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• Clinical Article •
Changes of ALPS index and its clinical significance in patients with cerebral small vessel disease presenting with chronic dizziness
WU Zhaoxin  WANG Weitao  ZHANG Gang  YIN Suo  ZHANG Daopei 

Cite this article as WU Z X, WANG W T, ZHANG G, et al. Changes of ALPS index and its clinical significance in patients with cerebral small vessel disease presenting with chronic dizziness[J]. Chin J Magn Reson Imaging, 2026, 17(6): 28-35. DOI:10.12015/issn.1674-8034.2026.06.004.


[Abstract] Objective To investigate glymphatic system dysfunction and its clinical significance in patients with cerebral small vessel disease (CSVD) presenting with chronic dizziness.Materials and Methods A retrospective study was conducted, enrolling 136 inpatients with chronic dizziness as the chief complaint from January 2024 to November 2025. Combined with clinical symptoms, signs, and comprehensive auxiliary examinations (including cranial multimodal magnetic resonance imaging, vestibulo-ocular reflex, vestibulospinal reflex, and audiological tests), patients with chronic dizziness with definitive diagnosis were excluded as much as possible. Finally, 32 patients with chronic dizziness with CSVD, complete data, most likely unexplained cause were included in the CSVD with chronic dizziness group, and 32 age, gender, and vascular risk factor as well as emotional and sleep status-matched patients with CSVD without chronic dizziness were assigned to the control group. Total CSVD burden score and Dizziness Handicap Inventory (DHI) score were collected for CSVD with chronic dizziness groups. Meanwhile, glymphatic system function was quantified using diffusion tensor imaging along the perivascular space (ALPS). Correlations between ALPS indices, total CSVD imaging burden, and DHI scores were analyzed.Results There were no significant differences in baseline data between CSVD with chronic dizziness group and CSVD without chronic dizziness group (P > 0.05). The ALPS indices of both left and right (left: CSVD group 1.26 ± 0.21, CSVD without chronic dizziness group 1.48 ± 0.20; right: CSVD with chronic dizziness group 1.26 ± 0.15, CSVD without chronic dizziness group 1.50 ± 0.26) hemispheres in the CSVD with chronic dizziness group were significantly lower than those in the CSVD without chronic dizziness group (P < 0.05). The right ALPS index was negatively correlated with DHI score (r = -0.846, P = 0.002), and bilateral ALPS indices were also significantly negatively correlated with total CSVD imaging burden score (left r = -0.626, P = 0.003; right r = -0.876, P = 0.001).Conclusions Patients with CSVD presenting with chronic dizziness exhibit bilateral glymphatic system dysfunction, and the right ALPS index is decreased, and symptoms of chronic dizziness are more severe.
[Keywords] cerebral small vessel disease；chronic dizziness；magnetic resonance imaging；diffusion tensor imaging；diffusion tensor imaging along the perivascular space；cerebral glymphatic system

WU Zhaoxin1   WANG Weitao1   ZHANG Gang2   YIN Suo3   ZHANG Daopei1*  

1 Encephalopathy Center, the First Affiliated Hospital of Henan University of Chinese Medicine, Zhengzhou 450000, China

2 Magnetic Resonance Room, the First Affiliated Hospital of Henan University of Chinese Medicine, Zhengzhou 450000, China

3 Department of Medical Imaging, People's Hospital of Henan University of Chinese Medicine, Zhengzhou 450003, China

Corresponding author: ZHANG D P, E-mail: zhangdaopei89@163.com

Conflicts of interest   None.

Received  2025-12-19
Accepted  2026-05-11
DOI: 10.12015/issn.1674-8034.2026.06.004
Cite this article as WU Z X, WANG W T, ZHANG G, et al. Changes of ALPS index and its clinical significance in patients with cerebral small vessel disease presenting with chronic dizziness[J]. Chin J Magn Reson Imaging, 2026, 17(6): 28-35. DOI:10.12015/issn.1674-8034.2026.06.004.

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