Morphologic and functional alterations in the parasagittal dural space in mild cognitive impairment

Area of Science:

• Neuroimaging
• Neurology
• Dural Space Physiology

Background:

• Mild cognitive impairment (MCI) represents an early stage of cognitive decline, often preceding dementia.
• The parasagittal dural space (PSD) plays a role in cerebrospinal fluid dynamics and waste clearance via meningeal lymphatic vessels.
• Understanding structural and functional changes in the PSD could offer insights into early neurodegenerative processes.

Purpose of the Study:

• To investigate morphologic and functional differences in the PSD between MCI patients and cognitively unimpaired individuals.
• To assess the relationship between PSD characteristics and cognitive performance metrics.
• To explore the potential of PSD alterations as early imaging biomarkers for cognitive impairment.

Main Methods:

• Dynamic contrast-enhanced MRI (DCE MRI) was employed to evaluate PSD volume and hemodynamic parameters.
• Structural MRI was used for morphologic assessment.
• Statistical analyses, including multivariate regression, were performed to correlate PSD findings with cognitive scores (MMSE, MoCA).

Main Results:

• MCI patients exhibited significantly larger PSD volume, reduced peak wash-in rate, and delayed time to first peak enhancement compared to controls.
• PSD volume and wash-out rate were significantly associated with Mini-Mental State Examination (MMSE) scores.
• A lower peak wash-in rate correlated with poorer performance on the Montreal Cognitive Assessment (MoCA).

Conclusions:

• Alterations in PSD structure and function are evident in individuals with MCI.
• These PSD changes may reflect meningeal lymphatic dysfunction contributing to cognitive decline.
• PSD characteristics identified via DCE MRI show promise as early imaging markers for neurodegenerative conditions and cognitive impairment.