The Relationship Between Glymphatic Function, White Matter Hyperintensity and Cognition: A Structural Equation Model...

Area of Science:

• Neuroscience
• Radiology
• Gerontology

Background:

• White matter hyperintensity (WMH) is linked to impaired glymphatic system function.
• Limited research has explored the causal impact of glymphatic inflow and outflow pathway dysfunction on WMH and cognition.

Purpose of the Study:

• To investigate the directional relationships between glymphatic circulation, WMH, and cognitive function in older adults.
• To analyze the role of choroid plexus volume, CSF flow coupling, DTI-ALPS index, and meningeal lymphatic vessels in glymphatic function.

Main Methods:

• Employed structural equation models to assess directional effects.
• Quantified glymphatic circulation using lateral ventricle choroid plexus volume, blood oxygen signal coupling, DTI-ALPS index, and meningeal lymphatic vessels.
• Analyzed WMH volume and cognitive performance in older adults.

Main Results:

• Participants with WMH showed increased choroid plexus volume, lower DTI-ALPS, and reduced meningeal lymphatic vessel function, correlating with poorer cognition.
• Choroid plexus/lateral ventricle volume and DTI-ALPS significantly predicted WMH volume.
• Deep WMH partially mediated the link between glymphatic function and cognition.
• Glymphatic outflow negatively impacted WMH, which in turn negatively affected cognitive function.

Conclusions:

• Deep WMH mediates the association between glymphatic decline and cognitive impairment.
• Reduced glymphatic circulation volume leads to increased WMH and subsequent cognitive decline.