Duan Gaoxiong, Qin Haixia, Lai YinQi, Zhang Qingping, Lai Ziyan, Chen Ya, Wu Yuejuan, Liu Zhen, Zhou Kaixuan, Zhang Yan, Li Shanshan, Lin Shihuan, Sun Ruijing, Ou Yuanyuan, Liang Xiaoli, Liang Lingyan, Chen Zhizhong, Deng Demao
Department of Radiology, The People's Hospital of Guangxi Zhuang Autonomous Region, Guangxi Academy of Medical Sciences, Nanning, Guangxi, China.
Department of Neurology, The People's Hospital of Guangxi Zhuang Autonomous Region, Guangxi Academy of Medical Sciences, Nanning, Guangxi, China.
J Magn Reson Imaging. 2025 May;61(5):2271-2280. doi: 10.1002/jmri.29632. Epub 2024 Oct 23.
Women with premenstrual syndrome (PMS) are at increased risk for depression throughout their lives. White matter (WM) microstructure and inflammatory cytokine alterations have been proposed in its etiology.
To investigate whether WM, assessed using diffusion tensor imaging (DTI), and inflammatory cytokine levels are altered in PMS, and to examine the relationships between WM microstructure, inflammatory cytokines, and symptom severity.
Prospective.
Forty-two PMS patients and 58 healthy controls (HCs), categorized according to the daily record of severity of problems (DRSP).
FIELD STRENGTH/SEQUENCE: 3-T, echo planar imaging DTI.
Fractional anisotropy (FA), mean diffusivity (MD), axial diffusivity (AD), and radial diffusivity (RD) were measured by using tract-based spatial statistics (TBSS). Venous blood was collected to measure cytokines, including interleukin-1β (IL-1β) and tumor necrosis factor-α (TNF-α). Symptoms were assessed by using the DRSP.
Two-sample t test or Mann-Whitney U test were used to compare the DRSP and cytokines. Abnormal DTI metrics in WM were extracted and the differences between groups were analyzed by using two sample t-tests. Spearman's correlation (r) was used to assess the relationship between DTI metrics, cytokines, and DRSP. A P-value <0.05 with FDR correction was considered statistically significant.
Compared with HCs, PMS patients showed significantly lower FA in the corpus callosum and corona radiata, and significantly higher MD, AD, and RD in the corticospinal tract (CST), and significantly higher MD and RD in the anterior thalamic radiation (ATR). These differential metrics were significantly correlated with DRSP. Patients showed significantly higher IL-1β and TNF-α than HCs. Moreover, TNF-α correlated positively with MD, AD, and RD in both groups (r range, 0.256-0.315).
Alterations of WM microstructure and IL-1β and TNF-α may be associated with PMS symptom severity, and TNF-α may correlate with DTI metrics of CST and ATR pathways.
1 TECHNICAL EFFICACY: Stage 2.
经前期综合征（PMS）女性一生中患抑郁症的风险增加。其病因学中已提出白质（WM）微观结构和炎性细胞因子改变。
研究使用扩散张量成像（DTI）评估的WM以及炎性细胞因子水平在PMS中是否改变，并检查WM微观结构、炎性细胞因子与症状严重程度之间的关系。
前瞻性研究。
42例PMS患者和58例健康对照（HCs），根据问题严重程度每日记录（DRSP）进行分类。
场强/序列：3-T，回波平面成像DTI。
采用基于纤维束的空间统计学（TBSS）测量分数各向异性（FA）、平均扩散率（MD）、轴向扩散率（AD）和径向扩散率（RD）。采集静脉血以测量细胞因子，包括白细胞介素-1β（IL-1β）和肿瘤坏死因子-α（TNF-α）。使用DRSP评估症状。
采用两样本t检验或曼-惠特尼U检验比较DRSP和细胞因子。提取WM中异常的DTI指标，并使用两样本t检验分析组间差异。采用Spearman相关性（r）评估DTI指标、细胞因子与DRSP之间的关系。经错误发现率（FDR）校正后P值<0.05被认为具有统计学意义。
与HCs相比，PMS患者胼胝体和放射冠的FA显著降低，皮质脊髓束（CST）的MD、AD和RD显著升高，丘脑前辐射（ATR）的MD和RD显著升高。这些差异指标与DRSP显著相关。患者的IL-1β和TNF-α显著高于HCs。此外，两组中TNF-α与MD、AD和RD均呈正相关（r范围为0.256 - 0.315）。
WM微观结构以及IL-1β和TNF-α的改变可能与PMS症状严重程度相关，且TNF-α可能与CST和ATR通路的DTI指标相关。
1 技术效能：2级。
