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Related Experiment Video

Updated: May 9, 2025

Diffusion Tensor Magnetic Resonance Imaging in the Analysis of Neurodegenerative Diseases
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Impaired Glymphatic Function in Diffuse Axonal Injury: Evaluation Using the Diffusion Tensor Imaging Analysis Along

Sung Hyun An1, Miran Han1, Woo Sang Jung1

  • 1Department of Radiology, Ajou University School of Medicine, Ajou University Medical Center, Suwon, Korea.

Magnetic Resonance in Medical Sciences : MRMS : an Official Journal of Japan Society of Magnetic Resonance in Medicine
|April 30, 2025
PubMed
Summary

Traumatic brain injury with diffuse axonal injury (DAI) is linked to impaired glymphatic system function, as measured by the ALPS index. Severity of DAI correlates with greater glymphatic system impairment, impacting patient prognosis.

Keywords:
diffuse axonal injurydiffusion tensor imagingglymphatic systemmagnetic resonance imagingtraumatic brain injury

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Area of Science:

  • Neuroscience
  • Radiology
  • Biomedical Engineering

Background:

  • Traumatic brain injury (TBI) can lead to diffuse axonal injury (DAI), a key pathological feature.
  • Glymphatic system impairment is a suspected consequence of TBI, impacting brain waste clearance.

Purpose of the Study:

  • To evaluate glymphatic system function in patients with DAI using diffusion tensor imaging analysis along the perivascular space (DTI-ALPS).
  • To assess the relationship between DAI severity and glymphatic system activity.

Main Methods:

  • 162 TBI patients (84 with DAI, 78 without) underwent MRI with DTI.
  • The ALPS index was calculated to measure glymphatic system activity.
  • Statistical analyses included ANCOVA and correlation analysis with DAI grade and GCS score.

Main Results:

  • Patients with DAI exhibited a significantly lower ALPS index compared to those without DAI (P < 0.001).
  • The ALPS index significantly differed across DAI grades (P < 0.001).
  • A negative correlation was found between ALPS index and DAI grade (r=-0.47), and a weak positive correlation with GCS score (r=0.174).

Conclusions:

  • DAI is associated with impaired glymphatic system function, indicated by a lower ALPS index.
  • Higher DAI grades correspond to more severe glymphatic impairment.
  • Findings enhance understanding of DAI pathophysiology and aid in predicting patient prognosis and recovery.