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Abnormal glymphatic system in patients with autoimmune encephalitis: Relationship with cognitive performance
Yingchi Zhang1, Dianwei Wu1, Zhirong Fan1
1Department of Neurology, Xijing Hospital, Air Force Medical University, Xi'an, Shaanxi Province 710038, China.
Brain Research Bulletin
|January 29, 2025
Summary
Glymphatic system impairment, measured by DTI-ALPS, is linked to cognitive decline in autoimmune encephalitis (AE) patients. Lower baseline ALPS scores predict a higher risk of long-term cognitive impairment.
Area of Science:
- Neuroscience
- Immunology
- Radiology
Background:
- Autoimmune encephalitis (AE) is a severe neurological disorder.
- Glymphatic system dysfunction is implicated in various neurological conditions.
- The role of glymphatic function in AE pathogenesis and prognosis remains unclear.
Purpose of the Study:
- To investigate the impact of glymphatic function on patients diagnosed with autoimmune encephalitis (AE).
- To assess the relationship between glymphatic function and cognitive impairment in AE patients.
- To determine if glymphatic function can predict long-term cognitive outcomes in AE.
Main Methods:
- Prospective longitudinal study involving 85 AE patients and 30 healthy controls (HCs).
- Glymphatic function assessed using diffusion tensor imaging analysis along the perivascular space (DTI-ALPS).
- Cognitive impairment defined by Montreal Cognitive Assessment (MoCA) scores below 26 at 12-month follow-up.
Main Results:
- AE patients exhibited significantly lower baseline DTI-ALPS index compared to HCs (P < 0.001).
- Baseline ALPS index positively correlated with cognitive scores (MMSE: r=0.568, P<0.001; MoCA: r=0.645, P<0.001).
- A lower baseline ALPS index was associated with an increased risk of long-term cognitive impairment (HR=1.70, P=0.013).
Conclusions:
- Glymphatic system function is impaired in patients with autoimmune encephalitis.
- Decreased DTI-ALPS index is significantly associated with cognitive decline in AE.
- Low baseline glymphatic function may serve as a predictor for long-term cognitive impairment in AE.
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