Correlation of glymphatic system abnormalities with Parkinson’s disease progression: a clinical study based on non-invasive fMRI

• Published in: Journal of neurology Vol. 271; no. 1; pp. 457 - 471
• Main Authors: Meng, Jing-Cai, Shen, Ming-Qiang, Lu, Yan-Li, Feng, Hong-Xuan, Chen, Xin-Yi, Xu, Da-Qiang, Wu, Guan-Hui, Cheng, Qing-Zhang, Wang, Lin-Hui, Gui, Qian
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer Berlin Heidelberg 2024; Springer Nature B.V
• Subjects: Age; Alzheimer's disease; Basal Ganglia; Biomarkers; Brain research; Cerebrospinal fluid; Disease; Disease Progression; Drug dosages; Ethics; Functional magnetic resonance imaging; Glymphatic System - diagnostic imaging; Hospitals; Humans; Image processing; Magnetic Resonance Imaging; Medicine; Medicine & Public Health; Mesencephalon; Movement disorders; Neurodegenerative diseases; Neurology; Neuroradiology; Neurosciences; Original Communication; Parkinson Disease - diagnostic imaging; Parkinson's disease; Diffusion tensor image analysis along the perivascular space; Glymphatic system; Enlarged perivascular spaces; Parkinson’s disease
• ISSN: 0340-5354; 1432-1459
• DOI: 10.1007/s00415-023-12004-6

Background The glymphatic system is reportedly involved in Parkinson’s disease (PD). Based on previous studies, we aimed to confirm the correlation between the glymphatic system and PD progression by combining two imaging parameters, diffusion tensor image analysis along the perivascular space (DTI-ALPS), and enlarged perivascular spaces (EPVS). Methods Fifty-one PD patients and fifty healthy control (HC) were included. Based on the Hoehn-Yahr scale, the PD group was divided into early-stage and medium-to late-stage. All PD patients were scored using the Unified PD Rating Scale (UPDRS). We assessed the DTI-ALPS indices in the bilateral hemispheres and EPVS numbers in bilateral centrum semiovale (CSO), basal ganglia (BG), and midbrain. Results The DTI-ALPS indices were significantly lower bilaterally in PD patients than in the HC group, and EPVS numbers in any of the bilateral CSO, BG, and midbrain were significantly higher, especially for the medium- to late-stage group and the BG region. In PD patients, the DTI-ALPS index was significantly negatively correlated with age, while the BG-EPVS numbers were significantly positively correlated with age. Furthermore, the DTI-ALPS index was negatively correlated with UPDRS II and III scores, while the BG-EPVS numbers were positively correlated with UPDRS II and III scores. Similarly, the correlation was more pronounced in the medium- to late-stage group. Conclusion The DTI-ALPS index and EPVS numbers (especially in the BG region) are closely related to age and PD progression and can serve as non-invasive assessments for glymphatic dysfunction and its interventions in clinical studies.