Changes in the along the perivascular space index and its relationship with brain injury in patients with relapsing-remitting multiple sclerosis
10.3760/cma.j.cn112149-20240824-00511
- VernacularTitle:复发缓解型多发性硬化患者沿血管周围间隙指数变化及其与脑损伤的关系
- Author:
Yuanjun SONG
1
;
He ZHAO
;
Shaoyu WANG
;
Yang GAO
Author Information
1. 内蒙古医科大学，呼和浩特 010050
- Publication Type:Journal Article
- Keywords:
Multiple sclerosis, relapsing-remitting;
Magnetic resonance imaging;
Glymphatic function;
Brain injury
- From:
Chinese Journal of Radiology
2025;59(5):511-517
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To explore changes in the along the perivascular space (ALPS) index in patients with relapsing-remitting multiple sclerosis (RRMS) and investigate its association with cerebral injury.Methods:The study was a cross-sectional investigation. A total of 32 patients diagnosed with RRMS (RRMS group) and 30 healthy controls (HC) were retrospectively collected from March 2023 to July 2024 at the Affiliated Hospital of Inner Mongolia Medical University. All participants underwent MRI scans, including high-resolution three-dimensional (3D) T 1-weighted magnetization-prepared rapid gradient echo sequence, 3D fluid-attenuated inversion recovery sequence, and diffusion spectrum imaging. Regions of interest (ROI) were manually placed on the axial plane of the lateral ventricular body based on fractional anisotropy (FA) maps to obtain diffusion rates along the x, y, and z axes for ALPS index calculation. Tract-based spatial statistics was used to extract diffusion values from the white matter skeleton of the participants, including FA, mean diffusivity (MD), axial diffusivity (AD), radial diffusivity (RD), and quantitative anisotropy (QA). Lesion growth algorithms were employed to extract white matter lesion volume (WMLV) and number (WMLN). After lesion filling on T 1 images, brain segmentation was performed, and normalized gray matter volume (nGMV), normalized white matter volume (nWMV), and normalized cerebrospinal fluid volume (nCSFV) were obtained by normalizing with total intracranial volume(TIV). Independent sample t-tests, Mann-Whitney U tests, and χ2 tests were used to assess differences in clinical and imaging indicators between the RRMS and HC groups. Spearman′s rank correlation analysis was performed to evaluate the relationship between the ALPS index and clinical and imaging indicators. Results:The ALPS index, FA, and nGMV values were lower in the RRMS group compared to the HC group ( t=2.42, P=0.019; Z=4.85, P<0.001; t=2.56, P=0.013), while the RD value was significantly higher in the RRMS group ( Z=-2.42, P=0.015). No significant difference was found in other clinical and imaging indicators between the two groups ( P>0.05). In the RRMS group, the ALPS index was negatively correlated with WMLV ( r=-0.43, P=0.018) and positively correlated with FA ( r=0.45, P=0.012). There was no correlation between ALPS index and MD values, AD values, RD values, QA values, WLMN values, nGMV values, nMWV values, nCSFV values, TIV values, and duration of the disease ( P>0.05). Conclusions:Patients with RRMS exhibit abnormal diffusion in the perivascular spaces at the lateral ventricular body, suggesting possible glymphatic system dysfunction. The ALPS index is associated with demyelination and neurodegeneration.
