Xia Xiaona, Ren Qingguo, Zhang Juntao, Guan Shuai, Jiang Qingjun, Wei Ying, Hua Rui, Zhao Shen, Hu Xiangjun, Shi Feng, Meng Xiangshui
Department of Radiology, Qilu Hospital (Qingdao) of Shandong University, Qingdao, China.
GE Healthcare PDX GMS Medical Affairs, Shanghai, China.
Front Aging Neurosci. 2024 Dec 16;16:1506980. doi: 10.3389/fnagi.2024.1506980. eCollection 2024.
To investigate the function of the glymphatic system (GS) and its association with neuropsychological tests in spontaneous intracerebral hemorrhage (sICH) by diffusion tensor imaging analysis along the perivascular space (DTI-ALPS).
This retrospective study included 58 patients with sICH and 63 age- and sex-matched healthy controls (HCs). Partial correlation analyses were performed to examine the relationships between the DTI-ALPS index and radiological as well as clinical data. Mediation analyses were performed to explore the mediating role of the grey matter proportion (GM%) in the relationship between DTI-ALPS index and Montreal Cognitive Assessment (MoCA) score.
Significantly lower DTI-ALPS index values were observed in sICH compared with HCs (FDR- < 0.001). In the acute-subacute sICH group, the ALPS index was significantly correlated with hematoma volume ( = -0.572, FDR- = 0.031). In the chronic sICH group, the ALPS index was significantly correlated with MoCA scores ( = 0.425, FDR- = 0.014). In chronic sICH groups, GM% served as a significant mediator in the relationship between the DTI-ALPS index and MoCA scores (indirect effects = 4.925, 95%CI: 0.028, 11.841). The ALPS index was identified as an independent prognostic indicator for unfavorable outcomes in sICH ( = -9.851, = 0.018).
Our study demonstrated that the DTI-ALPS index decreased in sICH patients, suggesting potential functional impairment of the lymphoid system. Additionally, the DTI-ALPS index served as an independent predictor of poor 90-day prognosis. In the acute-subacute stage of sICH, the DTI-ALPS index had negative correlation with hematoma volume. In the chronic sICH group, the GM% partially mediated the relationship between the GS and cognitive function.
通过沿血管周围间隙的扩散张量成像分析（DTI-ALPS），研究脑内自发性出血（sICH）中淋巴系统（GS）的功能及其与神经心理学测试的关联。
这项回顾性研究纳入了58例sICH患者和63例年龄及性别匹配的健康对照（HCs）。进行偏相关分析以检验DTI-ALPS指数与放射学及临床数据之间的关系。进行中介分析以探讨灰质比例（GM%）在DTI-ALPS指数与蒙特利尔认知评估（MoCA）评分关系中的中介作用。
与HCs相比，sICH患者的DTI-ALPS指数值显著降低（FDR-<0.001）。在急性-亚急性期sICH组中，ALPS指数与血肿体积显著相关（= -0.572，FDR- = 0.031）。在慢性sICH组中，ALPS指数与MoCA评分显著相关（= 0.425，FDR- = 0.014）。在慢性sICH组中，GM%在DTI-ALPS指数与MoCA评分的关系中起显著中介作用（间接效应= 4.925，95%CI：0.028，11.841）。ALPS指数被确定为sICH不良结局的独立预后指标（= -9.851，= 0.018）。
我们的研究表明，sICH患者的DTI-ALPS指数降低，提示淋巴系统可能存在功能障碍。此外，DTI-ALPS指数是90天预后不良的独立预测指标。在sICH的急性-亚急性期，DTI-ALPS指数与血肿体积呈负相关。在慢性sICH组中，GM%部分介导了GS与认知功能之间的关系。
