Evaluation of Glymphatic System Activity Using Diffusion Tensor Imaging Analysis Along the Perivascular Space (DTI-ALPS) in Alzheimer’s Disease

Öz

Aim: The glymphatic system is a recently discovered waste drainage system that facilitates the movement of cerebrospinal fluid through the brain's perivascular spaces and aids in removing soluble proteins. The Diffusion Tensor Imaging (DTI-ALPS) index analysis is a modern method used to evaluate the movement of water molecules in these spaces by measuring the diffusion coefficient. This study aimed to examine glymphatic system function in Alzheimer's disease (AD) patients compared to healthy controls (HC) using the DTI-ALPS method and to analyze its relationship with cognitive disorders. Methods:DTI data from 59 AD patients and 59 HC were obtained by downloading medical data from the Alzheimer's Disease Neuroimaging Initiative (ADNI) platform. Using DSI Studio software, the diffusivities of the DTI data were extracted, and DTI-ALPS indices were calculated. Correlation analysis evaluated the relationship between the DTI-ALPS index and clinical features. Results:The findings indicated that the DTI-ALPS index was significantly lower in AD patients compared to HC (p = 0.042). Furthermore, the DTI-ALPS index showed a significant correlation with the Functional Activities Questionnaire (FAQ) (r = -0.214, p = 0.020) and the Mini-Mental State Examination (MMSE) (r = 0.225, p = 0.014) Conclusions:The study demonstrated that AD individuals have impaired glymphatic system function, as indicated by the DTI-ALPS index, which correlates with worse cognitive performance. These findings support early diagnosis methods for AD. A better understanding of glymphatic system function may provide new perspectives for monitoring AD progression.

Anahtar Kelimeler

• Alzheimer
• Brain Perivascular Space
• Diffusion Tensor Imaging
• G-lymphatic System
• G-lymphatic Clearance System

Alzheimer Hastalığında Perivasküler Alan Boyunca Difüzyon Tensor Görüntüleme Analizi (DTI-ALPS) Kullanılarak G-lenfatik Sistem Aktivitesinin Değerlendirilmesi

Öz

Amaç: G-lenfatik sistem, beyin perivasküler boşlukları boyunca beyin omurilik sıvısının hareketini kolaylaştıran ve çözünür proteinlerin uzaklaştırılmasına yardımcı olan, yakın zamanda keşfedilmiş bir atık drenaj sistemidir. Difüzyon Tensör Görüntüleme (DTI-ALPS) indeks analizi, bu boşluklardaki su moleküllerinin hareketini difüzyon katsayısını ölçerek değerlendirmede kullanılan modern bir yöntemdir. Bu çalışma, DTI-ALPS yöntemi kullanılarak Alzheimer hastalığı (AH) olan bireylerde g-lenfatik sistem fonksiyonunu sağlıklı kontrollerle (SK) karşılaştırmayı ve bilişsel bozukluklarla olan ilişkisini incelemeyi amaçlamıştır. Yöntem: 59 AH hastasına ve 59 sağlıklı kontrole ait DTI verileri, Alzheimer Hastalığı Nörogörüntüleme Girişimi (ADNI) platformundan indirilen tıbbi veriler kullanılarak elde edilmiştir. DSI Studio yazılımı kullanılarak DTI verilerinin difüziviteleri çıkarılmış ve DTI-ALPS indeksleri hesaplanmıştır. Korelasyon analizi, DTI-ALPS indeksi ile klinik özellikler arasındaki ilişkiyi değerlendirmek için uygulanmıştır. Bulgular: Bulgular, AH hastalarında DTI-ALPS indeksinin sağlıklı kontrollere kıyasla anlamlı derecede düşük olduğunu göstermiştir (p = 0.042). Ayrıca DTI-ALPS indeksi, Fonksiyonel Aktivite Anketi (FAQ) (r = -0.214, p = 0.020) ve Mini Mental Durum Değerlendirmesi (MMSE) (r = 0.225, p = 0.014) ile anlamlı korelasyon göstermiştir. Sonuç: Bu çalışma, DTI-ALPS indeksiyle gösterildiği üzere Alzheimer hastalarında g-lenfatik sistem fonksiyonunun bozulduğunu ve bunun daha kötü bilişsel performansla ilişkili olduğunu ortaya koymuştur. Bu bulgular, Alzheimer hastalığının erken tanısına yönelik yöntemleri desteklemekte olup, g-lenfatik sistem fonksiyonunun daha iyi anlaşılması hastalığın ilerlemesinin izlenmesinde yeni bakış açıları sağlayabilir.

Anahtar Kelimeler

• Alzheimer Hastalığı
• Beyin Perivasküler Alanı
• Difüzyon Tensör Görüntüleme
• G-lenfatik Sistem

Kaynakça

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