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Diffusion Tensor Magnetic Resonance Imaging in the Analysis of Neurodegenerative Diseases
Published on: July 28, 2013
Association of the DTI-ALPS Index with Sleep Disturbances and Intestinal Inflammation in Crohn's Disease: A Diffusion
1Department of Radiology, the Second Xiangya Hospital of Central South University, Changsha 410011, China (Y.Y., L.Z.).
Rationale And Objectives:
Crohn's disease (CD) is often associated with sleep disturbances through poorly understood mechanisms. The glymphatic-related perivascular clearance system may provide a potential link via the gut-brain axis. This study investigated noninvasive diffusion tensor imaging analysis along the perivascular space (DTI-ALPS) in patients with CD and its correlations with intestinal inflammation and sleep quality. MATERIALS AND METHODS: This study enrolled 90 patients with CD (45 active, 45 in remission) and 50 healthy controls (HC). All subjects underwent comprehensive clinical screening, sleep evaluation using the Pittsburgh Sleep Quality Index, and 3T magnetic resonance imaging with DTI for ALPS index quantification. Patients with CD additionally provided stool samples for fecal calprotectin to assess levels of intestinal inflammation.
Results:
Patients with CD demonstrated significantly reduced ALPS index compared to HC (P < 0.001), particularly in the active disease state. The ALPS index exhibited moderate diagnostic utility in distinguishing active from remitted CD (area under the curve = 0.785, 95% confidence interval: 0.688-0.883). Partial correlation analysis revealed a significantly negative correlation between the ALPS index and both inflammatory markers and poor sleep quality. Mediation analysis revealed that reduced ALPS statistically accounted for 25.22% of the association between intestinal inflammation and sleep disturbances.
Conclusion:
Reduced periventricular diffusivity assessed by DTI-ALPS is associated with both intestinal inflammation and sleep disturbances in CD, statistically accounting for a modest proportion of their association. These cross-sectional findings suggest a potential gut-brain perivascular pathway connection that requires prospective validation.
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