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CSF turnover dysfunction: a hidden early biomarker in iRBD?

Stephan Grimaldi^1,2,3, Kavita Singh^4,5, María Guadalupe García-Gomar^4,6

¹Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA. stephan.grimaldi@ap-hm.fr.

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Summary

This summary is machine-generated.

Patients with prodromal synucleinopathy (isolated rapid-eye-movement sleep behavior disorder) show increased cerebrospinal fluid (CSF) and perivascular spaces (PVS) volumes. This suggests impaired waste clearance and potential glymphatic dysfunction, contributing to neurodegeneration.

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Area of Science:

Neuroscience
Radiology
Neurology

Background:

Cerebrospinal fluid (CSF) turnover and perivascular spaces (PVS) volume changes are linked to Alzheimer's disease progression.
Impaired glymphatic pathways hinder waste clearance in neurodegenerative diseases.
Current MRI studies often exclude CSF, PVS, and venous sinus volumes in premanifest synucleinopathy.

Purpose of the Study:

To investigate modifications in CSF, PVS, and venous sinus volumes in prodromal synucleinopathy.
To compare these volumes in patients with isolated rapid-eye-movement sleep behavior disorder (iRBD) against healthy controls.

Main Methods:

Utilized 7 Tesla MRI for high-resolution imaging.
Compared 18 patients with iRBD to 20 young and 18 elderly healthy controls.
Quantified volumes of CSF, PVS, and drainage venous structures.

Main Results:

Patients with iRBD exhibited increased CSF and PVS volumes.
No corresponding increase in drainage venous structures was observed in iRBD patients.
Elderly controls showed increased CSF and PVS volumes with matching venous structure increases.

Conclusions:

Increased CSF and PVS fluid stasis in iRBD suggests impaired CSF filtration.
This mechanism may reduce glymphatic function, potentially exacerbating neurodegeneration.
Findings highlight the role of glymphatic dysfunction in prodromal synucleinopathy.