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Published on: September 1, 2023
DTI-ALPS: An MR biomarker for motor dysfunction in patients with subacute ischemic stroke
Yue Qin1,2, Xin Li2, Yanqiang Qiao1,2
1Department of Medical Imaging, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China.
Purpose:
Brain 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.
Methods:
Twenty-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.
Results:
Six 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.
Conclusions:
Glymphatic 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.
Insights
Glymphatic dysfunction, measured by Diffusion Tensor Image Analysis along the Perivascular Space (DTI-ALPS), is linked to motor deficits in subacute ischemic stroke (IS). Lower DTI-ALPS indicates poorer motor function and corticospinal tract integrity in IS patients.
Area of Science:
- Neuroscience
- Radiology
- Neurology
Background:
- Brain glymphatic system dysfunction is implicated in acute ischemic stroke (IS) pathology.
- The precise role of glymphatic activity in subacute IS motor deficits remains unclear.
Purpose of the Study:
- To investigate the relationship between glymphatic activity and motor dysfunction in subacute IS patients.
- To assess if Diffusion Tensor Image Analysis along the Perivascular Space (DTI-ALPS) index correlates with motor impairment.
Main Methods:
- Recruited 26 subacute IS patients and 32 healthy controls (HCs).
- Measured DTI-ALPS index and DTI metrics (FA, MD).
- Analyzed correlations between DTI-ALPS, Fugl-Meyer assessment (FMA) scores, and corticospinal tract (CST) integrity.
Main Results:
- Subacute IS patients showed significantly lower left DTI-ALPS index compared to HCs (p=0.004).
- A positive correlation was found between the left DTI-ALPS index and FMA motor function scores in IS patients (p=0.019).
- Negative correlations were observed between the left DTI-ALPS index and fractional anisotropy (FA) and mean diffusivity (MD) of the right CST (p=0.023 and p=0.032, respectively).
Conclusions:
- Glymphatic system dysfunction is evident in subacute IS.
- The DTI-ALPS index shows potential as an MR biomarker for assessing motor dysfunction in subacute IS.
- Findings enhance understanding of IS pathophysiology and suggest new therapeutic targets.
