ArticleMovement disorders : official journal of the Movement Disorder Society2025
Impaired Glymphatic Clearance, Measured Using Diffusion Tensor Image Analysis Along the Perivascular Space (DTI-ALPS), is Linked to Poor Cognitive Outcomes in Parkinson's Disease.
Article in Movement disorders : official journal of the Movement Disorder Society, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers.
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Who cites it
10 citing papers in PubMed.
- Brain Clearance of Contrast Agent in Intravenous DCE-MRI Is Measurable and Cannot Be Explained by Clearance Across the BBB Alone.Magnetic resonance in medicine · 2026Article
- Advanced diffusion MRI tract signatures in Alzheimer's disease, dementia with Lewy bodies, and the FTD/PPA spectrum.NeuroImage · 2026Review
- Enlarged choroid plexus in chronic insomnia patients and its association with DTI-ALPS index alterations and cognitive decline.Neuroradiology · 2026Article
- Associations of DTI-ALPS index and choroid plexus volume with clinical severity across the Parkinson's disease spectrum.NPJ Parkinson's disease · 2026Article
- Sleep-circadian modulation of autophagy and glymphatic function: failure of coordinated brain clearance in Parkinson's disease.NPJ Parkinson's disease · 2026Review
- Hierarchical organization of tau topography across the Alzheimer's disease continuum integrates amyloid, connectome, and intrinsic molecular vulnerability.Communications biology · 2026Article
- From phenotype to biology: a multi-modal roadmap of biofluid, tissue, imaging, and digital biomarkers in Parkinson's disease.Translational neurodegeneration · 2026Review
- DTI-ALPS Is Associated with Temporolimbic Amyloid but Not Plasma p-Tau181 Across the Alzheimer's Disease Continuum.Research square · 2026Article
- Diffusion tensor imaging analysis along the perivascular space suggests impaired glymphatic clearance in Lewy body dementia subtypes.Alzheimer's research & therapy · 2026Article
- "Mind the Gap"-enlarged perivascular spaces as a potential magnetic resonance imaging biomarker of impaired glymphatic clearance in brain disorders.Frontiers in cellular neuroscience · 2026Review
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Authors and funding
9 authors.
Funding
Abstract
backgroundImpaired glymphatic clearance may contribute to pathological accumulations in Parkinson's (PD), but how it interacts with other processes causing dementia remains unclear. Diffusion tensor image analysis along the perivascular space (DTI-ALPS) has been proposed as an indirect proxy for glymphatic clearance.
objectivesTo clarify DTI-ALPS' relationship with cognition in PD, and its relationship with established imaging markers.
methodsWe assessed DTI-ALPS in 98 PD patients (31 PD poor outcomes: dementia, mild cognitive impairment, frailty, or death within a 3-year follow-up; 67 PD good outcomes) and 28 controls. We assessed DTI-ALPS' relationship to cognition, white matter (fiber cross-section), cortical thickness, iron accumulation (quantitative susceptibility mapping [QSM]), and plasma markers [phosphorylated tau-181 (p-tau181 and neurofilament light (NfL)] cross-sectionally and longitudinally).
resultsDTI-ALPS was lower in PD-poor outcomes compared with PD good outcomes and controls (P = 0.005) with further longitudinal reductions only in PD poor outcomes (group × time interaction: β = -0.013, P = 0.021). Lower DTI-ALPS was associated with lower fiber cross-section in PD, at baseline and longitudinally but with different spatial distribution from white matter changes relating to PD cognition. There was no correlation between baseline DTI-ALPS and plasma p-tau181 (P = 0.642), NFL (P = 0.448), or baseline cortical thickness. Lower DTI-ALPS was associated with accelerated cortical thinning within left precentral gyrus and changes in brain iron distribution.
conclusionsPD patients who develop poor outcomes show lower DTI-ALPS, potentially reflecting impaired glymphatic clearance. DTI-ALPS correlated with white matter integrity and brain iron accumulation. However, both showed different spatial distribution than that seen in PD dementia, suggesting DTI-ALPS captures a distinct contribution to cognitive decline. © 2025 The Author(s). Movement Disorders published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society.
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