Department of Neurology, Centre for Leading Medicine and Advanced Technologies of IHM, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui, China.
Department of Radiology, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui, China.
J Affect Disord. 2024 Dec 15;367:255-262. doi: 10.1016/j.jad.2024.08.229. Epub 2024 Sep 3.
Respective changes in neurovascular coupling (NVC) and glymphatic function have been reported in post-stroke depression (PSD). Recent studies have found a link between NVC and waste clearance by the glymphatic system, which has not been illustrated in PSD.
We prospectively recruited ninety-six stroke patients and forty-four healthy controls (HC), with fifty-nine patients undergoing a second MRI scan. NVC metrics were investigated by exploring Pearson correlation coefficients and ratios between cerebral blood flow (CBF) and BOLD-derived quantitative maps (ALFF, fALFF, REHO maps). Diffusion tensor imaging along the perivascular (DTI-ALPS) index was used to reflect glymphatic function. We first analyzed the altered NVC metrics in stroke patients relative to the HC group. Then, we explored the relationship between NVC metrics, ALPS index and depressive symptoms at baseline and during the follow-up period through correlation and mediation analyses.
Stroke patients exhibited significantly lower global CBF-fALFF coupling and ALPS index. At the regional level, abnormal NVC alterations in brain regions involved in cognition, emotion, and sensorimotor function in PSD. Baseline analyses showed that ALPS index exhibited positive associations with both global and local NVC and abnormal regional NVC may contribute to generation of PSD by reducing glymphatic function (β = -0.075, p < 0.05, CI = [-0.169 to -0.012]). Longitudinal analyses similarly showed that ALPS index changes were positively associated with changes in NVC and mediated improvements in depressive symptoms.
Our findings suggest that NVC abnormalities leading to impaired glymphatic system function may be a potential neurobiological mechanism of PSD.
脑卒中后抑郁（PSD）患者的神经血管耦合（NVC）和神经淋巴系统功能均发生相应改变。最近的研究发现 NVC 与神经淋巴系统的废物清除之间存在联系，但在 PSD 中尚未得到证实。
我们前瞻性招募了 96 例脑卒中患者和 44 例健康对照者（HC），其中 59 例患者进行了第二次 MRI 扫描。通过探索脑血流（CBF）与 BOLD 衍生的定量图（ALFF、fALFF、REHO 图）之间的 Pearson 相关系数和比值，研究 NVC 指标。使用沿血管周围的扩散张量成像（DTI-ALPS）指数反映神经淋巴系统功能。我们首先分析了脑卒中患者相对于 HC 组的 NVC 指标改变。然后，通过相关性和中介分析，探讨了基线和随访期间 NVC 指标、ALPS 指数与抑郁症状之间的关系。
脑卒中患者的全局 CBF-fALFF 偶联和 ALPS 指数明显降低。在区域水平，PSD 患者的认知、情绪和感觉运动功能相关脑区存在异常的 NVC 改变。基线分析显示，ALPS 指数与全局和局部 NVC 均呈正相关，异常的局部 NVC 通过降低神经淋巴系统功能可能导致 PSD 的发生（β=-0.075，p<0.05，CI=[-0.169，-0.012]）。纵向分析同样表明，ALPS 指数的变化与 NVC 的变化呈正相关，并介导抑郁症状的改善。
我们的研究结果表明，导致神经淋巴系统功能障碍的 NVC 异常可能是 PSD 的潜在神经生物学机制。
