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• Clinical Article •
Glymphatic system alterations and cognitive-emotional impairment in bilateral sudden sensorineural hearing loss: A structural MRI study
FANG Zihuai  XU Xiaomin  CHEN Yuchen  HUANG Hongjie  YIN Xindao 

DOI:10.12015/issn.1674-8034.2025.12.005.


[Abstract] Objective To investigate the neuroimaging mechanisms underlying the association between structural alterations of the glymphatic system and cognitive and emotional impairments in patients with sudden sensorineural hearing loss (SSNHL), using structural magnetic resonance imaging.Materials and Methods Forty-eight patients with bilateral SSNHL and 47 healthy controls were enrolled. All participants underwent hearing assessments, multidimensional neuropsychological evaluations, and 3D T1-weighted magnetic resonance imaging scans. Choroid plexus volume, perivascular space volume, and ventricular volumes (bilateral, third, and fourth ventricles) were automatically segmented and quantified using a U-net deep learning model and FreeSurfer tool. Spearman correlation analyses were performed to examine the relationships between imaging-derived metrics and cognitive and emotional scores.Results Patients and healthy controls were well matched in age, sex, and education (P > 0.05). Patients showed higher mean binaural hearing thresholds compared to controls, as well as differences in cognitive and depression scale scores (P < 0.05). Compared with controls, bilateral SSNHL patients exhibited larger raw and normalized choroid plexus volumes, perivascular space volumes, and bilateral lateral ventricular volumes (P < 0.05), while no significant group differences were observed in the raw or normalized volumes of the third and fourth ventricles (P > 0.05). Normalized choroid plexus volume was negatively correlated with Symbol Digit Modalities Test performance (r = -0.311, P = 0.032) and positively correlated with mean binaural hearing threshold (r = 0.382, P = 0.007).Conclusions Bilateral SSNHL is associated with structural alterations in glymphatic system-related brain regions. Enlargement of the choroid plexus is significantly related to reduced information processing speed, providing insight into the neuroimaging mechanisms underlying cognitive and emotional impairments in SSNHL.
[Keywords] sudden sensorineural hearing loss；structural magnetic resonance imaging；glymphatic system；cognition；emotion

FANG Zihuai   XU Xiaomin   CHEN Yuchen   HUANG Hongjie   YIN Xindao*  

Department of Radiology, Nanjing First Hospital, Nanjing Medical University, Nanjing 210006, China

Corresponding author: YIN X D, E-mail: y.163yy@163.com

Conflicts of interest   None.

Received  2025-09-30
Accepted  2025-12-03
DOI: 10.12015/issn.1674-8034.2025.12.005
DOI:10.12015/issn.1674-8034.2025.12.005.

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