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Increased glymphatic system activity in patients with mild traumatic brain injury
Zhuozhi Dai1,2, Zhiqi Yang3, Zhaolin Li4
1Department of Radiology, Shantou Central Hospital, Shantou, Guangdong, China.
Purpose:
This study aims to investigate the glymphatic system activity changes in patients with mild traumatic brain injury (mTBI), particularly in MRI-negative patients, using analysis along the perivascular space (ALPS) technology.
Methods:
A total of 161 mTBI patients (age: 15-92 years old) and 28 healthy controls (age: 15-84 years old) were included in this retrospective study. The mTBI patients were divided into MRI-negative and MRI-positive groups. ALPS index was calculated automatically using whole-brain T1-MPRAGE imaging and diffusion tensor imaging. The Student's t and chi-squared tests were performed to compare the ALPS index, age, gender, course of disease, and Glasgow Coma Scale (GCS) score between groups. Correlations among ALPS index, age, course of disease and GCS score were computed using Spearman's correlation analysis.
Results:
Increased activity of the glymphatic system was suggested in mTBI patients based on ALPS index analysis, including the MRI-negative patients. There was a significant negative correlation between the ALPS index and age. In addition, a weak positive correlation between the ALPS index and course of disease was also observed. On the contrary, there was no significant correlation between the ALPS index and sex nor between the ALPS index and GCS score.
Conclusion:
Our study demonstrated that the activity level of the glymphatic system was enhanced in mTBI patients, even when their brain MRI scans were negative. These findings may provide novel insights for understanding the pathophysiology of mild TBI.
Insights
Glymphatic system activity is enhanced in mild traumatic brain injury (mTBI) patients, even those with negative MRI scans. This finding offers new insights into mTBI pathophysiology.
Area of Science:
- Neuroscience
- Radiology
- Medical Imaging
Background:
- Mild traumatic brain injury (mTBI) is a common condition with complex pathophysiology.
- The glymphatic system plays a crucial role in brain waste clearance.
- Assessing glymphatic function in mTBI, especially in MRI-negative cases, remains challenging.
Purpose of the Study:
- To investigate changes in glymphatic system activity in mTBI patients.
- To specifically evaluate glymphatic function in MRI-negative mTBI patients.
- To utilize Analysis along the Perivascular Space (ALPS) technology for this assessment.
Main Methods:
- Retrospective study including 161 mTBI patients and 28 healthy controls.
- mTBI patients categorized into MRI-negative and MRI-positive groups.
- ALPS index calculated using T1-MPRAGE and diffusion tensor imaging; statistical analyses performed.
Main Results:
- Glymphatic system activity, indicated by the ALPS index, was found to be increased in mTBI patients, including those with negative MRI.
- A significant negative correlation was observed between ALPS index and patient age.
- A weak positive correlation was noted between ALPS index and the course of disease.
Conclusions:
- Glymphatic system activity is enhanced in mTBI patients, irrespective of MRI findings.
- These findings contribute to understanding the underlying mechanisms of mild TBI.
- ALPS technology proves valuable for assessing glymphatic function in mTBI.
