Sleep disorders and structural alterations in brain regions linked with motivation: a neuroimaging meta-analysis

Sleep disorders are linked with cognitive impairments, emotional dysregulation, and motivational alterations and have been parsed into two broad categories, parasomnias (altered sleep cycles) and dyssomnias (difficulties falling/staying asleep). We conducted coordinate-based meta-analyses to delineate common and distinct brain alterations across structural neuroimaging studies assessing parasomnias (n = 17) and dyssomnias (n = 40). To infer brain network-level and behavioral implications we additionally performed meta-analytic connectivity modeling (MACM) and functional decoding. Across all disorders, sleep disruption was associated with convergent structural decreases in the thalamus. When focusing on parasomnia-related studies, convergent structural decreases were observed in the posterior cingulate cortex (PCC). No regions of convergent structural alterations were identified across dyssomnia-related studies. MACM analyses indicated that the identified thalamic region was embedded in a broader cortico–striato–thalamic network, whereas the PCC region was embedded within a network composed of medial prefrontal, striatal, insular, and mid-cingulate regions. Functional decoding linked the thalamic region to behavioral domains involving task execution and performance monitoring, while the PCC region was associated with valuation, decision-making, and motivational regulation. These outcomes suggest that structural alterations associated with sleep-related disorders may disrupt distributed brain networks, potentially contributing to altered cognitive, emotional, and motivational functioning.