Department of Neurology, Guangdong Neuroscience Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China.
The Second School of Clinical Medicine, Southern Medical University, Guangzhou, China.
CNS Neurosci Ther. 2023 Jan;29(1):111-121. doi: 10.1111/cns.13984. Epub 2022 Oct 2.
The aim of the study was to evaluate the glymphatic function and its related factors in patients with Parkinson's disease (PD) and patients with PD of different ages using the diffusion tensor image analysis along the perivascular space (DTI-ALPS) method.
Medical records and imaging data of 93 patients with idiopathic PD and 42 age- and sex-matched healthy controls (HCs) were retrospectively reviewed and analyzed. The diffusivity along the perivascular spaces, projection fibers, and association fibers were calculated on diffusion tensor imaging (DTI) to acquire the analysis along the perivascular space (ALPS) index.
PD patients exhibited a reduced ALPS index compared with the HCs. Negative correlations between the ALPS index and clinical information including age, age at disease onset, Parkinson's disease sleep scale 2nd version (PDSS-2) scores, and history of diabetes mellitus were revealed in the PD group. Besides, a negative correlation between the ALPS index and the severity of motor symptoms was identified in the subgroup aged 65 and above, rather than in the younger ones.
The results demonstrate that reduced ALPS index, a potential noninvasive measure of compromised glymphatic activity, is involved in the pathophysiology of PD, especially in the aged ones and those with sleep disorders.
本研究旨在通过血管周围空间弥散张量成像分析（DTI-ALPS）方法，评估不同年龄帕金森病（PD）患者的脑淋巴系统功能及其相关因素。
回顾性分析了 93 例特发性 PD 患者和 42 名年龄和性别匹配的健康对照者（HCs）的病历和影像学资料。通过弥散张量成像（DTI）计算血管周围弥散率、投射纤维和联合纤维，获得血管周围分析（ALPS）指数。
PD 患者的 ALPS 指数较 HCs 降低。PD 组的 ALPS 指数与年龄、发病年龄、帕金森病睡眠量表 2 版（PDSS-2）评分、糖尿病病史等临床信息呈负相关。此外，在年龄 65 岁及以上的亚组中，ALPS 指数与运动症状的严重程度呈负相关，而在年轻组中则无相关性。
研究结果表明，ALPS 指数降低，即潜在的脑淋巴系统功能受损的非侵入性测量指标，与 PD 的病理生理学有关，尤其是与老年患者和睡眠障碍患者有关。
