Sleep spindles have been implicated in sleep protection, depression and anxiety. However, spindle-related brain imaging mechanism underpinning the deficient sleep protection and emotional regulation in insomnia disorder (ID) remains elusive. The aim of the current study is to investigate the relationship between spindle-related brain activations and sleep quality, symptoms of depression and anxiety in patients with ID. Participants (n = 46, 28 females, 18–60 years) were recruited through advertisements including 16 with ID, according to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, and 30 matched controls. Group differences in spindle-related brain activations were analyzed using multimodality data acquired with simultaneous electroencephalography and functional magnetic resonance imaging during sleep. Compared with controls, patients with ID showed significantly decreased bilateral spindle-related brain activations in the cingulate gyrus (familywise error corrected p ˂ 0.05, cluster size 4401 mm³). Activations in the cingulate gyrus were negatively correlated with Pittsburgh Sleep Quality Index scores (r = -0.404, p = 0.005) and Self-Rating Anxiety Scale scores (r = -0.364, p = 0.013), in the pooled sample. These findings underscore the key role of spindle-related brain activations in the cingulate gyrus in subjective sleep quality and emotional regulation in ID.

睡眠纺锤体与睡眠保护、抑郁和焦虑有关。然而，支撑失眠症（ID）睡眠保护和情绪调节不足的纺锤体相关脑成像机制仍然难以捉摸。本研究的目的是调查与纺锤体相关的大脑激活与 ID 患者的睡眠质量、抑郁和焦虑症状之间的关系。参与者 ( n  = 46, 28女性，18-60 岁）是通过广告招募的，其中 16 名有 ID，根据《精神疾病诊断和统计手册》第五版，以及 30 名匹配的对照。使用在睡眠期间通过同步脑电图和功能性磁共振成像获得的多模态数据分析了与纺锤体相关的大脑激活的组差异。与对照组相比，ID 患者的扣带回双侧纺锤体相关脑激活显着降低（家庭误差校正p ˂ 0.05，簇大小4401 mm ³）。扣带回的激活与匹兹堡睡眠质量指数得分呈负相关（r  = -0.404，p = 0.005)和自评焦虑量表得分 ( r  = -0.364, p  = 0.013)，在合并样本中。这些发现强调了扣带回中与纺锤体相关的大脑激活在 ID 的主观睡眠质量和情绪调节中的关键作用。