Deng Zipeng, Wang Wei, Nie Zhaowen, Ma Simeng, Zhou Enqi, Xie Xinhui, Gong Qian, Yao Lihua, Bu Lihong, Kang Lijun, Liu Zhongchun
Department of Psychiatry, Renmin Hospital of Wuhan University, Wuhan 430060, China.
PET/CT/MRI and Molecular Imaging Center, Renmin Hospital of Wuhan University, Wuhan, China.
Neuroimage Clin. 2025 Mar 18;46:103769. doi: 10.1016/j.nicl.2025.103769.
Major depressive disorder (MDD) is a significant contributor to global disease burden, with somatic symptoms frequently complicating its diagnosis and treatment. Recent advances in neuroimaging have provided insights into the neurobiological underpinnings of MDD, yet the role of the glymphatic system remains largely unexplored. This study aimed to assess glymphatic function in drug-naïve somatic depression (SMD) patients using the diffusion tensor image analysis along the perivascular space (DTI-ALPS) index. A total of 272 participants, including somatic depression patients (SMD), pure depression (PMD), and healthy controls (HC), were enrolled. We collected T1-weighted (T1w) and DTI (diffusion tensor image) scans and clinical data of all participants. The DTI-ALPS indices were calculated and compared among three groups. Gray matter regions associated with the DTI-ALPS index were identified by voxel-based morphometry analysis (VBM), revealing a cluster located in the thalamus. Then, we performed partial correlation analyses to further investigate the relationships between the DTI-ALPS index, thalamic volume, and clinical data. The DTI-ALPS index was significantly higher in the MDD group compared to the HC group, particularly in the SMD group. Furthermore, a significant positive correlation was observed between the DTI-ALPS index and thalamic volume, with lower DTI-ALPS values associated with reduced thalamic volumes, especially in the SMD group. Our findings suggest heightened glymphatic activity in MDD patients, especially SMD patients, and a potential link between glymphatic function and thalamic vulnerability. Therefore, the thalamus' vulnerability to glymphatic system function may play a role in the pathophysiology of depression, particularly somatic depression, suggesting that both the glymphatic system and the thalamus could serve as potential therapeutic or intervention targets for future treatments.
重度抑郁症（MDD）是全球疾病负担的一个重要因素，其躯体症状常常使诊断和治疗复杂化。神经影像学的最新进展为MDD的神经生物学基础提供了见解，但类淋巴系统的作用在很大程度上仍未得到探索。本研究旨在使用沿血管周围间隙的扩散张量图像分析（DTI-ALPS）指数评估未服用过药物的躯体抑郁症（SMD）患者的类淋巴功能。总共招募了272名参与者，包括躯体抑郁症患者（SMD）、单纯抑郁症患者（PMD）和健康对照者（HC）。我们收集了所有参与者的T1加权（T1w）和DTI（扩散张量图像）扫描以及临床数据。计算并比较了三组的DTI-ALPS指数。通过基于体素的形态计量分析（VBM）确定了与DTI-ALPS指数相关的灰质区域，发现一个位于丘脑的簇。然后，我们进行了偏相关分析，以进一步研究DTI-ALPS指数、丘脑体积和临床数据之间的关系。与HC组相比，MDD组的DTI-ALPS指数显著更高，尤其是在SMD组。此外，观察到DTI-ALPS指数与丘脑体积之间存在显著正相关，DTI-ALPS值越低，丘脑体积越小，尤其是在SMD组。我们的研究结果表明，MDD患者，尤其是SMD患者的类淋巴活性增强，并且类淋巴功能与丘脑易损性之间存在潜在联系。因此，丘脑对类淋巴系统功能的易损性可能在抑郁症，特别是躯体抑郁症的病理生理学中起作用，这表明类淋巴系统和丘脑都可能成为未来治疗的潜在治疗或干预靶点。
