Yang Jie, Liu Yujian, Ma Yuanying, Zhang Wei, Han Limei, Feng Hao, Chen Meining, Zhong Jianquan
Department of Radiology, Zigong First People's Hospital, Zigong, PR China.
Sichuan Vocational College of Health and Rehabilitation, Zigong, PR China.
J Stroke Cerebrovasc Dis. 2025 Feb;34(2):108187. doi: 10.1016/j.jstrokecerebrovasdis.2024.108187. Epub 2024 Dec 10.
Cerebral small vessel disease (CSVD) is a common disease in the elderly, and its pathogenesis is still being explored. Glymphatic clearance function can be evaluated by diffusion tensor imaging analysis along the perivascular space (DTI-ALPS) index. This study aims to investigate the changes in glymphatic clearance function in CSVD patients and its relationship with imaging markers and risk factors of CSVD.
The DTI-ALPS index of all participants was calculated. The DTI-ALPS index was compared between the patient group and healthy controls (HCs) group. Pearson correlation analysis was used to analyze the relation between the DTI-ALPS index and CSVD imaging markers, and to explore the effect of mean diffusivity (MD) as a covariate. Regression analysis was used to investigate the correlation between DTI-ALPS index and risk factors.
The DTI-ALPS index in the bilateral hemispheres of CSVD patients was significantly lower than that in the HCs group (p < 0.001). The DTI-ALPS index in the bilateral hemisphere of CSVD patients was negatively correlated with the grade of EPVS in basal ganglia. There was a significant negative correlation between the left DTI-ALPS index and lacunas, the right DTI-ALPS index and DWMHs. After removing the covariate MD, there was no significant correlation between the DTI-ALPS index and CSVD imaging markers. The DTI-ALPS index was associated with gender, diabetes, drinking and smoking.
The CSVD patients have glymphatic clearance dysfunction, which may be related to the imaging features and CSVD risk factors. Meanwhile, it's recommended to consider removing MD as mixed signal.
脑小血管病（CSVD）是老年人的常见疾病，其发病机制仍在探索中。脑淋巴清除功能可通过沿血管周围间隙的扩散张量成像分析（DTI-ALPS）指数进行评估。本研究旨在探讨CSVD患者脑淋巴清除功能的变化及其与CSVD影像学标志物和危险因素的关系。
计算所有参与者的DTI-ALPS指数。比较患者组和健康对照组（HCs）的DTI-ALPS指数。采用Pearson相关分析分析DTI-ALPS指数与CSVD影像学标志物之间的关系，并探讨平均扩散率（MD）作为协变量的影响。采用回归分析研究DTI-ALPS指数与危险因素之间的相关性。
CSVD患者双侧半球的DTI-ALPS指数显著低于HCs组（p < 0.001）。CSVD患者双侧半球的DTI-ALPS指数与基底节区脑白质疏松（EPVS）分级呈负相关。左侧DTI-ALPS指数与腔隙灶、右侧DTI-ALPS指数与深部白质高信号（DWMHs）之间存在显著负相关。去除协变量MD后，DTI-ALPS指数与CSVD影像学标志物之间无显著相关性。DTI-ALPS指数与性别、糖尿病、饮酒和吸烟有关。
CSVD患者存在脑淋巴清除功能障碍，可能与影像学特征和CSVD危险因素有关。同时，建议考虑去除MD作为混合信号。
