Impaired glymphatic function as a biomarker for subjective cognitive decline: An exploratory dual cohort study, 2024, Yuxia Li et al

Impaired glymphatic function as a biomarker for subjective cognitive decline: An exploratory dual cohort study
Yuxia Li, Luyao Wang, Jiayi Zhong, Huanyu Xu, Ying Han, Chuantao Zuo, Jiehui Jiang

Background: Subjective cognitive decline (SCD) has been recognized as a potential risk stage for progression to Alzheimer's disease (AD), while glymphatic dysfunction is considered an important characteristic of AD. We hypothesize that glymphatic dysfunction occurs during the SCD stage, aiming to discover potential biomarkers for SCD.

Methods: Participants from two independent studies, Sino Longitudinal Study on Cognitive Decline (SILCODE, n = 654) and the Alzheimer's Disease Neuroimaging Initiative (ADNI, n = 650), representing different ethnicities and disease stages, were included to assess glymphatic function using diffusion tensor image analysis along the perivascular space (DTI-ALPS).

Results: Abnormal glymphatic function occurs during the SCD stage, with the ALPS index demonstrating excellent classification performance for SCD and normal controls (area under the receiver operating characteristic curve [AUC]SILCODE = 0.816, AUCADNI = 0.797). Lower ALPS index indicates higher risk of cognitive progression, which is negatively correlated with Subjective Cognitive Decline Questionnaire 9 scores and amyloid positron emission tomography burden.

Disscusion: Our study suggests the ALPS index has the potential to serve as a biomarker for SCD.

Highlights: Glymphatic function characterized by the analysis along the perivascular space (ALPS) index becomes abnormal in subjective cognitive decline (SCD), the earliest symptomatic manifestation and preclinical stage of Alzheimer's disease (AD). The ALPS index demonstrates excellent classification performance for SCD and normal controls in the East Asian and Western cohorts. Participants with a lower ALPS index show a higher risk of clinical progression. The ALPS index is closely associated with serval cognitive scales and amyloid beta burden.

Link (Alzheimer's & Dementia) [Open access]

 

Some other papers related to ALPS-index / glymphatic dysfunction —

Evaluation of glymphatic system activity with the diffusion MR technique: diffusion tensor image analysis along the perivascular space DTI-ALPS in Alzheimer’s disease cases (2017, Japanese Journal of Radiology)

Reproducibility of diffusion tensor image analysis along the perivascular space DTI-ALPS for evaluating interstitial fluid diffusivity and glymphatic function: CHanges in Alps index on Multiple conditiON acquIsition eXperiment CHAMONIX study (2021, Japanese Journal of Radiology)

Evaluation of glymphatic system activity by diffusion tensor image analysis along the perivascular space DTI-ALPS in dementia patients (2023, The British Journal of Radiology)

Glymphatic system impairment in sleep disruption: diffusion tensor image analysis along the perivascular space DTI-ALPS (2023, Japanese Journal of Radiology)

Impaired glymphatic system as evidenced by low diffusivity along perivascular spaces is associated with cerebral small vessel disease: a population-based study (2023, Stroke and Vascular Neurology)

Increased glymphatic system activity in migraine chronification by diffusion tensor image analysis along the perivascular space (2023, The Journal of Headache and Pain)

Glymphatic system dysfunction in recovered patients with mild COVID-19: A DTI-ALPS study (2023, iScience, existing S4ME thread)

Longitudinal assessment of glymphatic changes following mild traumatic brain injury: Insights from perivascular space burden and DTI-ALPS imaging (2024, Frontiers in Neurology)