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Related Experiment Video

Updated: Feb 12, 2026

Advanced Diffusion Imaging in The Hippocampus of Rats with Mild Traumatic Brain Injury
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Glymphatic System Dysfunction and Diffusion Tensor Imaging Along the Perivascular Space in Traumatic Brain Injury: A

Nima Broomand Lomer1, Amir Mahmoud Ahmadzadeh1, Mohammad Amin Ashoobi1

  • 1From the DiCIPHR (Diffusion and Connectomics in Precision Healthcare Research) Lab, Department of Radiology (N.B.L., R.V.), Department of Neurology (R.D.-A.), Perelman School of Medicine, University of Pennsylvania, Philadelphia, 19104 PA, USA; Department of Radiology (A.M.A.), School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran, PC: 99191-91778; Guilan Road Trauma Research Center (M.A.A.), Trauma Institute, Guilan University of Medical Sciences, Rasht, Iran, PC: 41937-1311.

AJNR. American Journal of Neuroradiology
|February 10, 2026
PubMed
Summary

Traumatic brain injury (TBI) significantly reduces diffusion tensor imaging along the perivascular space (DTI-ALPS) values, indicating impaired glymphatic function. These DTI-ALPS values show long-term decline, suggesting potential as a biomarker for glymphatic dysfunction.

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Area of Science:

  • Neuroscience
  • Radiology
  • Biomarker Discovery

Background:

  • The glymphatic system is crucial for brain homeostasis and waste clearance.
  • Traumatic brain injury (TBI) disrupts glymphatic function, necessitating reliable assessment methods.
  • Diffusion tensor imaging along the perivascular space (DTI-ALPS) shows promise for quantifying glymphatic dysfunction.

Purpose of the Study:

  • To systematically review and quantify differences in DTI-ALPS values between TBI patients and healthy controls (HCs).
  • To evaluate the potential of DTI-ALPS as a biomarker for glymphatic impairment post-TBI.

Main Methods:

  • A comprehensive literature search was conducted across major databases (PubMed, Embase, Scopus, Web of Science).
  • Eleven studies with 694 TBI patients and 503 HCs were included in a random-effects meta-analysis.
  • Standardized mean differences (Hedges' g) were calculated, and heterogeneity was assessed using I² statistics.

Main Results:

  • DTI-ALPS values were significantly lower in TBI patients compared to HCs (Hedges' g = -0.77).
  • A significant long-term decrease in DTI-ALPS values was observed in TBI patients over time.
  • No significant correlation was found between DTI-ALPS and age or Glasgow Coma Scale scores.

Conclusions:

  • Reduced DTI-ALPS values are a significant indicator of glymphatic impairment following TBI.
  • DTI-ALPS shows potential as a biomarker for assessing glymphatic dysfunction, particularly in long-term TBI recovery.
  • Methodological standardization and longitudinal studies are crucial for establishing the clinical utility of DTI-ALPS.