ORIGINAL RESEARCH article
Front. Neurol.
Sec. Sleep Disorders
Volume 16 - 2025 | doi: 10.3389/fneur.2025.1504645
This article is part of the Research TopicNeuroimaging in Psychiatry 2023: Sleep DisordersView all articles
Glymphatic system dysfunction in chronic tinnitus patients with sleep disturbance
Provisionally accepted
- 1Department of Otolaryngology-Head and Neck Surgery, Zhongda Hospital, Southeast University, Nanjing, Liaoning Province, China
- 2Department of Otolaryngology, Nanjing First Hospital, Nanjing Medical University, Nanjing, Jiangsu Province, China
- 3Nanjing Pukou People’s Hospital, Nanjing, China
- 4Department of Radiology, Nanjing Tongren Hospital, Nanjing, Liaoning Province, China
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The neural mechanisms of sleep disturbance associated with chronic tinnitus remains unknown. To investigate this issue, multimodal magnetic resonance imaging (MRI) was used to detect glymphatic system dysfunctions in chronic tinnitus patients with sleep disturbance.: This prospective study included 30 tinnitus with sleep disturbance (TSD), 30 tinnitus with no sleep disturbance (TNSD) and 38 age, sex, and education-matched healthy controls (HCs). All the subjects underwent MRI scans of the glymphatic indexes and clinical assessment. Multimodal MRI indices were used as proxies of glymphatic function and the relationships between the glymphatic function and sleep disturbance were further evaluated.Results: TSD group exhibited significantly higher choroid plexus volume (CPV) and enlarged perivascular spaces (EPVS) values than the HCs group (p<0.0001).Moreover, the TNSD group revealed significantly lower diffusion tensor image analysis along the perivascular space (DTI-ALPS) values than the HCs group (p=0.044). In chronic tinnitus patients, the decreased DTI-ALPS index was negatively associated with the Pittsburgh Sleep Quality Index (PSQI) scores (r=-0.428, p=0.001).In addition, the increased CPV and EPVS values were positively correlated with the PSQI scores (r=0. 374, p=0.005; r=0.335, p=0.013; respectively). Furthermore, reduced ALPS values were negatively associated with the Tinnitus Handicap Questionnaires (THQ) scores (r=-0.378, p=0.005).Using multimodal MRI approaches, this study provides preliminary evidence for disrupted glymphatic function in chronic tinnitus patients, which may be associated with sleep disturbance. CPV, EPVS, and ALPS could serve as neuroimaging markers and shed new light on neuropathological mechanisms for chronic tinnitus comorbid with sleep disturbance.
Keywords: chronic tinnitus, Sleep disturbance, Glymphatic system, Magnetic Resonance Imaging, Diffusion Tensor Imaging
Received: 01 Oct 2024; Accepted: 21 May 2025.
Copyright: © 2025 Du, Huang, Xu, Xue and Zigang. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Yuan Xue, Nanjing Pukou People’s Hospital, Nanjing, China
Che Zigang, Department of Radiology, Nanjing Tongren Hospital, Nanjing, 211102, Liaoning Province, China
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