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Magnetic Resonance Imaging01:24

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Magnetic resonance imaging (MRI) is a noninvasive medical imaging technique based on a phenomenon of nuclear physics discovered in the 1930s, in which matter exposed to magnetic fields and radio waves was found to emit radio signals. In 1970, a physician and researcher named Raymond Damadian noticed that malignant (cancerous) tissue gave off different signals than normal body tissue. He applied for a patent for the first MRI scanning device in clinical use by the early 1980s. The early MRI...
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Lesion Explorer: A Video-guided, Standardized Protocol for Accurate and Reliable MRI-derived Volumetrics in Alzheimer's Disease and Normal Elderly
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The Relationship Between Glymphatic Function, White Matter Hyperintensity and Cognition: A Structural Equation Model

Lin Wu1,2, Kaixiao Chen1,2, Zhi Zhang3

  • 1Jiangxi Provincial Key Laboratory for Precision Pathology and Intelligent Diagnosis, Department of Radiology, The First Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, China.

CNS Neuroscience & Therapeutics
|June 20, 2025
PubMed
Summary

Diminished glymphatic circulation contributes to white matter hyperintensity (WMH) and cognitive decline in older adults. Deep WMH mediates this relationship, highlighting glymphatic function

Keywords:
cognitionglymphatic functionstructural equation modelingwhite matter hyperintensity

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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.