DTI-ALPS: An MR biomarker for motor dysfunction in patients with subacute ischemic stroke

Abstract

PurposeBrain glymphatic dysfunction is involved in the pathologic process of acute ischemic stroke (IS). The relationship between brain glymphatic activity and dysfunction in subacute IS has not been fully elucidated. Diffusion tensor image analysis along the perivascular space (DTI-ALPS) index was used in this study to explore whether glymphatic activity was related to motor dysfunction in subacute IS patients.MethodsTwenty-six subacute IS patients with a single lesion in the left subcortical region and 32 healthy controls (HCs) were recruited in this study. The DTI-ALPS index and DTI metrics (fractional anisotropy, FA, and mean diffusivity, MD) were compared within and between groups. Spearman's and Pearson's partial correlation analyses were performed to analyze the relationships of the DTI-ALPS index with Fugl-Meyer assessment (FMA) scores and with corticospinal tract (CST) integrity in the IS group, respectively.ResultsSix IS patients and two HCs were excluded. The left DTI-ALPS index of the IS group was significantly lower than that of the HC group (t = −3.02, p = 0.004). In the IS group, a positive correlation between the left DTI-ALPS index and the simple Fugl-Meyer motor function score (ρ = 0.52, p = 0.019) and a significant negative correlation between the left DTI-ALPS index and the FA (R = −0.55, p = 0.023) and MD (R = −0.48, p = 0.032) values of the right CST were found.ConclusionsGlymphatic dysfunction is involved in subacute IS. DTI-ALPS could be a potential magnetic resonance (MR) biomarker of motor dysfunction in subacute IS patients. These findings contribute to a better understanding of the pathophysiological mechanisms of IS and provide a new target for alternative treatments for IS.

Exploring the Relationship Between Lymphatic System Damage and Insulin Resistance in T2DM Based on Vascular Periadventitial Tensor Analysis and Triglyceride-Glucose Index

“…Research by Taoka et al (Taoka et al, 2022) has demonstrated a strong correlation between ALPS indices acquired with different scanning parameters, a rming the feasibility of assessing lymphatic system function using multi-b-value diffusion MRI data obtained with DSI sequences. In a prior study, Qin et al (Qin et al, 2023) obtained DSI images from subacute ischemic stroke patients, from which they derived ALPS indices. They observed a signi cant reduction in the ALPS index on the affected side in comparison to the unaffected side and the same-side ALPS index in healthy subjects.…”

Glymphatic-System Function Is Associated with Addiction and Relapse in Heroin Dependents Undergoing Methadone Maintenance Treatment

“…To calculate the DTI-ALPS, regions of interest (ROI) were defined as 3 mm radius spheres, and the positions of the ROI were placed in the projection- and association-fiber regions of the bilateral hemisphere on the color-FA map in the horizontal plane of the lateral ventricle body, the same as previous DTI-ALPS research [ 29 ] ( Figure 1 ).…”

“…This novel method harnesses the spatial relationship between fiber tracts and the perivascular space at the corona radiata and determines the ratio of diffusivity in the direction of the perivascular space versus that perpendicular to the primary fiber tract and perivascular space. The DTI-ALPS index holds promise in several fields of neuroscience research, including the evaluation of neurodegenerative diseases and other neurological disorders, such as Parkinson’s disease [ 28 ], stroke [ 29 ], Alzheimer’s disease [ 30 ], and type 2 diabetes mellitus [ 31 ]. Being an in vivo method, it is also suitable for investigating the brain GS of patients in the MMT program.…”

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

“…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. 16,19,69,165,166 Some studies employ atlas based placement. 56,147 Yokota et al coregistered diffusion maps to the DTI-81 atlas of the International Consortium for Brain Mapping (ICBM) and established ROIs for projection and association fiber regions.…”