Glymphatic System Dysfunction in Thyroid Eye Disease Associated with Disease Activity and Duration

Area of Science:

• Neuroimaging
• Ophthalmology
• Neurology

Background:

• Thyroid eye disease (TED) is an autoimmune condition affecting the orbit.
• Glymphatic system dysfunction has been implicated in various neurological disorders.
• Diffusion tensor imaging analysis along the perivascular space (DTI-ALPS) is a novel method to assess glymphatic function.

Purpose of the Study:

• To investigate glymphatic system alterations in TED patients using DTI-ALPS.
• To explore the correlation between glymphatic function and clinical features in TED.

Main Methods:

• 47 TED patients (20 active, 27 inactive) and 24 healthy controls (HC) underwent DTI.
• ALPS values were calculated from diffusivity in the superior corona radiata and superior longitudinal fasciculus.
• Correlation analysis was performed between ALPS values and clinical characteristics.

Main Results:

• TED patients exhibited significantly lower mean and left ALPS values compared to HC.
• Inactive TED patients showed significantly lower left ALPS values than HC.
• In inactive TED, lower ALPS correlated with longer disease duration and greater palpebral fissure height.

Conclusions:

• Glymphatic system dysfunction is present in TED patients.
• The extent of glymphatic dysfunction is associated with disease activity and duration.