Imaging Biomarkers of the Glymphatic System in the Developing Brain

Area of Science:

• Neuroimaging and developmental neuroscience, focusing on the glymphatic system's role in brain health.

Background:

• The glymphatic system clears brain waste, but its development and importance in children are unclear.
• Understanding pediatric glymphatic function is crucial for diagnosing and treating neurological conditions.

Purpose of the Study:

• To review noninvasive MRI biomarkers for assessing glymphatic structure and function in pediatric neurodevelopment.
• To highlight the clinical potential of these biomarkers in infants and children.

Main Methods:

• Review of MRI-based glymphatic imaging biomarkers: perivascular space (PVS) grading/volumetry, diffusion tensor imaging-analysis along the perivascular space (DTI-ALPS), and choroid plexus (CP) volume.
• Focus on noninvasive techniques applicable to pediatric clinical practice.

Main Results:

• PVS, DTI-ALPS, and CP volume show age-related changes during early development, but normative data are limited.
• Altered glymphatic imaging findings are observed in preterm birth, hypoxic-ischemic injury, and autism spectrum disorder.

Conclusions:

• Non-contrast MRI biomarkers show promise for evaluating the pediatric glymphatic system.
• Further large-scale, longitudinal studies are needed to establish normative values and prognostic significance.