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Glymphatic dysfunction mediates altered regional neural abilities in night-shift nurses: A multimodal neuroimaging
Lingling Deng1, Na Jiang2, Shan Yuan2
1Department of Radiology, The Second Affiliated Hospital, University of South China, Hengyang, 421001, Hunan, China.
Background:
Frequent night shifts in nurses disrupt circadian rhythms, contributing to sleep disturbances, cognitive decline, and neuroinflammation. However, the neural mechanisms underlying such clinical phenotypes are largely unknown.
Objective:
This study aimed to investigate the glymphatic alterations and its related changes in regional neural activity in night-shift nurses.
Methods:
A total of 67 female nurses were included, which were further divided into day-shift (n = 36) and night-shift (n = 31) groups. Diffusion tensor image analysis along the perivascular space (DTI-ALPS index) and amplitude of low-frequency fluctuations (ALFF) were used to assess the glymphatic function and regional brain activity. Neuroimaging-transcriptional analyses on the between-group regional ALPS-ALFF changes were also performed.
Results:
Compared to day-shift nurses, night-shift nurses exhibited poor sleep qualities (p < 0.001), lower DTI-ALPS indices in the left hemisphere (p < 0.05) and across the whole-brain (p < 0.05). The lower DTI-ALPS indices were related to lower ALFF values in the left inferior parietal gyrus/angular gyrus (IPG/AG). In the night-shift nurses, all ALPS indices were negatively correlated with Pittsburgh Sleep Quality Index (PSQI) scores (p < 0.001). Further mediation analysis revealed that DTI-ALPS index mediated the relationship between PSQI scores and ALFF changes in the left IPG/AG (p < 0.05). Neuroimaging-transcriptional analyses revealed key biological processes and pathways linked to circadian rhythm regulation, synaptic plasticity, neuroinflammation, protein modification, and ubiquitination.
Conclusion:
We concluded that the impaired glymphatic function and disrupted regional neural activity may be the neural substrates underlying the poor sleep qualities and cognitive declines in night-shift nurses.
