Chen Shengli, Xu Ziyun, Guo Zheng, Lin Shiwei, Zhang Hongyuan, Liang Qunjun, Chen Qianyun, Zhang Yingli, Peng Bo, Zhao Yanzhen, Hou Gangqiang, Qiu Yingwei
Department of Radiology, Shenzhen Nanshan People's Hospital, Shenzhen, P.R. China.
Neuropsychiatry Imaging Center, Department of Radiology Shenzhen Mental Health Center, Shenzhen Kangning Hospital, Shenzhen, P.R. China.
Transl Psychiatry. 2025 Aug 5;15(1):265. doi: 10.1038/s41398-025-03486-1.
Cortisol dysregulation plays a critical role in the pathophysiology of depression, but its exact impact on the brain remains unclear. In this cross-sectional study, 210 participants, including 164 depressed patients and 46 healthy controls (HCs), were assessed. Glymphatic circulation was evaluated on Magnetic Resonance Imaging via choroid plexus (CP) volume fraction, perivascular space (PVS) volume fraction, fractional volume of extracellular-free water (FW), and diffusion tensor imaging along the perivascular space (DTI-ALPS) index. Chemiluminescence was employed to analyze the cortisol levels in a sub-cohort of the patients. Independent sample t-tests and Pearson's correlation analysis were used to assess differences in these metrics between groups and their correlation with cortisol levels. After adjusting for age, sex, years of education, and total intracranial volume, depressed patients exhibited a significantly higher FW and lower ALPS than HCs. No significant differences were found in CP volume and PVS fraction between depressed patients and HCs. Additionally, the increased FW correlated positively with cortisol levels in depressed patients, suggesting that glymphatic dysfunction is linked to plasma cortisol levels in depression.
皮质醇调节异常在抑郁症的病理生理学中起着关键作用，但其对大脑的确切影响仍不清楚。在这项横断面研究中，对210名参与者进行了评估，其中包括164名抑郁症患者和46名健康对照者（HCs）。通过磁共振成像，利用脉络丛（CP）体积分数、血管周围间隙（PVS）体积分数、细胞外自由水（FW）分数体积以及沿血管周围间隙的扩散张量成像（DTI-ALPS）指数来评估类淋巴循环。采用化学发光法分析部分患者亚组中的皮质醇水平。使用独立样本t检验和Pearson相关分析来评估这些指标在组间的差异及其与皮质醇水平的相关性。在调整年龄、性别、受教育年限和总颅内体积后，抑郁症患者的FW显著高于HCs，而ALPS则显著低于HCs。抑郁症患者与HCs之间在CP体积和PVS分数方面未发现显著差异。此外，抑郁症患者中升高的FW与皮质醇水平呈正相关，这表明类淋巴功能障碍与抑郁症患者的血浆皮质醇水平有关。
