Glymphatic dysfunction in isolated REM sleep behavior disorder

IntroductionIt is a recent finding that glymphatic system dysfunction contributes to various neurological problems. The purpose of this research was to assess the function of the glymphatic system in neurologically asymptomatic early chronic kidney disease (CKD) patients and healthy controls, using diffusion tensor image analysis along perivascular space (DTI-ALPS) index.MethodsIn a prospective study, we included patients with early CKD who were asymptomatic for neurological issues and obtained clinical and laboratory data. In all participants, brain magnetic resonance imaging (MRI) with diffusion tensor imaging (DTI) was conducted. We used DSI program for DTI preprocessing and DTI-ALPS index estimation. The DTI-ALPS index was compared between patients with early CKD and healthy controls, and the association between clinical characteristics and the DTI-ALPS index was investigated.ResultsEighteen patients with early CKD and 18 healthy controls were included in this study. Patients with early CKD had lower DTI-ALPS index than healthy controls (1.259 ± 0.199 vs. 1.477 ± 0.232, p = 0.004). In the correlation analysis, the DTI-ALPS index had no significant relationship with other clinical factors.ConclusionWe suggest dysfunction of glymphatic system in patients with early chronic kidney disease using the DTI-ALPS index. This may be related to the pathophysiology of neurological problems including impairment of cognition in patients with early CKD.

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“… Diagram depicting how the diffusion tensor image analysis along the perivascular space (DTI-ALPS) index is calculated ( 16 ). …”

Section: Methodsmentioning

confidence: 99%

Glymphatic system dysfunction in patients with early chronic kidney disease

et al. 2022

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“…These studies suggest the promise of the DTI-ALPS index as an imaging marker for assessing cognitive impairment. Two other researches on sleep disorders found that the DTI-ALPS index was significantly lower in patients with obstructive sleep apnea (OSA) and isolated rapid eye movement sleep behavior disorder (iRBD) than in healthy controls ( 94 , 95 ).…”

Section: Imaging Of Brain Glymphatic Systemmentioning

confidence: 99%

Perivascular Spaces, Glymphatic System and MR

et al. 2022

Front. Neurol.

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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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“…To further understand the effects of sleep deprivation on Aβ clearance, a clinical trial in 20 healthy controls who underwent 31 h of sleep deprivation showed that Aβ was increased by 5% in the hippocampus, the parahippocampus, and the thalamus ( 65 ). Moreover, a recent study that tracked the REM phase in patients who experienced poor sleep found that the index of diffusion tensor imaging analysis along the perivascular space was significantly lower in patients than in healthy controls, which indicated glymphatic dysfunction ( 66 ). Thus, we speculate that the GS is intimately linked to various aspects of sleep.…”

Section: The Glymphatic System and Sleep Disordersmentioning

confidence: 99%

Glymphatic System Dysfunction: A Novel Mediator of Sleep Disorders and Headaches

Gao

Zhu

et al. 2022

Front. Neurol.

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Sleep contributes to the maintenance of overall health and well-being. There are a growing number of patients who have headache disorders that are significantly affected by poor sleep. This is a paradoxical relationship, whereby sleep deprivation or excess sleep leads to a worsening of headaches, yet sleep onset also alleviates ongoing headache pain. Currently, the mechanism of action remains controversial and poorly understood. The glymphatic system is a newly discovered perivascular network that encompasses the whole brain and is responsible for removing toxic proteins and waste metabolites from the brain as well as replenishing nutrition and energy. Recent studies have suggested that glymphatic dysfunction is a common underlying etiology of sleep disorders and headache pain. This study reviews the current literature on the relationship between the glymphatic system, sleep, and headaches, discusses their roles, and proposes acupuncture as a non-invasive way to focus on the glymphatic function to improve sleep quality and alleviate headache pain.

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Glymphatic dysfunction in isolated REM sleep behavior disorder

Cited by 51 publications

References 32 publications

Glymphatic system dysfunction in patients with early chronic kidney disease

Glymphatic system dysfunction in patients with early chronic kidney disease

Perivascular Spaces, Glymphatic System and MR

Glymphatic System Dysfunction: A Novel Mediator of Sleep Disorders and Headaches

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