Li Junying, Ding Meiling, Zhang Wenmin, Yang Pan, Du Yang, Wang Weidong, Ding Jurong, Ding Xin
Department of Neurology, Chengdu Second People's Hospital, Chengdu, People's Republic of China.
School of Automation and Information Engineering, Sichuan University of Science and Engineering, Zigong, People's Republic of China.
Neurol Sci. 2025 Jun 5. doi: 10.1007/s10072-025-08275-8.
Glymphatic dysfunction is implicated in Parkinson's disease (PD), contributing to α-synuclein accumulation. This study investigates glymphatic activity in drug-naïve PD patients using the diffusion tensor imaging-analysis along the perivascular space (DTI-ALPS) and explores its correlation with clinical symptoms.
We included 23 drug-naïve PD patients and 23 age-matched healthy controls (HCs) from Chengdu Second People's hospital between November 2022 to October 2023. The DTI-ALPS index was calculated for both hemispheres to assess glymphatic function. Clinical data, including Hoehn and Yahr (H&Y) stage, new Freezing of Gait Questionnaire (n-FOGQ), International Restless Legs Syndrome (IRLS) scores, and the Mini-Mental State Examination (MMSE) scores, were collected. Correlations between the DTI-ALPS index and clinical measures were analyzed. Receiver operating characteristic was performed to test the predictive value of DTI-ALPS index.
PD patients showed significantly reduced both in the left and right hemispheric DTI-ALPS index compared to HCs (P < 0.001). The right hemisphere DTI-ALPS index positively correlated with MMSE scores but negatively correlated with the H&Y stage. The left hemisphere DTI-ALPS index positively correlated with n-FOGQ and IRLS scores. ROC analysis showed an area under the curve of 0.936 for left-hemispheric DTI-ALPS in distinguishing PD from HCs.
Reduced glymphatic dysfunction, assessed by the DTI-ALPS index, was associated with both motor and non-motor symptoms in drug-naïve PD, suggesting its potential as a non-invasive biomarker for PD, offering new directions for targeted therapeutic interventions.
类淋巴系统功能障碍与帕金森病（PD）有关，促使α-突触核蛋白积聚。本研究采用沿血管周围间隙的扩散张量成像分析（DTI-ALPS）研究未接受过药物治疗的PD患者的类淋巴系统活性，并探讨其与临床症状的相关性。
我们纳入了2022年11月至2023年10月期间来自成都第二人民医院的23例未接受过药物治疗的PD患者和23例年龄匹配的健康对照（HCs）。计算双侧半球的DTI-ALPS指数以评估类淋巴系统功能。收集临床数据，包括霍恩和雅尔（H&Y）分期、新的步态冻结问卷（n-FOGQ）、国际不宁腿综合征（IRLS）评分和简易精神状态检查表（MMSE）评分。分析DTI-ALPS指数与临床指标之间的相关性。进行受试者操作特征分析以检验DTI-ALPS指数的预测价值。
与HCs相比，PD患者双侧半球的DTI-ALPS指数均显著降低（P < 0.001）。右侧半球DTI-ALPS指数与MMSE评分呈正相关，但与H&Y分期呈负相关。左侧半球DTI-ALPS指数与n-FOGQ和IRLS评分呈正相关。ROC分析显示，左侧半球DTI-ALPS区分PD与HCs的曲线下面积为0.936。
通过DTI-ALPS指数评估的类淋巴系统功能障碍降低与未接受过药物治疗的PD患者的运动和非运动症状均相关，表明其作为PD非侵入性生物标志物的潜力，为靶向治疗干预提供了新方向。
