Magnetic Resonance Study on Restoration of the Glymphatic System and Brain Network in Insomnia Patients with TCM Physiotherapy: A Case Report

Impairment in the cerebral glymphatic system may be one of the primary etiologic reasons for insomnia. Traditional Chinese medicine (TCM) physiotherapy is helpful for treating insomnia patients, with few side effects; however, its influence on glymphatic system function has not yet been examined. The DTI-ALPS (diffusion tensor image analysis along the perivascular space) technique and structural brain network graph theory analysis are the only current methods that can show the glymphatic system’s function and the operating efficiency of the neurofibrillary network in a noninvasive and quantitative manner, but their utility has yet to be proven. We employed DTI-ALPS and structural brain network small-worldness to examine changes in the glymphatic system’s function and the network’s working efficiency before and after TCM meridian sinew treatment in a 35-year-old female with chronic insomnia. The ALPS index and small-worldness, the Insomnia Severity Index, and the Pittsburgh Sleep Quality Index were collected at various time intervals following therapy. The results showed that the patient’s glymphatic system functioning, neurofibrillary network arrangement status, and insomnia symptoms improved during the therapy period. Additionally, her glymphatic system functioning and network status had stabilized and her quality of sleep had improved one month after the treatment ended. Thus, TCM physiotherapy can improve insomnia symptoms, and this report suggests that the corresponding mechanism of action may be achieved by repairing the glymphatic system’s function and optimizing the state of neurofibrillary network arrangement, providing a new perspective for the study of the TCM therapeutic mechanism of insomnia.