Vij Sonali, Brooks Carson, Pivonka April, Abidin Zain, Koneru Manisha
Neurosciences, Cooper Medical School of Rowan University, Camden, USA.
Neurointerventional Surgery, Cooper University Health Care, Camden, USA.
Cureus. 2025 Apr 7;17(4):e81830. doi: 10.7759/cureus.81830. eCollection 2025 Apr.
Glymphatic dysfunction is linked to neurodegenerative diseases, and imaging markers of this dysfunction may aid in diagnosis and prognosis. Glymphatic dysfunction has been proposed as a key mechanism in the pathogenesis of normal pressure hydrocephalus (NPH). Advanced magnetic resonance techniques, especially diffusion tensor imaging, have been used to evaluate glymphatic function. Diffusion tensor imaging analysis along the perivascular space (DTI-ALPS) is a noninvasive metric that correlates with glymphatic function and has been recently studied in a variety of neurodegenerative diseases. We aim to summarize studies evaluating the association between DTI-ALPS index values and NPH diagnosis and outcomes. Current studies suggest lower DTI-ALPS index values in NPH patients compared to healthy controls. The DTI-ALPS index correlated with other imaging-based markers of NPH and clinical endpoints. However, limitations of the current literature include small cohort sizes; future studies are needed in larger, heterogeneous cohorts to validate these trends. Thus, the DTI-ALPS index shows promise as a valuable tool for diagnosing NPH, predicting treatment response, and assessing disease progression.
类淋巴系统功能障碍与神经退行性疾病相关，这种功能障碍的影像学标志物可能有助于诊断和预后评估。类淋巴系统功能障碍已被认为是正常压力脑积水（NPH）发病机制中的关键机制。先进的磁共振技术，尤其是扩散张量成像，已被用于评估类淋巴系统功能。沿血管周围间隙的扩散张量成像分析（DTI-ALPS）是一种与类淋巴系统功能相关的非侵入性指标，最近已在多种神经退行性疾病中进行了研究。我们旨在总结评估DTI-ALPS指数值与NPH诊断及预后之间关联的研究。目前的研究表明，与健康对照相比，NPH患者的DTI-ALPS指数值较低。DTI-ALPS指数与NPH的其他基于影像学的标志物及临床终点相关。然而，当前文献的局限性包括队列规模较小；未来需要在更大、更具异质性的队列中进行研究，以验证这些趋势。因此，DTI-ALPS指数有望成为诊断NPH、预测治疗反应和评估疾病进展的有价值工具。
