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Glymphatic system dysfunction and cognitive impairment in post-chemotherapy AML: A novel DTI-ALPS index study
Peng Li1, Ying Li1, Yifei Zhang2
1Department of Radiology, The Second Hospital of Dalian Medical University, Dalian, China.
Brain Research Bulletin
|February 16, 2026
Summary
Chemotherapy in acute myeloid leukemia (AML) patients impairs glymphatic function, indicated by the diffusion tensor imaging along the perivascular spaces (DTI-ALPS) index, and is linked to cognitive decline. These findings highlight potential neuroimaging biomarkers for chemotherapy-related cognitive impairment.
Area of Science:
- Neuroimaging
- Oncology
- Neurology
Background:
- Acute myeloid leukemia (AML) treatment can lead to cognitive impairment.
- Glymphatic system dysfunction is implicated in neurological disorders.
Purpose of the Study:
- To evaluate glymphatic function using the diffusion tensor imaging along the perivascular spaces (DTI-ALPS) index in post-chemotherapy AML patients.
- To explore the association between glymphatic function and cognitive performance in this cohort.
Main Methods:
- Assessed 21 post-chemotherapy AML patients and 20 healthy controls using brain MRI and cognitive tests.
- Measured cerebrospinal fluid (CSF) volume, basal ganglia perivascular space (BG-PVS) volume, DTI-ALPS index, and blood oxygen level-dependent-CSF coupling.
- Analyzed group differences and correlations between glymphatic markers and cognitive scores.
Main Results:
- Post-chemotherapy AML patients showed increased CSF and BG-PVS volumes, and a reduced DTI-ALPS index.
- Cognitive performance was impaired, with lower MMSE and MoCA scores and higher ADL scores.
- BG-PVS volume correlated inversely with MMSE and MoCA scores; DTI-ALPS index positively correlated with MoCA scores.
Conclusions:
- Post-chemotherapy AML patients exhibit glymphatic system dysfunction and cognitive decline.
- Impaired glymphatic function may contribute to chemotherapy-related cognitive deficits in AML.
- DTI-ALPS index and BG-PVS volume are potential neuroimaging biomarkers for cognitive impairment in AML patients.
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