Kuang Zhanyu, Huang Xiaofei, Wang Mengfan, Bu Shuwen, Guo Riyu, Xu Yongzhou, Chen Amei, Wei Xinhua
Department of Radiology, the Second Affiliated Hospital, School of Medicine, South China University of Technology, Guangzhou, Guangdong, China.
Philips Healthcare, Guangzhou, Guangdong, China.
Neuroscience. 2025 Jul 23;579:218-226. doi: 10.1016/j.neuroscience.2025.05.303. Epub 2025 May 27.
Free Water (FW) is considered an indicator of neuroinflammation, while the Index of Diffusivity along the Perivascular Space (ALPS) is a recently introduced measure of glymphatic function. However, no study has yet investigated the specific relationships between these factors simultaneously. This study aimed to examine changes in FW in the thalamic midline and lateral nuclei in Parkinson's disease (PD), with a particular focus on the potential influence of glymphatic system dysfunction. MRI data and clinical information were obtained from 32 healthy controls (HC), 32 participants with prodromal PD (pPD), and 90 participants with PD, sourced from the Parkinson's Progression Markers Initiative (PPMI) database. The ALPS index and Free Water fractional volume (FWF) were calculated based on diffusion tensor images. Intergroup comparisons of and correlations among MRI measures and clinical assessments were analyzed. FWF was elevated in the bilateral thalamic midline and right lateral nuclei of PD and in right midline nuclei of pPD compared to HC. In the PD group, the right ALPS index was significantly and negatively associated with FWF in the bilateral thalamic lateral nuclei, and mean ALPS index was negatively correlated to FWF in right lateral nuclei. Moreover, FWF in the right lateral thalamic nuclei of PD was correlated with follow-up Montreal Cognitive Assessment (MoCA) scores and its 2-years decrease rate. We provided indirect evidence to support that thalamic FW was significantly increased in PD participants, potentially exacerbated by glymphatic system dysfunction.
自由水（FW）被认为是神经炎症的一个指标，而沿血管周围间隙扩散率指数（ALPS）是最近引入的一种衡量脑淋巴功能的指标。然而，尚无研究同时调查这些因素之间的具体关系。本研究旨在检查帕金森病（PD）患者丘脑中线和外侧核中自由水的变化，特别关注脑淋巴系统功能障碍的潜在影响。从帕金森病进展标志物倡议（PPMI）数据库中获取了32名健康对照者（HC）、32名前驱帕金森病（pPD）参与者和90名帕金森病患者的MRI数据和临床信息。基于扩散张量图像计算ALPS指数和自由水分数体积（FWF）。分析了MRI测量值与临床评估之间的组间比较和相关性。与健康对照者相比，帕金森病患者双侧丘脑中线和右侧外侧核以及前驱帕金森病患者右侧中线核中的FWF升高。在帕金森病组中，右侧ALPS指数与双侧丘脑外侧核中的FWF显著负相关，平均ALPS指数与右侧外侧核中的FWF负相关。此外，帕金森病患者右侧丘脑外侧核中的FWF与随访的蒙特利尔认知评估（MoCA）评分及其2年下降率相关。我们提供了间接证据支持帕金森病患者丘脑FW显著增加，可能因脑淋巴系统功能障碍而加剧。
