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• Clinical Article •
Alterations in glymphatic system function in patients with disorders of consciousness following traumatic brain injury and their impact on consciousness levels and prognosis
MA Xiaoyang  HUANG Wenjing  YAN Jiahao  WANG Zhuo  YANG Dan  DA Minglian  LI Xiaoling  ZHANG Jing 

DOI:10.12015/issn.1674-8034.2025.11.013.


[Abstract] Objective To investigate glymphatic pathway impairment following traumatic brain injury (TBI) and its association with consciousness states and clinical outcomes in patients with post-traumatic disorders of consciousness (DoC).Materials and Methods This study recruited 22 patients with post-traumatic DoC and 30 healthy controls for magnetic resonance imaging scans. Glymphatic function was evaluated via choroid plexus volume (CPV) and the diffusion tensor imaging along the perivascular space (DTI-ALPS) index. Consciousness levels and functional recovery were assessed using the Coma Recovery Scale-Revised (CRS-R) and Glasgow Outcome Scale-Extended (GOSE). Intergroup differences in DTI-ALPS and CPV were compared. Pearson correlation analysis examined relationships among DTI-ALPS, CPV, CRS-R, and GOSE scores in the DoC group.Results The DoC group exhibited significantly lower DTI-ALPS indices and larger choroid plexus volume/total intracranial volume (CPV/TIV) compared to HC (P < 0.05). In DoC patients, DTI-ALPS positively correlated with CRS-R scores (r = 0.43, P = 0.04) but negatively with CPV (r = -0.46, P = 0.04). CPV/TIV showed negative correlation with CRS-R (r = -0.64, P = 0.01). At 3-month MRI follow-up, GOSE scores positively correlated with DTI-ALPS (r = 0.45, P = 0.04) and negatively with CPV/TIV (r = -0.59, P = 0.01).Conclusions TBI induces glymphatic pathway dysfunction, which influences consciousness states and clinical outcomes. These findings may reveal potential neural mechanisms of post-TBI DoC, clarify the relationship between glymphatic impairment and residual consciousness, and offer novel neuroimaging biomarkers for clinical diagnosis and prognosis in post-traumatic DoC.
[Keywords] traumatic brain injury；disorders of consciousness；magnetic resonance imaging；glymphatic function；choroid plexus volume

MA Xiaoyang1, 2, 3   HUANG Wenjing1, 2, 3   YAN Jiahao1, 2, 3   WANG Zhuo1, 2, 3   YANG Dan1, 2, 3   DA Minglian4   LI Xiaoling4   ZHANG Jing1, 2, 3*  

1 Department of Magnetic Resonance, Lanzhou University Second Hospital, Lanzhou 730030, China

2 Second Clinical School, Lanzhou University, Lanzhou 730030, China

3 Gansu Province Clinical Research Center for Functional and Molecular Imaging, Lanzhou 730030, China

4 Department of Rehabilitation Medicine, Lanzhou University Second Hospital, Lanzhou 730030, China

Corresponding author: ZHANG J, E-mail: ery_zhangjing@lzu.edu.cn

Conflicts of interest   None.

Received  2025-07-28
Accepted  2025-10-15
DOI: 10.12015/issn.1674-8034.2025.11.013
DOI:10.12015/issn.1674-8034.2025.11.013.

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