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• Clinical Article •
The association between DTI-ALPS, perivascular space and cognitive impairment in cerebral small vessel disease
ZHAO Jinghan  CHANG Peipei  DU Wei  CAO Jiajun  WANG Man  HU Shuai  SONG Qingwei  MIAO Yanwei 

Cite this article as: ZHAO J H, CHANG P P, DU W, et al. The association between DTI-ALPS, perivascular space and cognitive impairment in cerebral small vessel disease[J]. Chin J Magn Reson Imaging, 2025, 16(3): 31-37. DOI:10.12015/issn.1674-8034.2025.03.005.


[Abstract] Objective To evaluate the glymphatic system with diffusion tensor imaging analysis along the perivascular space (DTI-ALPS) and enlarged perivascular space (EPVS) changes, and to explore its relationship with cognitive function, and then to find influence factors for cognitive changes in cerebral small vessel disease (CSVD) patients.Materials and Methods The clinical data of CSVD group (n = 81) and control group (n = 20) were prospectively collected. According to the neuropsychological evaluation results, the CSVD patients were divided into normal cognition group (CSVD-NC, n = 27), mild cognitive impairment group (CSVD-MCI, n = 31), and vascular dementia group (CSVD-VaD, n = 23). The routine MRI sequence, diffusion tensor imaging (DTI) were performed in all. The grade of EPVS of basal ganglia (BG) and centrum semi-ovale (CSO) was quantitatively scored, and ALPS-index was measured. The differences of EPVS and ALPS-index were compared among the four groups. Correlation analysis and multiple linear regression was further analyzed between ALPS-index, EPVS and cognitive function.Results Compared with the HC group, the ALPS-index were decreased in the CSVD-NC group, CSVD-MCI group and CSVD-VaD group, the BG-EPVS and CSO-EPVS score were increased in the CSVD-MCI group and the CSVD-VaD group (P < 0.05). The BG-EPVS was negatively correlated with ALPS index, MoCA score and MMSE score in CSVD patients (r = -0.291, P = 0.008; r = -0.342, P = 0.002; r = -0.309, P = 0.005), and ALPS-index was positively correlated with MoCA score and MMSE score (r = 0.226, P = 0.043; r = 0.225, P = 0.044). Multiple linear regression analysis showed that BG-EPVS was independent factor of MoCA score and MMSE score (β = -0.294, P = 0.009; β = -0.274, P = 0.017).Conclusions The ALPS index and EPVS changes could be used to evaluate glymphatic system in CSVD patients, which were closely related to cognition impairment.
[Keywords] cerebral small vessel disease；diffusion tensor imaging analysis along the perivascular space；magnetic resonance imaging；glymphatic system；cognitive impairment；perivascular space

ZHAO Jinghan   CHANG Peipei   DU Wei   CAO Jiajun   WANG Man   HU Shuai   SONG Qingwei   MIAO Yanwei*  

Department of Radiology, the First Affiliated Hospital of Dalian Medical University, Dalian 116011, China

Corresponding author: MIAO Y W, E-mail: ywmiao716@163.com

Conflicts of interest   None.

Received  2024-10-13
Accepted  2025-03-03
DOI: 10.12015/issn.1674-8034.2025.03.005
Cite this article as: ZHAO J H, CHANG P P, DU W, et al. The association between DTI-ALPS, perivascular space and cognitive impairment in cerebral small vessel disease[J]. Chin J Magn Reson Imaging, 2025, 16(3): 31-37. DOI:10.12015/issn.1674-8034.2025.03.005.

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