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Published on: July 29, 2019
Impaired Glymphatic Function and Post-stroke Cognitive Decline after Intracerebral Hemorrhage: A Serial Neuroimaging
Nina H Nariman1, Md Faruk Hossain2, Khader M Hasan3
1Institute for Stroke and Cerebrovascular Diseases and Department of Neurology, McGovern Medical School, The University of Texas Health Science Center at Houston (UTHealth), Houston, USA.
Impaired glymphatic function (GF) after intracerebral hemorrhage (ICH) is linked to cognitive decline. The DTI-ALPS index, an MRI measure of GF, shows potential for assessing post-stroke cognitive impairment and guiding future research.
Area of Science:
- Neuroscience
- Radiology
- Neurology
Background:
- Intracerebral hemorrhage (ICH) can lead to impaired glymphatic function (GF), causing neurotoxin buildup.
- Glymphatic dysfunction is associated with cognitive decline in neurodegenerative diseases and post-stroke cognitive impairment (PSCI).
Purpose of the Study:
- To investigate the association between impaired GF and PSCI after ICH using serial MRI.
- To evaluate the DTI-ALPS index as a biomarker for GF in ICH patients.
Main Methods:
- Serial MRI imaging of 18 deep ICH patients at two time points (V1 and V2).
- Assessed GF using the diffusion tensor imaging along the perivascular space (DTI-ALPS) index.
- Measured cognitive function (MoCA), stroke severity (NIHSS), hematoma (HV), and edema (EV) volumes.
Main Results:
- The ipsilesional DTI-ALPS index was significantly lower than the contralesional index at V2 (p=0.041).
- NIHSS, HV, and EV significantly decreased from V1 to V2 (p<0.001).
- A near-significant negative association was found between the ipsilesional DTI-ALPS index and NIHSS (partial rS=-0.48, p=0.057) after adjustment.
Conclusions:
- The DTI-ALPS index is a feasible biomarker for assessing glymphatic dysfunction post-ICH.
- Impaired GF, indicated by lower DTI-ALPS index, is associated with cognitive impairment following intracerebral hemorrhage.
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