Li Yuting, Zhang Teng, Wang Chao, Geng Leiyu, Liu Tingting, Lu Tong, Ju Shenghong
Department of Radiology, Nurturing Center of Jiangsu Province for State Laboratory of AI Imaging & Interventional Radiology, Zhongda Hospital, Medical School of Southeast University, Nanjing, China (Y.L., T.L., T.L., S.J.).
Jiangsu Key Laboratory of Intelligent Medical Image Computing，School of Future Technology, Nanjing University of Information Science and Technology, Nanjing, China (T.Z.).
Acad Radiol. 2025 Apr;32(4):2209-2219. doi: 10.1016/j.acra.2024.11.030. Epub 2024 Dec 2.
To investigate the impact of sleep disorders on glymphatic system in Parkinson's disease (PD) using a non-invasive imaging technique called diffusion tensor image analysis along perivascular space (DTI-ALPS).
A total of 114 PD patients and 54 healthy controls (HCs) underwent sleep questionnaires and MRI examinations as part of data collection from the Parkinson's Progression Markers Initiative cohort. An automated pipeline was proposed for ALPS calculation to reduce biases from manually region delineation. ALPS indices were compared between PD and HCs, as well as between PD with and without sleep disorders. Correlation was assessed between ALPS index and clinical characteristics. Furthermore, a 2-year follow-up analysis was performed to explore longitudinal impact of sleep disorders on glymphatic function.
PD patients showed significantly decreased ALPS indices compared with HCs (P = 0.038). PD patients with sleep disorders showed slightly but not significantly decreased ALPS index compared with those with normal sleep (P = 0.058). However, PD patients who transitioned from normal sleep to sleep disorders showed significantly decreased ALPS index at follow-up compared to baseline (P = 0.047). In contrast, patients who maintained normal sleep showed no significant difference in ALPS index between follow-up and baseline (P = 0.934). In addition, PD patients who transitioned from normal sleep to sleep disorders showed significantly increased ΔMDS-UPDRS Part I score (P = 0.004), ΔMDS-UPDRS total score (P = 0.040) and ΔSCOPA-AUT (P = 0.048) compared with PD who remained normal sleep.
Sleep disorders accelerate dysfunction of glymphatic system as indicated by ALPS index in PD patients, which may be associated with symptom progression in follow-up analysis. Therefore, more attention should be devoted to prevent sleep disorders in early PD.
使用一种名为沿血管周围间隙扩散张量图像分析（DTI-ALPS）的非侵入性成像技术，研究睡眠障碍对帕金森病（PD）患者淋巴系统的影响。
作为帕金森病进展标志物倡议队列数据收集的一部分，共有114例PD患者和54名健康对照者（HCs）接受了睡眠问卷调查和MRI检查。提出了一种用于ALPS计算的自动化流程，以减少手动划定区域带来的偏差。比较了PD患者与HCs之间以及有和没有睡眠障碍的PD患者之间的ALPS指数。评估了ALPS指数与临床特征之间的相关性。此外，进行了为期2年的随访分析，以探讨睡眠障碍对淋巴系统功能的纵向影响。
与HCs相比，PD患者的ALPS指数显著降低（P = 0.038）。有睡眠障碍的PD患者与睡眠正常的患者相比，ALPS指数略有下降，但差异无统计学意义（P = 0.058）。然而，从正常睡眠转变为睡眠障碍的PD患者在随访时与基线相比，ALPS指数显著降低（P = 0.根据文本内容，以下是为您生成的ALPS指数与临床特征之间的相关性分析：
ALPS指数与临床特征之间的相关性分析：评估了ALPS指数与临床特征之间的相关性。具体来说，研究了ALPS指数与帕金森病相关症状评分（如MDS-UPDRS Part I评分、MDS-UPDRS总分和SCOPA-AUT评分）之间的关系。
结果：从正常睡眠转变为睡眠障碍的PD患者与保持正常睡眠的PD患者相比，前者的ΔMDS-UPDRS Part I评分（P = 0.004）、ΔMDS-UPDRS总分（P = 0.040）和ΔSCOPA-AUT（P = 0.048）显著增加。
结论：这些结果表明，睡眠障碍可能与帕金森病患者的症状进展相关，而ALPS指数的变化可能反映了睡眠障碍对淋巴系统功能的影响。 047）。相比之下，保持正常睡眠的患者在随访和基线之间的ALPS指数没有显著差异（P = 0.934）。此外，从正常睡眠转变为睡眠障碍的PD患者与保持正常睡眠的PD患者相比，前者的ΔMDS-UPDRS Part I评分（P = 0.004）、ΔMDS-UPDRS总分（P = 0.040）和ΔSCOPA-AUT（P = 0.048）显著增加。
睡眠障碍会加速PD患者淋巴系统功能障碍，如ALPS指数所示，这可能与随访分析中的症状进展有关。因此，应更加关注早期PD患者睡眠障碍的预防。
