ArticleAddiction biology2026
Reduced Coupling of Global Brain Activity and Cerebrospinal Fluid Flow in Individuals With Betel Quid Dependence.
Article in Addiction biology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Millions of people worldwide are affected by betel quid dependence (BQD), a prevalent psychoactive substance-use disorder. To evaluate cerebral glymphatic dysfunction in BQD, this work used the coupling between global blood-oxygen-level-dependent (gBOLD) and cerebrospinal fluid (CSF) signals collected via resting-state functional MRI (rs-fMRI). Sixty-six participants (29 BQD individuals and 37 healthy controls) underwent rs-fMRI scanning. Cross-correlation analysis between cortical BOLD and CSF time series was carried out to compute the gBOLD-CSF coupling intensity. Group comparisons were performed via independent sample t-tests, and correlations with clinical features were assessed using exploratory Pearson's analysis. Bonferroni correction was applied to the five correlation analyses (BQDS, duration, daily consumption, HAMA-14 and HAMD-24). The corrected significance threshold was set at p < 0.01 (0.05/5). BQD individuals exhibited significantly reduced gBOLD-CSF coupling (t = -2.42, p = 0.019), and weaker coupling correlated with longer BQD duration (r = 0.4313, uncorrected p = 0.0195). After Bonferroni correction for multiple comparisons, the correlation between duration and gBOLD-CSF coupling (original p = 0.0195) did not reach the adjusted threshold. Chronic betel quid exposure may impair glymphatic function, reflecting disrupted brain-CSF interactions. The gBOLD-CSF coupling metric could be used as a noninvasive imaging biomarker to evaluate neurotoxic effects and glymphatic dysfunction in substance-use disorders.
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