Associations of <scp>MRI</scp>‐Derived Glymphatic System Impairment With Global White Matter Damage and Cognitive Impairment in Mild Traumatic Brain Injury: A <scp>DTI‐ALPS</scp> Study

Yang, Danni; Sun, Zheng; Yu, Meijuan; Zou, Qiao-Qiao; Li, Peng-Yang; Zhang, Jingkun; Wu, Xue; Li, Yuehua; Wang, Ming L.

doi:10.1002/jmri.28797

Cited by 10 publications

(10 citation statements)

References 39 publications

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“…This has been pointed out in many papers. 68,80,81,88,160 This is discussed in section "Placement of ROI" with respect to various methods of solution.…”

Section: Controversy In Dti-alps Methodsmentioning

confidence: 99%

“…In humans, several studies using the noninvasive ALPS method have reported abnormal ISF dynamics after TBI. [66][67][68] It has been reported that ALPS-index is decreased in the brain after TBI. 66,68 On the other hand, there are reports that ALPS-index is elevated in young patients with mild TBI.…”

Section: Application For Traumatic Brain Injurymentioning

confidence: 99%

“…[66][67][68] It has been reported that ALPS-index is decreased in the brain after TBI. 66,68 On the other hand, there are reports that ALPS-index is elevated in young patients with mild TBI. 67 The possible causes include increased expression of AQP4 after trauma, hemodynamic changes after trauma, and the possibility that the glymphatic system is a compensatory mechanism to reduce secondary injury by eliminating endotoxin after trauma.…”

Section: Application For Traumatic Brain Injurymentioning

confidence: 99%

“…In many recent papers, the average of the ROI on both sides is used. 18,26,30,34,57,62,67,68,72,78,82,86,[159][160][161][162][163][164] This method is expected to have the potential to cancel out the effects of head tilt and other factors. There is also a paper that examines the ALPS-index calculated for the right hemisphere and the ALPS-index calculated for the left hemisphere separately.…”

Section: Placement Of Roimentioning

confidence: 99%

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Diffusion Tensor Image Analysis ALong the Perivascular Space (DTI-ALPS): Revisiting the Meaning and Significance of the Method

Taoka,

Ito,

Nakamichi

et al. 2024

MRMS

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More than 5 years have passed since the Diffusion Tensor Image Analysis ALong the Perivascular Space (DTI-ALPS) method was proposed with the intention of evaluating the glymphatic system. This method is handy due to its noninvasiveness, provision of a simple index in a straightforward formula, and the possibility of retrospective analysis. Therefore, the ALPS method was adopted to evaluate the glymphatic system for many disorders in many studies. The purpose of this review is to look back and discuss the ALPS method at this moment.The ALPS-index was found to be an indicator of a number of conditions related to the glymphatic system. Thus, although this was expected in the original report, the results of the ALPS method are often interpreted as uniquely corresponding to the function of the glymphatic system. However, a number of subsequent studies have pointed out the problems on the data interpretation. As they rightly point out, a higher ALPS-index indicates predominant Brownian motion of water molecules in the radial direction at the lateral ventricular body level, no more and no less. Fortunately, the term "ALPS-index" has become common and is now known as a common term by many researchers. Therefore, the ALPS-index should simply be expressed as high or low, and whether it reflects a glymphatic system is better to be discussed carefully. In other words, when a decreased ALPS-index is observed, it should be expressed as "decreased ALPS-index" and not directly as "glymphatic dysfunction". Recently, various methods have been proposed to evaluate the glymphatic system. It has become clear that these methods also do not seem to reflect the entirety of the extremely complex glymphatic system. This means that it would be desirable to use various methods in combination to evaluate the glymphatic system in a comprehensive manner.

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“…This has been pointed out in many papers. 68,80,81,88,160 This is discussed in section "Placement of ROI" with respect to various methods of solution.…”

Section: Controversy In Dti-alps Methodsmentioning

confidence: 99%

Section: Application For Traumatic Brain Injurymentioning

confidence: 99%

Section: Application For Traumatic Brain Injurymentioning

confidence: 99%

Section: Placement Of Roimentioning

confidence: 99%

See 2 more Smart Citations

Diffusion Tensor Image Analysis ALong the Perivascular Space (DTI-ALPS): Revisiting the Meaning and Significance of the Method

Taoka,

Ito,

Nakamichi

et al. 2024

MRMS

View full text Add to dashboard Cite

show abstract

“… 18 Previous studies have demonstrated the DTI‐ALPS index as a potential biomarker for glymphatic system function, with a lower value indicating reduced activity. 17 The DTI‐ALPS is not invasive and does not require gadolinium‐based contrast administration, which has been recently applied in AD, 17 PD, 19 mild traumatic brain injury, 20 and obstructive sleep apnea. 21 Most studies focused on the relationship between the ALPS index and cognition.…”

Section: Introductionmentioning

confidence: 99%

Evaluation of glymphatic system activity by diffusion tensor image analysis along the perivascular space in presbycusis

Xu,

Zhang,

Xing

et al. 2023

CNS Neurosci Ther

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PurposePrevious studies have suggested that presbycusis (age‐related hearing loss) is accompanied with cognitive decline and dementia. However, the neural mechanism underlying the cognitive decline in presbycusis remains unclear. This study aimed to evaluate the glymphatic system function in presbycusis patients compared to healthy controls using diffusion tensor imaging (DTI) with the perivascular space (DTI‐ALPS) method.MethodsDTI scans were obtained from 30 presbycusis patients with cognitive decline (PCD), 30 presbycusis patients with no cognitive decline (PNCD) and 40 age‐, gender‐, and education‐matched healthy controls (HCs). The DTI‐ALPS index was calculated for each group. We evaluated the differences in the DTI‐ALPS index among PCD, PNCD and HCs. In addition, we conducted a correlation analysis between the DTI‐ALPS index and cognitive performance.ResultsThere were significant differences of the DTI‐ALPS index among three groups. Post‐hoc analysis suggested that the DTI‐ALPS index in PCD was significantly lower patients in relative to PNCD and HCs (1.49147 vs. 1.57441 vs. 1.62020, p < 0.001). After correcting for age, gender, and education, the DTI‐ALPS index is positively correlated with the MoCA scores (rho = 0.426, p = 0.026).ConclusionPresbycusis patients with cognitive impairment exhibited decreased glymphatic activity than those without cognitive impairment and HCs. The DTI‐ALPS index may provide useful disease progression or treatment biomarkers for patients with presbycusis as an indicator of modulation of glymphatic activity.

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Evaluation of alterations in interstitial fluid dynamics in cases of whole‐brain radiation using the diffusion‐weighted image analysis along the perivascular space method

Taoka,

Ito,

Nakamichi

et al. 2023

NMR in Biomedicine

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In the current study, we assessed changes in interstitial fluid dynamics resulting after whole‐brain radiotherapy using the diffusion‐weighted image analysis along the perivascular space (DWI‐ALPS) method, which is a simplified variation of the diffusion tensor image ALPS (DTI‐ALPS) method using diffusion‐weighted imaging (DWI) with orthogonal motion‐probing gradients (MPGs). This retrospective study included 47 image sets from 22 patients who underwent whole‐brain radiotherapy for brain tumors. The data for the normal control group comprised 105 image sets from 105 participants with no pathological changes. DWI was performed with the three MPGs applied in an orthogonal direction to the imaging plane, and apparent diffusion coefficient images for the x‐, y‐, and z‐axes were retrospectively generated. The ALPS index was calculated to quantify interstitial fluid dynamics. The independent t‐test was used to compare the ALPS index between normal controls and patients who underwent whole‐brain radiotherapy. Patients were compared in all age groups and individual age groups (20–39, 40–59, and 60–84 years). We also examined the correlation between biologically equivalent doses (BEDs) and the ALPS index, as well as the correlation between white matter hyperintensity and the ALPS index. In the comparison of all age groups, the ALPS index was significantly lower (p < 0.001) in the postradiation group (1.32 ± 0.16) than in the control group (1.44 ± 0.17), suggesting that interstitial fluid dynamics were altered in patients following whole‐brain radiotherapy. Significant age group differences were found (40–59 years: p < 0.01; 60–84 years: p < 0.001), along with a weak negative correlation between BEDs (r = −0.19) and significant correlations between white matter hyperintensity and the ALPS index (r = −0.46 for periventricular white matter, r = −0.38 for deep white matter). It was concluded that the ALPS method using DWI with orthogonal MPGs suggest alteration in interstitial fluid dynamics in patients after whole‐brain radiotherapy. Further systematic prospective studies are required to investigate their association with cognitive symptoms.

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Associations of MRI‐Derived Glymphatic System Impairment With Global White Matter Damage and Cognitive Impairment in Mild Traumatic Brain Injury: A DTI‐ALPS Study

Cited by 10 publications

References 39 publications

Diffusion Tensor Image Analysis ALong the Perivascular Space (DTI-ALPS): Revisiting the Meaning and Significance of the Method

Diffusion Tensor Image Analysis ALong the Perivascular Space (DTI-ALPS): Revisiting the Meaning and Significance of the Method

Evaluation of glymphatic system activity by diffusion tensor image analysis along the perivascular space in presbycusis

Evaluation of alterations in interstitial fluid dynamics in cases of whole‐brain radiation using the diffusion‐weighted image analysis along the perivascular space method

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