TY - JOUR T1 -轻度认知障碍和阿尔茨海默病中Glymphatic系统MRI指标与淀粉样蛋白沉积和认知的关系JF -神经学JO -神经学SP - e2648 LP - e2660 DO - 10.1212/WNL.0000000000201300首页六世- 99 - 24盟Koji Kamagata AU -克里斯蒂娜Andica盟Kaito Takabayashi AU - Yuya Saito盟Toshiaki Taoka AU - Hayato Nozaki盟Junko Kikuta AU - Shohei Fujita盟Akifumi Hagiwara AU - Kouhei Kamiya AU - Akihiko和田AU - Toshiaki明石盟Sano大友盟第三Nishizawa盟渡边Hori AU -真嗣Naganawa盟Shigeki青木AU -阿尔茨海默病的神经影像学的Y1 2022/12/13 UR - //www.ez-admanager.com/content/99/24/e2648.abstract N2 -背景和首页Objectives The glymphatic system is a whole-brain perivascular network, which promotes CSF/interstitial fluid exchange. Alterations to this system may play a pivotal role in amyloid β (Aβ) accumulation. However, its involvement in Alzheimer disease (AD) pathogenesis is not fully understood. Here, we investigated the changes in noninvasive MRI measurements related to the perivascular network in patients with mild cognitive impairment (MCI) and AD. Additionally, we explored the associations of MRI measures with neuropsychological score, PET standardized uptake value ratio (SUVR), and Aβ deposition.Methods MRI measures, including perivascular space (PVS) volume fraction (PVSVF), fractional volume of free water in white matter (FW-WM), and index of diffusivity along the perivascular space (ALPS index) of patients with MCI, those with AD, and healthy controls from the Alzheimer's Disease Neuroimaging Initiative database were compared. MRI measures were also correlated with the levels of CSF biomarkers, PET SUVR, and cognitive score in the combined subcohort of patients with MCI and AD. Statistical analyses were performed with age, sex, years of education, and APOE status as confounding factors.Results In total, 36 patients with AD, 44 patients with MCI, and 31 healthy controls were analyzed. Patients with AD had significantly higher total, WM, and basal ganglia PVSVF (Cohen d = 1.15–1.48; p < 0.001) and FW-WM (Cohen d = 0.73; p < 0.05) and a lower ALPS index (Cohen d = 0.63; p < 0.05) than healthy controls. Meanwhile, the MCI group only showed significantly higher total (Cohen d = 0.99; p < 0.05) and WM (Cohen d = 0.91; p < 0.05) PVSVF. Low ALPS index was associated with lower CSF Aβ42 (rs = 0.41, pfdr = 0.026), FDG-PET uptake (rs = 0.54, pfdr < 0.001), and worse multiple cognitive domain deficits. High FW-WM was also associated with lower CSF Aβ42 (rs = −0.47, pfdr = 0.021) and worse cognitive performances.Discussion Our study indicates that changes in PVS-related MRI parameters occur in MCI and AD, possibly due to impairment of the glymphatic system. We also report the associations between MRI parameters and Aβ deposition, neuronal change, and cognitive impairment in AD.Aβ=amyloid β; ADAS=Alzheimer's Disease Assessment Scale; ADNI=Alzheimer's Disease Neuroimaging Initiative; ALPS=diffusivity along the perivascular space; BG=basal ganglia; CDR-SB=Clinical Dementia Rating Scale Sum of Boxes; DBP=diastolic blood pressure; DTI=diffusion tensor imaging; DW=diffusion weighted; FA=fractional anisotropy; FAQ=Functional Activities Questionnaire; FDG=[18F] fluorodeoxyglucose; FLAIR=fluid-attenuated inversion recovery; FSL=FMRIB Software Library 6.0.3; FW=free water; GBCA=gadolinium-based contrast agent; GMVF=gray matter volume fraction; Hipp=hippocampus; HMSCORE=Modified Hachinski Ischemic Score; ISF=interstitial fluid; MCI=mild cognitive impairment; MMSE=Mini-Mental State Examination; PVS=perivascular space; PVSVF=PVS volume fraction; RAVLT=Rey Auditory Verbal Learning Test; ROI=region of interest; SBP=systolic blood pressure; SUVR=standardized uptake value ratio; T1w=T1 weighted; WM=white matter; WML=white matter lesion; WMLVF=white matter lesion volume fraction; WMVF=white matter volume fraction ER -