Evaluation of the Glymphatic System With Diffusion Tensor Imaging-Along the Perivascular Space in Cancer Pain

Wang, Aibo; Chen, Lei; Tian, Chushun; Yin, Xiao‐Yu; Wang, Xinyue; Zhao, Yize; Zhang, Miao; Yang, Lili; Ye, Zhaoxiang

doi:10.3389/fnins.2022.823701

Cited by 7 publications

(6 citation statements)

References 41 publications

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“…The HIT-6 measured the daily life impacts (Supplementary Table 2 in Additional file 1 ) due to RCVS. A recent study revealed that the DTI-ALPS index may be an imaging marker of cancer pain [ 48 ]. Our data further support the potential use of the DTI-ALPS index in the evaluation of subjects with RCVS regarding clinical impacts and implicate the potential role of glymphatics in pain modulation.…”

Section: Discussionmentioning

confidence: 99%

Dynamic changes in glymphatic function in reversible cerebral vasoconstriction syndrome

Wu,

Kuo,

Ling

et al. 2024

J Headache Pain

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Background The pathophysiology of the reversible cerebral vasoconstriction syndrome (RCVS) remains enigmatic and the role of glymphatics in RCVS pathophysiology has not been evaluated. We aimed to investigate RCVS glymphatic dynamics and its clinical correlates. Methods We prospectively evaluated the glymphatic function in RCVS patients, with RCVS subjects and healthy controls (HCs) recruited between August 2020 and November 2023, by calculating diffusion-tensor imaging along the perivascular space (DTI-ALPS) index under a 3-T MRI. Clinical and vascular (transcranial color-coded duplex sonography) investigations were conducted in RCVS subjects. RCVS participants were separated into acute (≤ 30 days) and remission (≥ 90 days) groups by disease onset to MRI interval. The time-trend, acute stage and longitudinal analyses of the DTI-ALPS index were conducted. Correlations between DTI-ALPS index and vascular and clinical parameters were performed. Bonferroni correction was applied to vascular investigations (q = 0.05/11). Results A total of 138 RCVS patients (mean age, 46.8 years ± 11.8; 128 women) and 42 HCs (mean age, 46.0 years ± 4.5; 35 women) were evaluated. Acute RCVS demonstrated lower DTI-ALPS index than HCs (p < 0.001) and remission RCVS (p < 0.001). A continuously increasing DTI-ALPS trend after disease onset was demonstrated. The DTI-ALPS was lower when the internal carotid arteries resistance index and six-item Headache Impact test scores were higher. In contrast, during 50–100 days after disease onset, the DTI-ALPS index was higher when the middle cerebral artery flow velocity was higher. Conclusions Glymphatic function in patients with RCVS exhibited a unique dynamic evolution that was temporally coupled to different vascular indices and headache-related disabilities along the disease course. These findings may provide novel insights into the complex interactions between glymphatic transport, vasomotor control and pain modulation.

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Section: Discussionmentioning

confidence: 99%

Dynamic changes in glymphatic function in reversible cerebral vasoconstriction syndrome

Wu,

Kuo,

Ling

et al. 2024

J Headache Pain

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“…An earlier study suggested that chronic pain states might also lead to several microstructural and functional changes in the brain. It showed that patients with cancer pain had significantly impaired ISF drainage compared to healthy people 42 . In addition, worse subjective sleep quality is more common in CM people, and studies have established the effectiveness of sleep interventions in reversing CM into EM 43 .…”

Section: Discussionmentioning

confidence: 99%

“…It showed that patients with cancer pain had significantly impaired ISF drainage compared to healthy people. 42 In addition, worse subjective sleep quality is more common in CM people, and studies have established the effectiveness of sleep interventions in reversing CM into EM. 43 Both state of pain and lack of sleep time can cause increased adrenergic signaling, inhibiting the function of the glymphatic system.…”

Section: Discussionmentioning

confidence: 99%

Enlarged perivascular spaces in patients with migraine: a case–control study based on 3T MRI

Yuan,

Li,

Tang

et al. 2023

Ann Clin Transl Neurol

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Objective To explore whether MRI‐visible enlarged perivascular spaces (EPVS) are associated with migraine and may serve as a predictor of migraine. Then further explore its correlation with migraine chronification. Methods A total of 231 participants (healthy control [HC] = 57, episodic migraine [EM] = 59, chronic migraine [CM] = 115) were included in this case–control study. A 3T MRI device and the validated visual rating scale were used to assess the grades of EPVS in centrum semiovale (CSO), midbrain (MB), and basal ganglia (BG). Comparisons between the two groups were made using the chi‐square or Fisher's exact tests to initially determine whether high‐grade EPVS were associated with migraine and migraine chronification. A multivariate logistic regression model was constructed to further investigate the role of high‐grade EPVS in migraine. Results The prevalence of high‐grade EPVS in CSO and MB were significantly higher in patients with migraine than in HCs (CSO: 64.94% vs. 42.11%, P = 0.002; MB: 55.75% vs. 29.82%, P = 0.001). Subgroup analysis showed no statistical difference between patients with EM and CM (CSO: 69.94% vs. 62.61%, P = 0.368; MB: 50.85% vs. 58.26%, P = 0.351). Individuals with high‐grade EPVS in CSO (odds ratio [OR]: 2.324; 95% confidence interval [CI]: 1.136–4.754; P = 0.021) and MB (OR: 3.261; 95% CI: 1.534–6.935; P = 0.002) were more likely to suffer from migraine. Interpretation This case–control study showed that high‐grade EPVS in CSO and MB in clinical practice with the underlying mechanism of dysfunction of the glymphatic system could be a predictor of migraine, but no significant correlation had been found with migraine chronification.

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“…Using both glymphatic magnetic resonance imaging (MRI) and DTI-ALPS methods, Zhang et al (2021) measured and compared glymphatic clearance function and found a significant correlation between the DTI-ALPS index and the brain glymphatic clearance rate calculated by classical glymphatic MRI, indicating that DTI-ALPS might represent the precise function of brain glymphatic clearance (Siow et al, 2022). The DTI-ALPS index has been used to assess variations in the glymphatic system in several diseases, such as Alzheimer's disease, type 2 diabetes mellitus, idiopathic normal pressure hydrocephalus, Parkinson's disease, cancer pain, and other diseases (Taoka et al, 2017;Yang et al, 2020;Bae et al, 2021;Heo et al, 2021;Ma et al, 2021;Okada et al, 2021;Toh and Siow, 2021a;Wang et al, 2022). Zhang et al (2022) used the DTI-ALPS method in patients with hemorrhagic stroke and found the impairment of the ipsilateral glymphatic system function on the lesion side.…”

Section: Introductionmentioning

confidence: 99%

DTI-ALPS: An MR biomarker for motor dysfunction in patients with subacute ischemic stroke

Qin

Li²,

Qiao

et al. 2023

Front. Neurosci.

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PurposeBrain glymphatic dysfunction is involved in the pathologic process of acute ischemic stroke (IS). The relationship between brain glymphatic activity and dysfunction in subacute IS has not been fully elucidated. Diffusion tensor image analysis along the perivascular space (DTI-ALPS) index was used in this study to explore whether glymphatic activity was related to motor dysfunction in subacute IS patients.MethodsTwenty-six subacute IS patients with a single lesion in the left subcortical region and 32 healthy controls (HCs) were recruited in this study. The DTI-ALPS index and DTI metrics (fractional anisotropy, FA, and mean diffusivity, MD) were compared within and between groups. Spearman's and Pearson's partial correlation analyses were performed to analyze the relationships of the DTI-ALPS index with Fugl-Meyer assessment (FMA) scores and with corticospinal tract (CST) integrity in the IS group, respectively.ResultsSix IS patients and two HCs were excluded. The left DTI-ALPS index of the IS group was significantly lower than that of the HC group (t = −3.02, p = 0.004). In the IS group, a positive correlation between the left DTI-ALPS index and the simple Fugl-Meyer motor function score (ρ = 0.52, p = 0.019) and a significant negative correlation between the left DTI-ALPS index and the FA (R = −0.55, p = 0.023) and MD (R = −0.48, p = 0.032) values of the right CST were found.ConclusionsGlymphatic dysfunction is involved in subacute IS. DTI-ALPS could be a potential magnetic resonance (MR) biomarker of motor dysfunction in subacute IS patients. These findings contribute to a better understanding of the pathophysiological mechanisms of IS and provide a new target for alternative treatments for IS.

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Evaluation of the Glymphatic System With Diffusion Tensor Imaging-Along the Perivascular Space in Cancer Pain

Cited by 7 publications

References 41 publications

Dynamic changes in glymphatic function in reversible cerebral vasoconstriction syndrome

Dynamic changes in glymphatic function in reversible cerebral vasoconstriction syndrome

Enlarged perivascular spaces in patients with migraine: a case–control study based on 3T MRI

DTI-ALPS: An MR biomarker for motor dysfunction in patients with subacute ischemic stroke

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