Glymphatic function assessment in Parkinson's disease using diffusion tensor image analysis along the perivascular...

Area of Science:

• Neuroscience
• Radiology
• Biomedical Engineering

Background:

• Glymphatic system dysfunction is implicated in alpha-synucleinopathies.
• Investigating glymphatic function is crucial for understanding Parkinson's disease (PD) pathogenesis.

Purpose of the Study:

• To evaluate glymphatic function in de novo Parkinson's disease (PD) patients using Diffusion Tensor Image Analysis aLong the Perivascular Space (DTI-ALPS).
• To correlate glymphatic function, assessed by the ALPS-index, with clinical and imaging markers in PD.

Main Methods:

• Recruited de novo PD patients and age/sex-matched controls.
• Acquired Diffusion Tensor Imaging (DTI) and ¹²³I-FP-CIT SPECT.
• Calculated the ALPS-index from DTI to measure perivascular water motion and correlated it with UPDRS-III, MMSE, MoCA scores, and striatal ¹²³I-FP-CIT specific binding ratios (SBRs).

Main Results:

• The ALPS-index was significantly lower in PD patients compared to controls (P < 0.001).
• In PD patients, the ALPS-index showed negative correlation with UPDRS-III scores and positive correlations with MMSE and MoCA scores (P < 0.05).
• No significant correlation was found between the ALPS-index and striatal ¹²³I-FP-CIT SBRs.

Conclusions:

• DTI-ALPS is a viable method for detecting glymphatic dysfunction in PD.
• Glymphatic dysfunction severity in PD correlates with motor and cognitive deficits.
• Glymphatic function, as measured by DTI-ALPS, is not directly associated with striatal dopamine transporter levels in early PD.