William M. Perlstein, Michael E. Robinson

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

5 Scopus citations

Abstract

Study Objectives: Insomnia frequently co-occurs with fibromyalgia, which is associated with gray matter atrophy. We examined the effect of cognitive behavioral therapy for insomnia (CBT-I) and pain (CBT-P) on cortical thickness. Methods: Patients with fibromyalgia and insomnia underwent MRI before and after random assignment to CBT-I (n = 14), CBT-P (n = 16), or waitlist control (WLC; n = 7). Results: Repeated-measures analyses of variance revealed significant interactions for two regions (left lateral orbitofrontal cortex, left rostral middle frontal, Ps < .05) and trends for four regions (right medial orbitofrontal cortex, right posterior cingulate, left caudal middle frontal, left transverse temporal; Ps < .10). Cortical thickness increased in all regions for CBT-I and decreased in five regions for CBT-P and WLC. Hierarchical regressions revealed that for the CBT-I group, reductions in wake after sleep onset were associated with an increase in cortical thickness. Conclusions: Our pilot study presents novel evidence suggesting that CBT-I may slow or reverse cortical gray matter atrophy in patients with fibromyalgia and insomnia. Clinical Trial Registration: Registry: ClinicalTrials.gov, Identifier: NCT02001077, Title: Sleep and Pain Interventions in Fibromyalgia (SPIN), URL: https://clinicaltrials.gov/ct2/show/NCT02001077

Original languageEnglish (US)
Pages (from-to)1595-1603
Number of pages9
JournalJournal of Clinical Sleep Medicine
Volume14
Issue number9
DOIs
StatePublished - Sep 15 2018

Keywords

  • Clinical trial
  • Cognitive behavioral therapy
  • Fibromyalgia
  • Insomnia
  • MRI

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine
  • Neurology
  • Clinical Neurology

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