Journal of psychiatric research · 2026
Assessment of glymphatic system function in young major depressive disorder using multimodal MRI.
СтатьяПоддержка исследования: вне правительства СШАНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Sun Xiaofen, Han Jinhua, Deng Lingling, Wang Xiaocheng, Shi Peng, Lin Mingshuan, Zhu Jiang, Fan Xinying, Zhang Yunqi, Zhan Yuefu, Chen Jianqiang
Аннотация
OBJECTIVES: To assess glymphatic system function in young major depressive disorder (MDD) patients using multimodal MRI and explore associations between imaging parameters and clinical severity.
METHODS: First-episode, treatment-native young MDD patients (December 2023 to January 2025) were divided into mild, moderate, and severe subgroups based on HAMD-24 scores. Age and sex matched healthy controls (HCs) were recruited. Clinical data and MRI scans were collected. Glymphatic parameters-perivascular space (PVS) volume, diffusion tensor image analysis along the perivascular space (DTI-ALPS) index, and global blood oxygen level-dependent cerebrospinal fluid (gBOLD-CSF) coupling coefficient-were compared between groups and across MDD severity subgroups. Spearman correlation analysis assessed associations with HAMD-24 scores and clinical data; to avoid extreme-group bias, analyses were performed in the whole sample and replicated within the MDD subgroup. Binary logistic regression identified independent MDD-related factors, with variance inflation factor (VIF) testing for multicollinearity. Receiver operating characteristic (ROC) curves evaluated diagnostic performance. The combined model was validated using stratified 10-fold cross-validation and 1000 permutation tests.
RESULTS: A total of 81 young MDD patients (20 mild, 29 moderate, 32 severe) and 61 HCs were included. (1) MDD patients showed lower DTI-ALPS index (P < 0.001), larger PVS volume (P < 0.001), and higher gBOLD-CSF coupling coefficient (P = 0.014) than HCs. (2) With increasing severity, DTI-ALPS index decreased, PVS volume increased, and gBOLD-CSF coupling coefficient increased. Pairwise comparisons (Bonferroni): severe vs. mild/moderate differed in all parameters (all P < 0.05); moderate vs. mild differed in PVS volume and gBOLD-CSF (both P < 0.05), but not in DTI-ALPS (P > 0.05). (3) DTI-ALPS index correlated negatively with HAMD-24 scores (r = -0.37, P < 0.001); PVS volume (r = 0.66-0.74) and gBOLD-CSF (r = 0.59) correlated positively (all P < 0.001). Results within the MDD subgroup were consistent (all P < 0.001). (4) DTI-ALPS index and PVS volume were independently associated factors with MDD (both P < 0.001). The combined model achieved an AUC of 0.88 (sensitivity 0.91, specificity 0.77), outperforming single indicators. Cross-validation yielded an AUC of 0.87; permutation tests confirmed significance (P = 0.001).
CONCLUSION: Young MDD patients have impaired glymphatic function. PVS, DTI-ALPS, and gBOLD-CSF correlate with severity. The combination of DTI-ALPS index and PVS volume has high diagnostic value and may serve as a non-invasive imaging biomarker for young MDD.
METHODS: First-episode, treatment-native young MDD patients (December 2023 to January 2025) were divided into mild, moderate, and severe subgroups based on HAMD-24 scores. Age and sex matched healthy controls (HCs) were recruited. Clinical data and MRI scans were collected. Glymphatic parameters-perivascular space (PVS) volume, diffusion tensor image analysis along the perivascular space (DTI-ALPS) index, and global blood oxygen level-dependent cerebrospinal fluid (gBOLD-CSF) coupling coefficient-were compared between groups and across MDD severity subgroups. Spearman correlation analysis assessed associations with HAMD-24 scores and clinical data; to avoid extreme-group bias, analyses were performed in the whole sample and replicated within the MDD subgroup. Binary logistic regression identified independent MDD-related factors, with variance inflation factor (VIF) testing for multicollinearity. Receiver operating characteristic (ROC) curves evaluated diagnostic performance. The combined model was validated using stratified 10-fold cross-validation and 1000 permutation tests.
RESULTS: A total of 81 young MDD patients (20 mild, 29 moderate, 32 severe) and 61 HCs were included. (1) MDD patients showed lower DTI-ALPS index (P < 0.001), larger PVS volume (P < 0.001), and higher gBOLD-CSF coupling coefficient (P = 0.014) than HCs. (2) With increasing severity, DTI-ALPS index decreased, PVS volume increased, and gBOLD-CSF coupling coefficient increased. Pairwise comparisons (Bonferroni): severe vs. mild/moderate differed in all parameters (all P < 0.05); moderate vs. mild differed in PVS volume and gBOLD-CSF (both P < 0.05), but not in DTI-ALPS (P > 0.05). (3) DTI-ALPS index correlated negatively with HAMD-24 scores (r = -0.37, P < 0.001); PVS volume (r = 0.66-0.74) and gBOLD-CSF (r = 0.59) correlated positively (all P < 0.001). Results within the MDD subgroup were consistent (all P < 0.001). (4) DTI-ALPS index and PVS volume were independently associated factors with MDD (both P < 0.001). The combined model achieved an AUC of 0.88 (sensitivity 0.91, specificity 0.77), outperforming single indicators. Cross-validation yielded an AUC of 0.87; permutation tests confirmed significance (P = 0.001).
CONCLUSION: Young MDD patients have impaired glymphatic function. PVS, DTI-ALPS, and gBOLD-CSF correlate with severity. The combination of DTI-ALPS index and PVS volume has high diagnostic value and may serve as a non-invasive imaging biomarker for young MDD.