Department of Radiology, Huazhong University of Science and Technology Union Shenzhen Hospital, Shenzhen, China.
Department of Radiology, the Affiliated TCM Hospital of Guangzhou Medical University, Guangzhou, China.
Ann Neurol. 2024 Nov;96(5):970-980. doi: 10.1002/ana.27047. Epub 2024 Aug 3.
Glymphatic system is a recently discovered macroscopic waste clearance system associated with numerous neurological diseases. However, little is known about glymphatic system development in neonates. We sought to evaluate diffusion along the perivascular space (ALPS) index, a proxy for glymphatic system function, in neonates and investigate its potential associations with maturation, sex, and preterm birth.
Diffusion magnetic resonance imaging (MRI) data in 418 neonates, including 92 preterm neonates (57 males) and 326 term neonates (175 males), from the Developing Human Connectome Project were used for evaluating ALPS index. Linear regression modeling was performed to assess group differences in the ALPS index according to preterm birth and sex. Pearson's and partial correlation analysis were performed to assess the association between the ALPS index and gestational age (GA) as well as postmenstrual age (PMA) at MRI. Moderation analysis was performed to assess the moderation effect of preterm birth on the relationship between the ALPS index and PMA.
Compared to term neonates, preterm neonates exhibited lower ALPS indices (p < 0.001). The ALPS index positively correlated with PMA (p = 0.004) and GA (p < 0.001). Preterm birth (p = 0.013) had a significant moderation effect on the relationship between the ALPS index and PMA. Sex had no significant direct effect (p = 0.639) or moderation effect (p = 0.333) on ALPS index.
Glymphatic system development is a dynamic process in neonates, which can be moderated by preterm birth, the ALPS index could serve as a sensitive biomarker for monitoring this process. ANN NEUROL 2024;96:970-980.
糖质分解系统是最近发现的与多种神经疾病相关的宏观废物清除系统。然而，关于新生儿糖质分解系统的发育知之甚少。我们试图评估沿血管周围空间（ALPS）扩散指数，这是糖质分解系统功能的一个替代指标，在新生儿中的表现，并研究其与成熟度、性别和早产的潜在关联。
使用来自发育人类连接组计划的 418 名新生儿（包括 92 名早产儿[57 名男性]和 326 名足月产儿[175 名男性]）的扩散磁共振成像（MRI）数据来评估 ALPS 指数。进行线性回归建模，以根据早产和性别评估 ALPS 指数的组间差异。进行 Pearson 和偏相关分析，以评估 ALPS 指数与 MRI 时的胎龄（GA）和月经后年龄（PMA）之间的关联。进行调节分析，以评估早产对 ALPS 指数与 PMA 之间关系的调节作用。
与足月产儿相比，早产儿的 ALPS 指数较低（p<0.001）。ALPS 指数与 PMA（p=0.004）和 GA（p<0.001）呈正相关。早产（p=0.013）对 ALPS 指数与 PMA 之间的关系有显著的调节作用。性别对 ALPS 指数没有显著的直接影响（p=0.639）或调节作用（p=0.333）。
糖质分解系统的发育是新生儿的一个动态过程，早产可以调节这一过程，ALPS 指数可以作为监测这一过程的敏感生物标志物。ANN NEUROL 2024；96：970-980。
