Department of Neurology, University of Alabama at Birmingham, Birmingham, Alabama, USA.
Department of Cell, Developmental and Integrative Biology, University of Alabama at Birmingham, Birmingham, Alabama, USA.
Mov Disord. 2024 Sep;39(9):1504-1513. doi: 10.1002/mds.29908. Epub 2024 Jul 11.
The glymphatic clearance pathway is a waste clearance system that allows for removal of soluble proteins such as amyloid β (Aβ) from the brain. Higher Aβ levels are associated with cognitive dysfunction in Parkinson's disease (PD). Diffusion tensor imaging-along the perivascular space (DTI-ALPS) is an imaging measure proposed to indirectly measure glymphatic function.
Evaluate differences in DTI-ALPS-index between PD and healthy controls (HC) and characterize relationships between this proposed measure of glymphatic clearance, cognition, and disease severity in PD.
PD (n = 32) and HC (n = 23) participants underwent brain imaging to assess DTI-ALPS. PD participants were classified as PD-normal cognition (PD-NC; n = 20) or PD-mild cognitive impairment (PD-MCI; n = 12) based on a Level II comprehensive cognitive assessment. A subgroup of PD participants (n = 21) returned for annual assessments for up to 4 years after baseline. Longitudinal outcomes included changes in performance on the comprehensive cognitive assessment and changes in the Movement Disorders Society Unified Parkinson's Disease Rating Scale (MDS-UPDRS).
PD participants had lower DTI-ALPS-index compared to HC. PD participants classified as PD-MCI had significantly lower DTI-ALPS-index compared to PD-NC. Lower DTI-ALPS-index at baseline was associated with longitudinal cognitive decline and worse longitudinal disease severity.
Glymphatic clearance, as measured with DTI-ALPS, has potential to serve as a marker of longitudinal disease progression. Interventions targeting glymphatic function should be explored for potential to slow cognitive decline in PD. © 2024 International Parkinson and Movement Disorder Society.
糖质清道系统是一种废物清除系统，可清除大脑中的可溶性蛋白，如淀粉样蛋白β（Aβ）。较高的 Aβ 水平与帕金森病（PD）的认知功能障碍有关。沿血管周围空间的弥散张量成像（DTI-ALPS）是一种被提议的间接测量糖质清道功能的影像学指标。
评估 PD 与健康对照组（HC）之间 DTI-ALPS 指数的差异，并描述该糖质清除功能的拟议测量指标与 PD 患者认知功能和疾病严重程度之间的关系。
32 名 PD 患者和 23 名 HC 参与者接受了脑部成像检查以评估 DTI-ALPS。根据二级全面认知评估，PD 患者分为 PD 正常认知（PD-NC；n=20）或 PD 轻度认知障碍（PD-MCI；n=12）。PD 患者亚组（n=21）在基线后最多 4 年每年进行一次评估。纵向结局包括全面认知评估的表现变化和运动障碍协会统一帕金森病评定量表（MDS-UPDRS）的变化。
PD 患者的 DTI-ALPS 指数明显低于 HC。PD-MCI 患者的 DTI-ALPS 指数明显低于 PD-NC。基线时较低的 DTI-ALPS 指数与纵向认知下降和更差的纵向疾病严重程度相关。
用 DTI-ALPS 测量的糖质清除率有可能成为纵向疾病进展的标志物。应探索针对糖质清道功能的干预措施，以减缓 PD 患者的认知下降。© 2024 国际帕金森病和运动障碍协会。
