Association of MRI parameters of brain waste clearance function with cortisol and inflammatory markers in middle-aged and older adults with major depressive disorder

IF 4.5 4区医学 Q1 PSYCHIATRY

Asian journal of psychiatry Pub Date : 2025-08-16 DOI:10.1016/j.ajp.2025.104667

Chun Yang , Shiyun Tian , Meichen Liu , Fan Tan , Weiwei Wang , Wei Du , Bingbing Gao , Qingwei Song , Tieli Liu , Huimin Zhang , Yanwei Miao

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Abstract

Background

Suicide risk remains high in middle-aged and older adults with major depressive disorder (MDD). Dysregulation of cortisol (CORT) and neuroinflammation may impair glymphatic clearance, but their effects in this population are unclear.

Methods

Diffusion tensor imaging analysis along the perivascular space (DTI-ALPS) index, choroid plexus volume (CPV), free water (FW) in white matter, and enlarged perivascular space (EPVS) grading of 20 MDD patients with elevated CORT (high-CORT), 39 MDD with normal CORT levels (normal-CORT), and 29 healthy controls (HCs) were compared. Inflammatory indices included the neutrophil-to-lymphocyte ratio (NLR), systemic immune-inflammation index (SII), systemic inflammation response index (SIRI), aggregate index of systemic inflammation (AISI), platelet-to-lymphocyte ratio (PLR), and monocyte-to-lymphocyte ratio (MLR). MRI parameters were also correlated with inflammatory indices and neuropsychological scales.

Results

After controlling for age, gender, ACTH and HAMD-sleep disturbance, high-CORT group exhibited the lowest DTI-ALPS index (p < 0.01), significantly higher CPV (p = 0.04) compared to HCs, and tended to be higher BG EPVS grading compared to normal-CORT (p = 0.02). The DTI-ALPS index was negatively correlated with depression severity and HAMD-cognitive impairment (r ranging from −0.437 to −0.300; p ranging from 0.001 to 0.031). Moreover, the DTI-ALPS index was negatively associated with NLR (r = −0.277, p = 0.047). Additionally, CPV was positively correlated with multiple inflammatory indices (r ranging from 0.380 to 0.595, all p ≤ 0.01).

Conclusion

Significant differences in MRI-based markers of brain metabolic waste clearance were observed among middle-aged and older MDD patients with varying cortisol levels and HCs. These alterations were linked to depressive symptoms, cognitive impairment, and inflammation markers.

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中老年抑郁症患者脑废物清除功能的MRI参数与皮质醇和炎症标志物的关系

背景：患有重度抑郁症（MDD）的中老年人自杀风险仍然很高。皮质醇（CORT）和神经炎症的失调可能会损害淋巴清除，但它们在这一人群中的影响尚不清楚。方法对20例CORT升高的MDD患者（high-CORT）、39例CORT正常的MDD患者（normal-CORT）和29例健康对照（hc）进行沿血管周围空间（DTI-ALPS）指数、脉络膜丛体积（CPV）、白质游离水（FW）和血管周围空间增大（EPVS）分级的弥散张量成像分析。炎症指标包括中性粒细胞与淋巴细胞比值（NLR）、全身免疫-炎症指数（SII）、全身炎症反应指数（SIRI）、全身炎症聚集指数（AISI）、血小板与淋巴细胞比值（PLR）、单核细胞与淋巴细胞比值（MLR）。MRI参数也与炎症指数和神经心理量表相关。结果在控制年龄、性别、ACTH、hamd -睡眠障碍等因素后，高cort组DTI-ALPS指数最低（p <； 0.01），CPV显著高于正常组（p = 0.04），BG EPVS评分高于正常组（p = 0.02）。DTI-ALPS指数与抑郁严重程度和hamd认知障碍呈负相关（r范围为- 0.437 ~ - 0.300，p范围为0.001 ~ 0.031）。DTI-ALPS指数与NLR呈负相关（r = −0.277,p = 0.047）。CPV与多项炎症指标呈正相关（r范围为0.380 ~ 0.595，p均 ≤ 0.01）。结论不同皮质醇水平和hc的中老年MDD患者脑代谢性废物清除mri标志物存在显著差异。这些改变与抑郁症状、认知障碍和炎症标志物有关。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Asian journal of psychiatry Medicine-Psychiatry and Mental Health

CiteScore

12.70

自引率

5.30%

发文量

297

审稿时长

35 days

期刊介绍： The Asian Journal of Psychiatry serves as a comprehensive resource for psychiatrists, mental health clinicians, neurologists, physicians, mental health students, and policymakers. Its goal is to facilitate the exchange of research findings and clinical practices between Asia and the global community. The journal focuses on psychiatric research relevant to Asia, covering preclinical, clinical, service system, and policy development topics. It also highlights the socio-cultural diversity of the region in relation to mental health.