Circadian rhythm disruption alters gray and white matter microstructure: Higher-order diffusion analysis coupled with hormonal/inflammatory biomarkers

doi:10.5498/wjp.v16.i6.117066

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World Journal of Psychiatry

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2220-3206

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Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA

Observational Study

Copyright: ©Author(s) 2026. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution-NonCommercial (CC BY-NC 4.0) license. No commercial re-use. See permissions. Published by Baishideng Publishing Group Inc.

World J Psychiatry. Jun 19, 2026; 16(6): 117066
Published online Jun 19, 2026. doi: 10.5498/wjp.v16.i6.117066

Circadian rhythm disruption alters gray and white matter microstructure: Higher-order diffusion analysis coupled with hormonal/inflammatory biomarkers

Fang Zhang, Wei-Yuan Huang, Lei Zhang, Zhuo-Ran Huang, Wei Zhao, Yong-Qiang Yu

Fang Zhang, Yong-Qiang Yu, Department of Radiology, The First Affiliated Hospital of Anhui Medical University, Hefei 230000, Anhui Province, China

Fang Zhang, Lei Zhang, Wei Zhao, Department of Radiology, Huaibei People's Hospital, Huaibei 235000, Anhui Province, China

Wei-Yuan Huang, Department of Radiology, Hainan General Hospital, Haikou 570311, Hainan Province, China

Zhuo-Ran Huang, College of Life Sciences, Huaibei Normal University, Huaibei 235000, Anhui Province, China

Author contributions: Zhang F was responsible for conceptualization, methodology, writing - original draft; Huang WY was responsible for validation, methodology, data curation; Zhang L was responsible for validation, methodology, data curation; Huang ZR was responsible for validation, methodology, data curation; Zhao W was responsible for supervision, writing - review & editing, resources; Yu YQ was responsible for writing - review & editing, supervision, resources, project administration, funding acquisition, conceptualization; all authors have read and approved the final manuscript.

AI contribution statement: Tencent Yuanbao was used for language polishing to improve grammar and readability. Tencent Yuanbao was used solely for language polishing (proofreading and editing for grammar, spelling, and clarity). No AI tools were used for translation, data analysis, or writing assistance beyond proofreading.

Supported by 2024 Huaibei City Science and Technology Plan Project, No. HK2024057.

Institutional review board statement: This study was conducted in accordance with the Declaration of Helsinki and received ethical approval from the Institutional Review Board of Huaibei People's Hospital, Anhui Province (Approval No. 2024-074).

Informed consent statement: All study participants, or their legal guardian, provided informed written consent prior to study enrollment.

Conflict-of-interest statement: The authors declare no competing financial or non-financial interests in relation to this article. No external funding bodies influenced the design, conduct, or reporting of this study.

STROBE statement: The authors have read the STROBE Statement—checklist of items, and the manuscript was prepared and revised according to the STROBE Statement—checklist of items.

Data sharing statement: Technical appendix, statistical code, and dataset available from the corresponding author at e-mail address.

Corresponding author: Yong-Qiang Yu, PhD, Professor, Department of Radiology, The First Affiliated Hospital of Anhui Medical University, No. 218 Jixi Road, Hefei 230000, Anhui Province, China. yuyongqiang@ahmu.edu.cn

Received: December 2, 2025
Revised: January 7, 2026
Accepted: February 6, 2026
Published online: June 19, 2026
Processing time: 182 Days and 6.7 Hours

Abstract

BACKGROUND

The hypothalamic suprachiasmatic nucleus, as the master circadian pacemaker, coordinates circadian homeostasis via neuroendocrine signaling networks. Circadian rhythm disruption (CRD) denotes functional impairment of this system, driven by etiologies ranging from environmental stressors to intrinsic insults, triggering pathophysiological cascades.

AIM

To delineate neuroendocrine-immune circuits in female textile workers with CRD by integrating diffusion spectrum imaging (DSI)-based neurite orientation dispersion and density imaging (NODDI) with biochemical indices, in order to identify specific biomarkers linked to circadian-hormonal-inflammatory crosstalk.

METHODS

This prospective observational study included 55 female patients with CRD (≥ 10 annual night-shift cycles) and 41 age-, sex-, and education-matched controls. A comprehensive multimodal assessment was performed, including quantitative DSI-based NODDI analysis of gray and white matter regions, serum biomarker profiling, standardized neuropsychological evaluations, and statistical analysis of group differences. Within the CRD group, interrelations among multimodal variables were explored using correlation analyses.

RESULTS

Compared with controls, the CRD group showed significantly higher volume fraction of the isotropically diffusing water and intracellular volume fraction (ICVF) values in seven gray matter regions (P < 0.05), primarily within the default mode network and visual network (VN); white matter ICVF was also elevated in three fiber tracts associated with the VN. The CRD group had poorer neurofunctional performance compared to controls. The CRD group also demonstrated increased triiodothyronine (T3; 2.33 nmol/L vs 2.02 nmol/L), prolactin (303.20 µIU/mL vs 249.60 µIU/mL), neutrophil-to-lymphocyte ratio (2.02 vs 1.80); and decreased thyrotropin receptor antibody (0.75 IU/L vs 0.98 IU/L) and luteinizing hormone (14.77 mIU/mL vs 24.29 mIU/mL) compared with the control group. Correlation analysis showed that ICVF in the left middle occipital gyrus and pontine crossing tract correlated positively with T3 (r = 0.268 and 0.321 respectively), while ICVF in the left cuneus and left superior occipital gyrus correlated with cortisol (r = 0.278 and 0.268 respectively).

CONCLUSION

Prolonged night-shift causes CRD via neurostructural remodeling, endocrine dysregulation, neuroinflammation; hypothalamic-pituitary-thyroid/hypothalamic-pituitary-gonadal axis dysfunction mediates neuroimmune crosstalk. Multimodal biomarkers enable precise diagnosis/intervention.

Keywords: Inflammatory factors; Endocrine; Neuroimaging; Diffusion spectrum imaging; Circadian rhythm disruption

Core Tip: This study focuses on female night-shift textile workers with circadian rhythm disruption (CRD), innovatively integrating diffusion spectrum imaging-based neurite orientation dispersion and density neuroimaging, endocrine/inflammatory biomarkers, and neuropsychological assessments. The study results reveal, for the first time, that neuroendocrine-immune crosstalk in CRD is mediated by neurostructural remodeling, dysregulation of the hypothalamic-pituitary-thyroid/hypothalamic-pituitary-gonadal axis, and neuroinflammation, providing critical evidence for precision diagnosis and intervention of CRD driven by multimodal biomarkers.