Expansion of white matter hyperintensities is associated with the glymphatic system dysfunction in cerebral small vessel disease

IF 3.7 3区医学 Q2 NEUROSCIENCES

Brain Research Bulletin Pub Date : 2025-05-22 DOI:10.1016/j.brainresbull.2025.111391

Bang Zeng , Peng Zeng , Yayun Xiang , Yuling Peng , Dan Luo , Binglan Li , Ying Chai , Dan Wang , Lisha Nie , Yongmei Li

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引用次数: 0

Abstract

Objectives

To explore the relationship between the glymphatic system and various patterns of white matter hyperintensities (WMHs) in the early stages of cerebral small vessel disease (CSVD), as well as their impact on cognitive function.

Methods

The report included 84 patients with CSVD and 23 healthy controls (HCs). To comprehensively assess the impact of white matter hyperintensity volume (WMHV) and WMH counts, we introduced the mean WMHV (WMHV/count) as a new biomarker. Using a threshold of 0.1 for mean WMHV, we categorized participants into two groups to compare intergroup differences. The metrics of the glymphatic system included the index of diffusivity along the perivascular space (Analysis aLong the Perivascular Space [ALPS] index) and the fractional volume of free water (FW). Finally, we analyzed the correlations between imaging indicators and cognitive scales using linear regression models.

Results

Compared to HC and Group 1 (mean WMHV ≤ 0.1), Group 2 (mean WMHV > 0.1) exhibited a lower ALPS index and higher fractional volume of FW across various brain regions, including the whole brain (FW-ALL), white matter (FW-WM), basal ganglia (FW-BG), and hippocampus (FW-Hipp). In a correlation analysis, the mean WMHV showed significant correlations with FW-ALL, FW-WM, and FW-BG. Meanwhile, WMHV was only correlated with FW-BG. Furthermore, both FW-BG and the ALPS index were associated with Digit Symbol Substitution Test scores.

Conclusions

Mean WMHV can reflect the confluence and expansion of WMH and is closely associated with glymphatic system disfunction.

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脑血管病患者白质高信号扩张与淋巴系统功能障碍相关

目的：探讨脑小血管病（CSVD）早期不同类型白质高信号（WMHs）与淋巴系统的关系及其对认知功能的影响。方法：84例CSVD患者和23例健康对照（hc）。为了全面评估白质高强度体积（WMHV）和WMH计数的影响，我们引入了平均WMHV （WMHV/计数）作为新的生物标志物。使用0.1的平均WMHV阈值，我们将参与者分为两组来比较组间差异。淋巴系统的指标包括沿血管周围空间扩散指数（Analysis along The perivascular space [ALPS] index）和游离水分数体积（FW）。最后，我们利用线性回归模型分析了影像学指标与认知量表之间的相关性。结果：与HC和1组（平均WMHV≤0.1）相比，2组（平均WMHV > 0.1）在全脑（FW- all）、白质（FW- wm）、基底节区（FW- bg）和海马（FW- hipp）各脑区表现出较低的ALPS指数和较高的FW分数体积。在相关分析中，平均WMHV与FW-ALL、FW-WM和FW-BG呈显著相关。WMHV仅与FW-BG相关。此外，FW-BG和ALPS指数与数字符号替代测试成绩相关。结论：平均WMHV能反映WMH的融合和扩张，与淋巴系统功能障碍密切相关。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Brain Research Bulletin 医学-神经科学

CiteScore

6.90

自引率

2.60%

发文量

253

审稿时长

67 days

期刊介绍： The Brain Research Bulletin (BRB) aims to publish novel work that advances our knowledge of molecular and cellular mechanisms that underlie neural network properties associated with behavior, cognition and other brain functions during neurodevelopment and in the adult. Although clinical research is out of the Journal''s scope, the BRB also aims to publish translation research that provides insight into biological mechanisms and processes associated with neurodegeneration mechanisms, neurological diseases and neuropsychiatric disorders. The Journal is especially interested in research using novel methodologies, such as optogenetics, multielectrode array recordings and life imaging in wild-type and genetically-modified animal models, with the goal to advance our understanding of how neurons, glia and networks function in vivo.