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ORIGINAL RESEARCH article
Front. Neurol.
Sec. Cognitive and Behavioral Neurology
Volume 16 - 2025 | doi: 10.3389/fneur.2025.1536001
This article is part of the Research Topic Diffusion-Weighted Imaging: Advances and Implementations in Neurology View all 4 articles
Reduced DTI-ALPS in H-type hypertension: Insights into perivascular space function
Provisionally accepted- 1 Department of Radiology, Huai’an Maternity and Child Healthcare Hospital, Soon Chun Hyang University Bucheon Hospital, Bucheon, Gyeonggi, Republic of Korea
- 2 Department of Laboratory Medicine, The Fifth People's Hospital of Huaian, Huai’an 223300, Jiangsu, China, Soon Chun Hyang University Bucheon Hospital, Bucheon, Gyeonggi, Republic of Korea
- 3 Department of Radiology, Third Affiliated Hospital of Soochow University, No.185 Juqian Street, Tianning District, Changzhou 213000, Jiangsu, China, Soon Chun Hyang University Bucheon Hospital, Bucheon, Gyeonggi, Republic of Korea
Recent studies suggest that glymphatic dysfunction plays a significant role in vascular cognitive impairment (VCI). Both hypertension and hyperhomocysteinemia are independent risk factors for VCI, and their combination is referred to as H-type hypertension (HHT). However, the impact of HHT on glymphatic function remains unclear. This study used the recently popular indirect marker, diffusion tensor imaging along the perivascular space (DTI-ALPS) to assess potential changes in glymphatic function in patients with HHT. We recruited 58 HHT patients and 50 healthy controls without hypertension, collecting clinical, cognitive, biochemical, and diffusion MRI data. Behaviorally, HHT patients scored lower on global cognitive tests compared to controls. DTI-ALPS analysis revealed a bilateral reduction in DTI-ALPS in HHT patients. Correlation analysis showed strong associations between lower DTI-ALPS values, reduced cognitive scores, and elevated homocysteine (Hcy) levels in HHT patients. Mediation analysis further indicated that DTI-ALPS largely mediates the relationship between Hcy levels and cognitive performance. These findings suggest that hypertension and elevated Hcy levels contribute to DTI-ALPS reduction, which may underlie the cognitive decline observed in HHT.
Keywords: Hypertension, Homocysteine, glymphatic function, diffusion imaging, vascular cogitive impairment
Received: 28 Nov 2024; Accepted: 10 Mar 2025.
Copyright: © 2025 Zhang, Song, Sheng, Pan, Sun and Xing. 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:
Wei Xing, Department of Radiology, Third Affiliated Hospital of Soochow University, No.185 Juqian Street, Tianning District, Changzhou 213000, Jiangsu, China, Soon Chun Hyang University Bucheon Hospital, Bucheon, Gyeonggi, Republic of Korea
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