Emotional reactivity to negative stimuli has been investigated in insomnia, but little is known about emotional reactivity to positive stimuli and its neural representation.
We used 3T fMRI to determine neural reactivity during the presentation of standardized short, 10-40-s, humorous films in insomnia patients (n=20, 18 females, aged 27.7 +/- 8.6 years) and age-matched individuals without insomnia (n=20, 19 females, aged 26.7 +/- 7.0 years), and assessed humour ratings through a visual analogue scale (VAS). Seed-based functional connectivity was analysed for left and right amygdala networks: group-level mixed-effects analysis (FLAME; FSL) was used to compare amygdala connectivity maps between groups.
fMRI seed-based analysis of the amygdala revealed stronger neural reactivity in insomnia patients than in controls in several brain network clusters within the reward brain network, without humour rating differences between groups (p = 0.6). For left amygdala connectivity, cluster maxima were in the left caudate (Z=3.88), left putamen (Z=3.79) and left anterior cingulate gyrus (Z=4.11), while for right amygdala connectivity, cluster maxima were in the left caudate (Z=4.05), right insula (Z=3.83) and left anterior cingulate gyrus (Z=4.29). Cluster maxima of the right amygdala network were correlated with hyperarousal scores in insomnia patients only.
Presentation of humorous films leads to increased brain activity in the neural reward network for insomnia patients compared to controls, related to hyperarousal features in insomnia patients, in the absence of humor rating group differences. These novel findings may benefit insomnia treatment interventions.

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