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Background and purpose <p>Glymphatic dysfunction is implicated in Parkinson’s disease (PD), contributing to α-synuclein accumulation. This study investigates glymphatic activity in drug-naïve PD patients using the diffusion tensor imaging-analysis along the perivascular space (DTI-ALPS) and explores its correlation with clinical symptoms.</p> Methods <p>We included 23 drug-naïve PD patients and 23 age-matched healthy controls (HCs) from Chengdu Second People’s hospital between November 2022 to October 2023. The DTI-ALPS index was calculated for both hemispheres to assess glymphatic function. Clinical data, including Hoehn and Yahr (H&amp;Y) stage, new Freezing of Gait Questionnaire (n-FOGQ), International Restless Legs Syndrome (IRLS) scores, and the Mini-Mental State Examination (MMSE) scores, were collected. Correlations between the DTI-ALPS index and clinical measures were analyzed. Receiver operating characteristic was performed to test the predictive value of DTI-ALPS index.</p> Results <p>PD patients showed significantly reduced both in the left and right hemispheric DTI-ALPS index compared to HCs (<i>P</i> &lt; 0.001). The right hemisphere DTI-ALPS index positively correlated with MMSE scores but negatively correlated with the H&amp;Y stage. The left hemisphere DTI-ALPS index positively correlated with n-FOGQ and IRLS scores. ROC analysis showed an area under the curve of 0.936 for left-hemispheric DTI-ALPS in distinguishing PD from HCs.</p> Conclusion <p>Reduced glymphatic dysfunction, assessed by the DTI-ALPS index, was associated with both motor and non-motor symptoms in drug-naïve PD, suggesting its potential as a non-invasive biomarker for PD, offering new directions for targeted therapeutic interventions.</p>

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Impaired glymphatic function assessed by DTI-ALPS in drug-naïve Parkinson’s disease and its association with motor and non-motor symptoms

  • 期刊论文

  • 发表日期：

    2025年6月5日

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  • Junying Li,
  • Meiling Ding,
  • Wenmin Zhang,
  • Pan Yang,
  • Yang Du,
  • Weidong Wang,
  • Jurong Ding,
  • Xin Ding

摘要

Background and purpose

Glymphatic dysfunction is implicated in Parkinson’s disease (PD), contributing to α-synuclein accumulation. This study investigates glymphatic activity in drug-naïve PD patients using the diffusion tensor imaging-analysis along the perivascular space (DTI-ALPS) and explores its correlation with clinical symptoms.

Methods

We included 23 drug-naïve PD patients and 23 age-matched healthy controls (HCs) from Chengdu Second People’s hospital between November 2022 to October 2023. The DTI-ALPS index was calculated for both hemispheres to assess glymphatic function. Clinical data, including Hoehn and Yahr (H&Y) stage, new Freezing of Gait Questionnaire (n-FOGQ), International Restless Legs Syndrome (IRLS) scores, and the Mini-Mental State Examination (MMSE) scores, were collected. Correlations between the DTI-ALPS index and clinical measures were analyzed. Receiver operating characteristic was performed to test the predictive value of DTI-ALPS index.

Results

PD patients showed significantly reduced both in the left and right hemispheric DTI-ALPS index compared to HCs (P < 0.001). The right hemisphere DTI-ALPS index positively correlated with MMSE scores but negatively correlated with the H&Y stage. The left hemisphere DTI-ALPS index positively correlated with n-FOGQ and IRLS scores. ROC analysis showed an area under the curve of 0.936 for left-hemispheric DTI-ALPS in distinguishing PD from HCs.

Conclusion

Reduced glymphatic dysfunction, assessed by the DTI-ALPS index, was associated with both motor and non-motor symptoms in drug-naïve PD, suggesting its potential as a non-invasive biomarker for PD, offering new directions for targeted therapeutic interventions.