Qin L, Wang K, Jiang LP, Xiao Z, Luo S. Correlation between anxiety-depression disorders and brain structural connectivity abnormalities after subarachnoid hemorrhage. World J Psychiatry 2025; 15(12): 111754 [PMID: 41357947 DOI: 10.5498/wjp.v15.i12.111754]
Corresponding Author of This Article
Lei Qin, MD, Department of Radiology, The First Affiliated Hospital of Bengbu Medical University, No. 801 Zhihuai Road, Bengbu 233004, Anhui Province, China. 15155296160@163.com
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Psychology, Clinical
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Basic Study
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This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Dec 19, 2025 (publication date) through Dec 9, 2025
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World Journal of Psychiatry
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2220-3206
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Qin L, Wang K, Jiang LP, Xiao Z, Luo S. Correlation between anxiety-depression disorders and brain structural connectivity abnormalities after subarachnoid hemorrhage. World J Psychiatry 2025; 15(12): 111754 [PMID: 41357947 DOI: 10.5498/wjp.v15.i12.111754]
World J Psychiatry. Dec 19, 2025; 15(12): 111754 Published online Dec 19, 2025. doi: 10.5498/wjp.v15.i12.111754
Correlation between anxiety-depression disorders and brain structural connectivity abnormalities after subarachnoid hemorrhage
Lei Qin, Kai Wang, Li-Ping Jiang, Zhang Xiao, Song Luo
Lei Qin, Kai Wang, Zhang Xiao, Department of Radiology, The First Affiliated Hospital of Bengbu Medical University, Bengbu 233004, Anhui Province, China
Lei Qin, Department of Image Diagnostics, School of Medical Imaging, Bengbu Medical University, Bengbu 233030, Anhui Province, China
Li-Ping Jiang, Department of Radiology, The Second Affiliated Hospital of Bengbu Medical University, Bengbu 233002, Anhui Province, China
Song Luo, Department of Neurology, The First Affiliated Hospital of Bengbu Medical University, Bengbu 233004, Anhui Province, China
Author contributions: Qin L was contributed to study design, data collection and analysis, manuscript writing, and funding acquisition; Wang K and Xiao Z were contributed to diffusion tensor imaging data acquisition, behavioral assessments, and statistical analysis; Jiang LP and Luo S were contributed to magnetic resonance imaging scanning protocols, clinical expertise, and manuscript review. All authors have read and approved the final manuscript.
Supported by Clinical Medicine Research and Translational Project of Anhui Province, No. 202204295107020036 and No. 202304295107020076; and the Science and Technology Innovation Guidance Project of Bengbu City, No. 20200338.
Institutional animal care and use committee statement: All animal experiments were conducted in accordance with the Guide for the Care and Use of Laboratory Animals. The study protocol was reviewed and approved by the Experimental Animal Ethics Committee of Bengbu Medical University (Approval No. LDKPZ2022-471).
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
ARRIVE guidelines statement: The authors have read the ARRIVE guidelines, and the manuscript was prepared and revised according to the ARRIVE guidelines.
Data sharing statement: The datasets generated and/or analyzed during the current study are available from the corresponding author upon reasonable request.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Lei Qin, MD, Department of Radiology, The First Affiliated Hospital of Bengbu Medical University, No. 801 Zhihuai Road, Bengbu 233004, Anhui Province, China. 15155296160@163.com
Received: July 29, 2025 Revised: August 31, 2025 Accepted: October 14, 2025 Published online: December 19, 2025 Processing time: 121 Days and 1.4 Hours
Abstract
BACKGROUND
Subarachnoid hemorrhage (SAH) is associated with high incidence of anxiety and depression disorders (27%-54% and 20%-42%, respectively), significantly affecting patient quality of life. However, the pathophysiological mechanisms underlying post-SAH emotional disorders remain poorly understood, limiting targeted therapeutic interventions.
AIM
To identify potential biomarkers and therapeutic targets through comprehensive analysis of behavioral, neuroimaging, and inflammatory parameters in a rat SAH model.
METHODS
We established a rat SAH model using cisternal injection of autologous blood and conducted comprehensive assessments including behavioral tests (elevated plus maze, forced swimming test, sucrose preference test), diffusion tensor imaging (DTI), and inflammatory factor detection. Seventy-two male SD rats were randomly divided into sham and SAH groups, with evaluations performed at multiple time points (1 hour to 72 hours post-hemorrhage). DTI parameters including fractional anisotropy (FA) and apparent diffusion coefficient were measured in limbic-prefrontal circuits. Serum and cerebrospinal fluid inflammatory markers [interleukin-6 (IL-6), IL-1β, tumor necrosis factor-α] were quantified using enzyme-linked immunosorbent assay.
RESULTS
SAH rats exhibited significant anxiety-like and depression-like behaviors at 12 hours, which further deteriorated at 24 hours (open arm time: 30.3 ± 4.7 seconds vs 82.1 ± 8.3 seconds in controls, P < 0.01; immobility time: 136.5 ± 12.7 seconds vs 78.3 ± 9.2 seconds in controls, P < 0.01). DTI analysis revealed progressive white matter microstructural damage, with hippocampus-prefrontal FA values decreasing by 21.8% and amygdala-prefrontal FA values by 20.3% at 24 hours (P < 0.001). Apparent diffusion coefficient values significantly decreased at 12 hours, indicating cellular edema. Inflammatory markers showed marked elevation, with stronger correlations between cerebrospinal fluid IL-1β and behavioral changes (r = 0.72-0.81, P < 0.001).
CONCLUSION
This study demonstrates that post-SAH emotional disorders result from a temporal cascade involving early neuroinflammation and progressive limbic-prefrontal circuit microstructural damage.
Core Tip: Post-subarachnoid hemorrhage anxiety-depression disorders follow a temporal cascade of early neuroinflammation (interleukin-1β elevation) leading to progressive limbic-prefrontal circuit damage. Strong correlations between cerebrospinal fluid inflammatory markers and behavioral deficits suggest central inflammation drives emotional dysfunction. This study emphasizes the correlation between anxiety and depression after subarachnoid hemorrhage and abnormal brain structural connections: Damage to the white matter microstructure centered on the limbic prefrontal lobe, corpus callosum, and thalamic-cortical fibers reduces network efficiency and is significantly associated with the severity of symptoms. Diffusion tensor imaging/structural connectome indicators (fractional anisotropy, mean diffusivity, global efficiency) can serve as imaging biomarkers for risk stratification and prognosis assessment, supporting early identification and targeted neuropsychological intervention.
