Age-related changes in glymphatic pathways in Parkinson′s disease patients based on diffusion tensor imaging analysis along the perivascular space and their relationship with cognitive function
10.3760/cma.j.cn112149-20240525-00290
- VernacularTitle:沿血管周围间隙扩散张量成像分析评价帕金森病患者年龄相关类淋巴通路的改变及其与认知功能的关系
- Author:
Yang ZHAO
1
;
Changyuan XU
;
Yufan CHEN
;
Mengyuan ZHUO
;
Tao GONG
;
Yuanyuan XIANG
;
Guangbin WANG
Author Information
1. 山东第一医科大学附属省立医院（山东省立医院）医学影像科，济南 250021
- Publication Type:Journal Article
- Keywords:
Parkinson′s disease;
Cognitive function;
Age factors;
Glymphatic system;
Diffusion tensor imaging along perivascular space
- From:
Chinese Journal of Radiology
2025;59(1):64-69
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the effect of age factor on glymphatic function in patients with Parkinson′s disease (PD) and its potential correlation with overall cognitive performance based on diffusion tensor imaging analysis along the perivascular space(DTI-ALPS) index.Methods:The study was cross-sectional. Clinical and imaging data of 77 PD patients (PD group) who attended the Provincial Hospital of Shandong First Medical University from October 2021 to June 2024 were retrospectively analyzed. In the same period, 30 healthy volunteers matched by age and gender were collected as the normal control (NC) group. All subjects underwent MRI scanning and DTI-ALPS index was calculated based on diffusion tensor imaging. Cognitive functions of 46 patients in the PD group were assessed using the mini-mental state examination (MMSE) and montreal cognitive assessment (MoCA) scores. Independent samples t-tests were used to compare the differences in DTI-ALPS index between the PD and NC groups. After adjusting for confounders, the relationship between DTI-ALPS and age was explored using partial correlation analyses, multiple linear regression models. A mediation model was further developed to explore the mediating effect of DTI-ALPS index between age and cognitive function scores. Results:The DTI-ALPS indices of PD and NC groups were 1.66±0.20 and 1.44±0.17, respectively, and the differences were statistically significant ( t=5.27, P<0.001). The age of patients in the PD group was negatively correlated with the DTI-ALPS index ( r=-0.54, P<0.001), and age (β=-0.467, P<0.001) was an independent influencer of DTI-ALPS index. The DTI-ALPS index was positively correlated with MMSE scores ( r=0.53, P<0.001) and positively correlated with MoCA scores ( r=0.56, P<0.001). The mediation model showed that the DTI-ALPS index fully mediated between age and MMSE scores and partially mediated between age and MoCA scores, with an effect share of 33.25%. Conclusion:Age is an independent risk factor for impaired glymphatic pathway in PD patients, and it may induce cognitive decline in PD patients by exacerbating glymphatic pathway impairment.
