Trial reportBMC psychiatry2026
Transcranial direct current stimulation improves reduced global BOLD-CSF coupling in patients with insomnia disorder and comorbid anxiety: a resting-state functional MRI study.
Trial report in BMC psychiatry, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT07340268 (The Effects of Transcranial Current Stimulation on Insomnia), which is not on this map. Not yet cited in PubMed.
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The Effects of Transcranial Current Stimulation on Insomnia
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7 authors.
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Abstract
backgroundInsomnia disorder with comorbid anxiety is a prevalent clinical challenge. Although transcranial direct current stimulation (tDCS) is a promising noninvasive neuromodulatory approach, its effects on glymphatic-related neurovascular-cerebrospinal fluid (CSF) coupling in insomnia remain unclear. This study investigated the effects of tDCS on global blood oxygen level-dependent (gBOLD)-CSF coupling using resting-state functional magnetic resonance imaging (rs-fMRI) in patients with insomnia disorder and comorbid anxiety.
methodsWe conducted a 2-week, double-blind, randomized, sham-controlled trial. Patients with insomnia disorder and comorbid anxiety were randomized to receive either active or sham tDCS. The intervention consisted of 14 consecutive daily 20-min sessions delivered at 1.1 mA, targeting the left forehead and right dorsolateral prefrontal cortex. Healthy controls were frequency-matched to the overall patient cohort by age and sex. The Pittsburgh Sleep Quality Index (PSQI), Insomnia Severity Index (ISI), 14-item Hamilton Anxiety Rating Scale (HAMA-14), 17-item Hamilton Depression Rating Scale, Epworth Sleepiness Scale, 20-item Multidimensional Fatigue Inventory, polysomnography (PSG), and rs-fMRI were assessed at baseline, and patients were reassessed after treatment. The primary outcome was the post-intervention between-group difference in gBOLD-CSF coupling; clinical scales and PSG parameters were secondary outcomes.
resultsSixty patients with insomnia disorder and comorbid anxiety and 30 healthy controls completed baseline assessments. Compared with healthy controls, patients showed significantly lower gBOLD-CSF coupling (P < 0.001, P
conclusionsPatients with insomnia disorder and comorbid anxiety showed reduced gBOLD-CSF coupling during wakeful rs-fMRI, which was associated with subjective sleep quality, insomnia severity, anxiety level, arousal index, and N3 sleep duration. Active tDCS enhanced gBOLD-CSF coupling compared with sham stimulation, suggesting that its therapeutic effects may involve modulation of neurovascular-CSF dynamics alongside improvements in sleep and anxiety symptoms. CLINICAL
trial registrationClinicalTrials.gov ID NCT07340268, retrospectively registered on January, 13, 2026.
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