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Glymphatic Dysfunction Coupled with Altered Neural Activity in High Myopia: Multimodal Study of Brain-Eye

Xiaopan Zhang1,2, Liang Liu1, Shaoqiang Han1

  • 1Department of Magnetic Resonance Imaging, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China.

Annals of the New York Academy of Sciences
|January 27, 2026
PubMed
Summary

High myopia is linked to impaired brain glymphatic function and altered neural activity. This study reveals a connection between eye changes, reduced brain waste clearance, and disrupted brain synchronization.

Keywords:
choroid plexusdiffusion tensor image analysis along the perivascular spaceglymphatic systemhigh myopiaregional homogeneity

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Area of Science:

  • Neuroscience
  • Ophthalmology
  • Medical Imaging

Background:

  • High myopia poses significant global health challenges, impacting the central nervous system.
  • The role of glymphatic system dysfunction and neural alterations in high myopia is poorly understood.
  • Brain-eye pathological interactions in high myopia require further investigation.

Purpose of the Study:

  • To investigate glymphatic system function and neural activity changes in high myopia using multimodal MRI.
  • To explore the relationship between high myopia, glymphatic dysfunction, and brain alterations.
  • To elucidate the brain-eye pathological interactions in high myopia.

Main Methods:

  • Multimodal magnetic resonance imaging (MRI) was employed.
  • Diffusion tensor image analysis along the perivascular space (DTI-ALPS) was used to assess glymphatic function.
  • Choroid plexus volumetry and regional homogeneity (ReHo) analyses were performed to evaluate neural activity.

Main Results:

  • Patients with high myopia showed reduced DTI-ALPS indices and enlarged choroid plexus volumes compared to controls.
  • Distinct regional homogeneity (ReHo) alterations were observed, with increased activity in the superior frontal gyrus and decreased activity in visual and auditory cortex regions.
  • DTI-ALPS indices and choroid plexus volume correlated with refractive error and axial length, and glymphatic dysfunction was linked to abnormal ReHo.

Conclusions:

  • High myopia is associated with impaired glymphatic clearance and disrupted neural synchronization.
  • A pathological cascade linking axial elongation, glymphatic dysfunction, and altered brain activity is suggested.
  • This study provides a multimodal framework for understanding brain-eye interactions in high myopia and its neurological risks.