Diffusion Tensor Imaging Along the Perivascular Space Index in Different Stages of Parkinson’s Disease

Ma, Xinxin; Li, Shuhua; Li, Chunmei; Wang, Rui; Chen, Min; Chen, Haibo; Su, Wen

doi:10.3389/fnagi.2021.773951

“…Impaired water diffusivity along PVS in the white matter with dense projection or association fibers was associated with lower mini-mental state examination (MMSE) score and AD severity ( 91 ). Similar results have been observed in Parkinson's patients ( 92 ). Another study in a community-dwelling population of non-demented older adults showed that a higher DTI-ALPS index was associated with higher scores on the neuropsychological performance test and also with higher gray matter volume ( 93 ).…”

Section: Imaging Of Brain Glymphatic Systemsupporting

confidence: 90%

Perivascular Spaces, Glymphatic System and MR

Yu

¹

,

Hu

²

,

Li

³

et al. 2022

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The importance of the perivascular space (PVS) as one of the imaging markers of cerebral small vessel disease (CSVD) has been widely appreciated by the neuroradiologists. The PVS surrounds the small blood vessels in the brain and has a signal consistent with the cerebrospinal fluid (CSF) on MR. In a variety of physio-pathological statuses, the PVS may expand. The discovery of the cerebral glymphatic system has provided a revolutionary perspective to elucidate its pathophysiological mechanisms. Research on the function and pathogenesis of this system has become a prevalent topic among neuroradiologists. It is now believed that this system carries out the similar functions as the lymphatic system in other parts of the body and plays an important role in the removal of metabolic waste and the maintenance of homeostatic fluid circulation in the brain. In this article, we will briefly describe the composition of the cerebral glymphatic system, the influencing factors, the MR manifestations of the PVS and the related imaging technological advances. The aim of this research is to provide a reference for future clinical studies of the PVS and glymphatic system.

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“…Recently, DTI-ALPS, proposed by Taoka et al [ 23 ], was recognized as a new noninvasive and robust method to help evaluate the function of the human GS. To date, DTI-ALPS has been employed in some studies to explore the mechanism of central nervous system-related diseases, such as Alzheimer's disease [ 16 ], Parkinson's disease [ 17 ], and type 2 diabetes mellitus [ 18 ]. The authors found that GS could reflect pathological changes, and the DTI-ALPS index was considered to be a promising biomarker of the GS in neurological disease.…”

Section: Discussionmentioning

confidence: 99%

“…Interestingly, we found no significant difference in DTI-ALPS on the same side (right side) between participants in the HC and sICH groups, but it was significantly reduced on the lesion side, which indicated that GS function decreased on the ipsilateral side of the lesion but not on the contralateral side. In previous studies, the DTI parameters were only measured in the left cerebral hemisphere because the subjects were right-handed [ 17 , 18 ]. Despite this, information on the DTI parameters of the right cerebral hemisphere is still lacking.…”

Section: Discussionmentioning

confidence: 99%

“…As a key anatomic structure of the GS, EPVS was suggested to be closely related to impaired GS clearance of inflammatory substances and metabolic waste in traumatic brain injury [ 15 ]. The GS was also reported to be strongly linked with the pathophysiology of other nontraumatic diseases, such as Alzheimer's disease [ 16 ], Parkinson's disease [ 17 ], and type 2 diabetes mellitus [ 18 ], by using diffusion tensor imaging analysis along with the PVS (DTI-ALPS). As suggested by the above studies, DTI-ALPS can be used as a quantitative imaging biomarker to monitor the ability of the GS to remove metabolic wastes, providing a new method for noninvasively evaluating human GS function in vivo [ 19 ].…”

Section: Introductionmentioning

confidence: 99%

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Evaluation of the Glymphatic System Using the DTI-ALPS Index in Patients with Spontaneous Intracerebral Haemorrhage

Zhang

¹

,

Sha

²

,

Cai

³

et al. 2022

Oxidative Medicine and Cellular Longevity

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Objective. To investigate the function of the human glymphatic system (GS) in patients with spontaneous intracerebral haemorrhage (sICH) using diffusion tensor imaging analysis along with the perivascular space (DTI-ALPS). Methods. Twenty patients with sICH and 31 healthy controls (HCs) were recruited for DTI and susceptibility-weighted imaging scanning. The diffusivity along the perivascular spaces, as well as the projection fibres and association fibres, was evaluated separately. The DTI-ALPS index of each subject was also calculated. Two-sample t -tests and paired t -tests were performed to analyse the difference in ALPS scores between patients and HCs, as well as that between the lesion side and contralateral side. Pearson correlation analysis was used to observe the relationship between disease duration and GS function. Results. The DTI-ALPS index on the lesion side was significantly lower than that of the contralateral side in patients with sICH ( p < 0.01 , t = − 5.77 ), and it was also significantly lower than that of the ipsilateral side of HCs ( p < 0.01 , t = − 9.50 ). No significant differences were found in the DTI-ALPS index on the nonlesion side between patients and HCs ( p = 0.96 , t = 0.05 ) or between the left and right cerebral hemispheres of HCs ( p = 0.41 , t = − 0.83 ). The DTI-ALPS index of the lesion side in patients with sICH was significantly correlated with disease duration ( p = 0.018 , r = 0.537 ). Conclusions. The present study confirmed that GS dysfunction on the ipsilateral side of the lesion is impaired in patients with haemorrhagic stroke, indicating that the GS may be a separate system in the left and right cerebral hemispheres. The DTI-ALPS index can reflect disease duration. These findings have significant implications for understanding sICH from a new perspective.

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“…Inflation of α -synuclein is the primary pathogenesis of PD because of the lack of a functional glymphatic system [ 9 ]. Association of the disturbed glymphatic system in PD is proved in diffusion tensor image analysis along with the perivascular space (DTI-ALPS) method where PD exerts a prominent reduction in ALPS index [ 12 ]. Sleep disturbance is characteristic of PD causing oxidative stress and metabolic waste( α -synuclein) accumulation [ 10 ].…”

mentioning

confidence: 99%