Glymphatic system dysfunction in pediatric acute lymphoblastic leukemia without clinically diagnosed central nervous system infiltration: a novel DTI-ALPS method

Lin, Liping; Su, Shu; Hou, Weifeng; Huang, Libin; Zhou, Qin; Zou, Mengsha; Qian, Long; Cui, Wei; Yang, Zhiyun; Tang, Yan-Lai; Chen, Yingqian

doi:10.1007/s00330-023-09473-8

Cited by 7 publications

(4 citation statements)

References 33 publications

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“…In this study, a total of 129 DWI images were acquired for each subject, encompassing 18 different b-values ranging from 0 to 3000 s/mm². Consequently, the diffusion rates of projection bers and association bers in the X, Y, and Z axes were lower than those obtained with traditional DTI sequence acquisition (Lin et al, 2023), while the ALPS index remained consistent with previous research ndings.…”

Section: Discussionsupporting

confidence: 90%

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

Xu,

Wang,

Yang

et al. 2023

Preprint

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Type 2 diabetes mellitus (T2DM) can lead to dysfunction in the brain's glymphatic system, but the relationship between glymphatic system function and insulin resistance remains unclear. The aim of this study was to investigate the connection between changes in the brain's glymphatic system function in T2DM and the surrogate marker for insulin resistance, the Triglyceride-Glucose Index (TyG). A total of 28 T2DM patients (T2DM group) and 24 healthy volunteers (HC group) were included in this study. We outlined circular regions with a diameter of 5.0 mm on diffusion tensor imaging (DTI) in the projection and association fibers in the body of the lateral ventricle. We compared the differences in DTI-ALPS index and related fiber diffusivity between the two groups. Additionally, TyG index in T2DM patients was calculated based on fasting blood glucose and triglyceride levels. Age was included as a covariate to analyze the correlation between the ALPS index and TyG index in T2DM patients. The results showed that the ALPS index and Dxproj in the T2DM group were lower than those in the HC group, while Dyproj was higher than in the HC group. In the T2DM group, the ALPS index, Dxassoc, and TyG index were all negatively correlated. The decreased ALPS index and fiber diffusivity in T2DM patients may be associated with the TyG index, suggesting a relationship between insulin resistance, lymphatic system damage, and white matter microstructure.

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Section: Discussionsupporting

confidence: 90%

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

Xu,

Wang,

Yang

et al. 2023

Preprint

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“…The diffusion tensor image analysis along the perivascular space (DTI‐ALPS) method has been introduced as an indirect, noninvasive method to evaluate interstitial fluid dynamics and has been applied in many studies 7–18 . The DTI‐ALPS method yields the ALPS index, which is the ratio of the diffusivity in the direction of the perivascular space to the diffusivity in the direction perpendicular to both the major fiber tract and perivascular space, based on a special spatial relationship in the fiber tracts and the perivascular space in the axial imaging plane at the corona radiata.…”

Section: Introductionmentioning

confidence: 99%

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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“…While there have been many reports of an association with aging in older patients, there have also been reports of the DTI-ALPS method in pediatric cases. [96][97][98] Lee et al showed a negative correlation between age and ALPS-index with a correlation coefficient of −0.375 in a group of young patients with myoclonic epilepsy aged 12−46 years. 87 However, there is a lack of validation of the applicability of this technique in children, in whom the construction of white matter fibers is incomplete.…”

Section: Findings On the Agingmentioning

confidence: 99%

“…Many papers have followed this method of placing ROIs in the dominant brain. 28,32,43,46,48,74,80,89,97,122,133,150,[156][157][158] Since association fibers are often thicker on the dominant side (left side), placement of a ROI on the left side has the advantage that a stable ROI can be set, even if it is done manually. In many recent papers, the average of the ROI on both sides is used.…”

Section: Placement Of Roimentioning

confidence: 99%

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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Glymphatic system dysfunction in pediatric acute lymphoblastic leukemia without clinically diagnosed central nervous system infiltration: a novel DTI-ALPS method

Cited by 7 publications

References 33 publications

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

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

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

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

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