Zhang Sheng, Yu Weitao, Zhang Xiaofan, Cheng Haoyue, Zhang Zheyu, Gao Shouxuan, Zheng Jie, Yu Liang, Wang Peng, Geng Yu, Zhang Jie, Gao Faliang
Center for Rehabilitation Medicine, Department of Neurology, Zhejiang Provincial People's Hospital (Affiliated People's Hospital), Hangzhou Medical College, Hangzhou, 310016, Zhejiang, China.
The Second School of Clinical Medicine, Hangzhou Normal University, Hangzhou, 310006, Zhejiang, China.
Sci Rep. 2025 Jun 3;15(1):19382. doi: 10.1038/s41598-025-04054-9.
Ischemic stroke impacts glymphatic function, but its role in prognosis remains unclear. This study evaluated glymphatic function in 146 participants, including non-stroke (healthy controls, n = 48; nonvascular cognitive impairment patients, n = 47) and ischemic stroke cohorts (n = 51). The bilateral diffusion tensor imaging analysis along the perivascular space (DTI-ALPS) index, choroid plexus (CP), and perivascular space (PVS) volume ratio, which represent the glymphatic system, were compared across two cohorts and between pre-rehabilitation (Time 1) and 30 days post-rehabilitation (Time 2). Post-stroke cognitive impairment (PSCI) was characterized as enduring cognitive deficits persisting six months after a stroke. Stroke patients exhibited significantly lower bilateral DTI-ALPS index compared with the non-stroke population (P < 0.05), while the infarct side showed post-rehabilitation improvement (P < 0.05). The DTI-ALPS index of infarct side at Time 1 did not predict poor outcome but was correlated with 6-month PSCI (P < 0.05). These results indicate that ischemic stroke diminishes glymphatic function, partially recovering post-rehabilitation, and suggest that the DTI-ALPS index could serve as a predictor for cognitive impairment following ischemic stroke.
缺血性中风会影响类淋巴功能，但其在预后中的作用仍不明确。本研究评估了146名参与者的类淋巴功能，包括非中风人群（健康对照组，n = 48；非血管性认知障碍患者，n = 47）和缺血性中风队列（n = 51）。比较了两个队列以及康复前（时间1）和康复后30天（时间2）之间代表类淋巴系统的沿血管周围间隙的双侧扩散张量成像分析（DTI-ALPS）指数、脉络丛（CP）和血管周围间隙（PVS）体积比。中风后认知障碍（PSCI）的特征为中风后持续六个月的持续性认知缺陷。与非中风人群相比，中风患者的双侧DTI-ALPS指数显著降低（P < 0.05），而梗死侧在康复后有所改善（P < 0.05）。时间1时梗死侧的DTI-ALPS指数不能预测不良预后，但与6个月时的PSCI相关（P < 0.05）。这些结果表明，缺血性中风会降低类淋巴功能，康复后部分恢复，并提示DTI-ALPS指数可作为缺血性中风后认知障碍的预测指标。
