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ORIGINAL RESEARCH article

Front. Aging Neurosci.
Sec. Neurocognitive Aging and Behavior
Volume 16 - 2024 | doi: 10.3389/fnagi.2024.1506980

Altered Brain Glymphatic Function on Diffusion-Tensor MRI in Patients with Spontaneous Intracerebral Hemorrhage: An Exploratory Study

Provisionally accepted
Xiangshui Meng Xiangshui Meng 1Qingguo Ren Qingguo Ren 1Juntao Zhang Juntao Zhang 2Shuai Guan Shuai Guan 1Qingjun Jiang Qingjun Jiang 1Ying Wei Ying Wei 3Rui Hua Rui Hua 3Shen Zhao Shen Zhao 3Feng Shi Feng Shi 3*Xiangshui Meng Xiangshui Meng 1*
  • 1 Qilu Hospital of Shandong University (Qingdao), Qingdao, Shandong, China
  • 2 GE Healthcare PDX GMS medical affairs, Shanghai, China
  • 3 Shanghai United Imaging Intelligence, Co., Ltd., Shanghai, China

The final, formatted version of the article will be published soon.

    Objectives: To investigate the function of the glymphatic system (GS) and its association with neuropsychological tests in spontaneous intracerebral hemorrhage (sICH) by diffusion tensor imaging analysis along the perivascular space (DTI-ALPS).: This retrospective study included 58 patients with sICH and 63 age-and sex-matched healthy controls (HCs). Partial correlation analyses were performed to examine the relationships between the DTI-ALPS index and radiological as well as clinical data. Mediation analyses were performed to explore the mediating role of the grey matter proportion (GM%) in the relationship between DTI-ALPS index and Montreal Cognitive Assessment (MoCA) score.Results: Significantly lower DTI-ALPS index values were observed in sICH compared with HCs (FDR-p < 0.001). In the acute-subacute sICH group, the ALPS index was significantly correlated with hematoma volume (r = -0.572, FDR-p = 0.031). In the chronic sICH group, the ALPS index was significantly correlated with MoCA scores (r = 0.425, FDR-p = 0.014). In chronic sICH groups, GM% served as a significant mediator in the relationship between the DTI-ALPS index and MoCA scores (indirect effects β = 4.925, 95%CI: 0.028, 11.841). The ALPS index was identified as an independent prognostic indicator for unfavorable outcomes in sICH (β = -9.851, p = 0.018).Our study demonstrated that the DTI-ALPS index decreased in sICH patients, suggesting potential functional impairment of the lymphoid system. Additionally, the DTI-ALPS index served as an independent predictor of poor 90-day prognosis. In the acute-subacute stage of sICH, the DTI-ALPS index had negative correlation with hematoma volume. In the chronic sICH group, the GM% partially mediated the relationship between the GS and cognitive function.

    Keywords: Spontaneous intracerebral haemorrhage, Glymphatic system, diffusion tensor imaging along the perivascular space (DTI-ALPS), cognitive, prognosis

    Received: 06 Oct 2024; Accepted: 02 Dec 2024.

    Copyright: © 2024 Meng, Ren, Zhang, Guan, Jiang, Wei, Hua, Zhao, Shi and Meng. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence:
    Feng Shi, Shanghai United Imaging Intelligence, Co., Ltd., Shanghai, 200030, China
    Xiangshui Meng, Qilu Hospital of Shandong University (Qingdao), Qingdao, 266035, Shandong, China

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