Glymphatic dysfunction is associated with cognitive impairment in white matter hyperintensities: A DTI-based study

Area of Science:

• Neuroimaging
• Neurology
• Cognitive Science

Background:

• Mechanisms of cognitive impairment in white matter hyperintensities (WMHs) are not fully understood.
• Glymphatic dysfunction, assessed by diffusion tensor imaging along the perivascular space (DTI-ALPS) index, is linked to cognitive decline in various disorders.

Purpose of the Study:

• To investigate the association between glymphatic dysfunction (DTI-ALPS index) and cognitive impairment in patients with WMHs.

Main Methods:

• 88 patients with WMHs (mild, moderate, severe) and 32 controls underwent neuropsychological assessments and MRI scans.
• Demographics, cognitive function, and DTI-ALPS indices were compared between groups.
• Correlation between cognitive impairment and DTI-ALPS index was evaluated.

Main Results:

• Patients with WMHs exhibited significant cognitive deficits in multiple domains.
• WMH patients showed reduced Left_ALPS, Right_ALPS, and Mean_ALPS, negatively correlated with WMH volume.
• Mean_ALPS correlated significantly with language function and showed trends with other cognitive domains.

Conclusions:

• Cognitive impairment in WMH patients is associated with decreased DTI-ALPS index, worsening with lesion severity.
• Glymphatic dysfunction may be a key factor in WMH-related cognitive impairment.
• The DTI-ALPS index shows potential as a biomarker for cognitive impairment in WMH patients.