Association of glymphatic clearance function with imaging markers and risk factors of cerebral small vessel disease.

Abstract

Background: Cerebral small vessel disease (CSVD) is a common disease in the elderly, and its pathogenesis is still being explored. Glymphatic clearance function can be evaluated by diffusion tensor imaging analysis along the perivascular space (DTI-ALPS) index. This study aims to investigate the changes in glymphatic clearance function in CSVD patients and its relationship with imaging markers and risk factors of CSVD.

Methods: The DTI-ALPS index of all participants was calculated. The DTI-ALPS index was compared between the patient group and healthy controls (HCs) group. Pearson correlation analysis was used to analyze the relation between the DTI-ALPS index and CSVD imaging markers, and to explore the effect of mean diffusivity (MD) as a covariate. Regression analysis was used to investigate the correlation between DTI-ALPS index and risk factors.

Results: The DTI-ALPS index in the bilateral hemispheres of CSVD patients was significantly lower than that in the HCs group (p < 0.001). The DTI-ALPS index in the bilateral hemisphere of CSVD patients was negatively correlated with the grade of EPVS in basal ganglia. There was a significant negative correlation between the left DTI-ALPS index and lacunas, the right DTI-ALPS index and DWMHs. After removing the covariate MD, there was no significant correlation between the DTI-ALPS index and CSVD imaging markers. The DTI-ALPS index was associated with gender, diabetes, drinking and smoking.

Conclusions: The CSVD patients have glymphatic clearance dysfunction, which may be related to the imaging features and CSVD risk factors. Meanwhile, it's recommended to consider removing MD as mixed signal.