Evidence map›Paper›PMID 41454064›Full record

ArticleEuropean journal of nuclear medicine and molecular imaging2026

Impaired glymphatic function is associated with synaptic loss in cognitive impairment.

Kun He, Jie Wang, Junhao Wu, Xing Chen, Haijuan Chen, Junpeng Li, Qihao Guo, Yiyun Henry Huang, Yihui Guan, Jun Zhao and 3 more

Abstract read
PubMed Publisher
In one paragraph

Article in European journal of nuclear medicine and molecular imaging, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.

0numbers the graph read from it
0cells of the map it votes in
7citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

7 citing papers in PubMed.

  1. Review
  2. Review
  3. Article
  4. Review
  5. Article
  6. A pilot study of nectin-4-targeted radioligand [European journal of nuclear medicine and molecular imaging · 2026
    Article
  7. Molecular Physiology of the Neuronal Synapse.Current issues in molecular biology · 2026
    Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

13 authors.

Kun He *Department of Nuclear Medicine & PET Center, Huashan Hospital, Fudan University, No. 518, East Wuzhong Rd, Xuhui District, Shanghai, 200040, China.
Jie Wang *Department of Nuclear Medicine & PET Center, Huashan Hospital, Fudan University, No. 518, East Wuzhong Rd, Xuhui District, Shanghai, 200040, China.
Junhao WuDepartment of Nuclear Medicine & PET Center, Huashan Hospital, Fudan University, No. 518, East Wuzhong Rd, Xuhui District, Shanghai, 200040, China.
Xing ChenDepartment of Nuclear Medicine, Shanghai East Hospital, Tongji University School of Medicine, 150 Jimo Rd, Lujiazui, Pudong District, Shanghai, 200120, China.
Haijuan ChenDepartment of Neurology & Institute of Neurology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, 227 South Chongqing Rd, Huangpu District, Shanghai, 200025, China.
Junpeng LiDepartment of Nuclear Medicine & PET Center, Huashan Hospital, Fudan University, No. 518, East Wuzhong Rd, Xuhui District, Shanghai, 200040, China.
Qihao GuoDepartment of Gerontology, Shanghai Jiaotong University Affiliated Sixth People's Hospital, 600 Yishan Rd, Xuhui District, Shanghai, 200233, China.
Yiyun Henry HuangPET Center, Department of Radiology and Biomedical Imaging, Yale University School of Medicine, 333 Cedar St, New Haven, 06510, CT, US.
Yihui GuanDepartment of Nuclear Medicine & PET Center, Huashan Hospital, Fudan University, No. 518, East Wuzhong Rd, Xuhui District, Shanghai, 200040, China.
Jun ZhaoDepartment of Nuclear Medicine, Shanghai East Hospital, Tongji University School of Medicine, 150 Jimo Rd, Lujiazui, Pudong District, Shanghai, 200120, China. petcenter@126.com.
Binyin LiClinical Neuroscience Center, Ruijin Hospital LuWan Branch, Shanghai Jiao Tong University School of Medicine, 182 Chongqing Rd (S), Huangpu District, Shanghai, 200025, China. libinyin@126.com.
Fang XieDepartment of Nuclear Medicine & PET Center, Huashan Hospital, Fudan University, No. 518, East Wuzhong Rd, Xuhui District, Shanghai, 200040, China. fangxie@fudan.edu.cn.ORCID 0000-0003-2667-281X
Qi HuangDepartment of Nuclear Medicine & PET Center, Huashan Hospital, Fudan University, No. 518, East Wuzhong Rd, Xuhui District, Shanghai, 200040, China. hq_1124@163.com.

Funding

National Natural Science Foundation of China 82572263Shanghai Municipal Health Commission 2025ZHYL035STI2030-Major Projects 2022ZD0213800
6 · The paper itself

Abstract

purposeTo investigate the correlation between glymphatic impairment and synaptic loss and to explore whether this relationship is affected by amyloid-β (Aβ) pathology or reactive astrocytes in individuals spanning the Alzheimer's disease-related pathological spectrum.

methodsWe investigated the diffusion tensor imaging analysis along the perivascular space (DTI-ALPS) index as a biomarker of the glymphatic system. A total of 182 participants underwent synaptic vesicle glycoprotein 2 A (SV2A) PET/MRI and amyloid-β (Aβ) PET/CT imaging, with SV2A serving as a biomarker of synaptic density. Additionally, plasma Aβ42/40 ratios were measured in 139 participants, and glial fibrillary acidic protein (GFAP) levels were assessed in 143 participants. Controlling for age, sex, years of education, and cognitive status, we investigated the relationships between glymphatic system impairment and synaptic density, along with other biomarkers. Mediation analyses were conducted using the SPSS PROCESS macro (version 3.3) to examine whether synaptic density mediates the relationship between the ALPS index and cognitive performance.

resultsA lower ALPS index, indicating greater glymphatic impairment, was significantly associated with reduced synaptic density. The ALPS index was also significantly positively associated with the residual SV2A PET standardized uptake value ratio (SUVr) in the hippocampus of participants with Aβ deposition or greater plasma GFAP concentrations. The correlation between hippocampal synaptic loss and cerebral Aβ was stronger in participants with a lower ALPS index. In addition, the hippocampal synaptic density fully mediated the association between ALPS index and global cognition.

conclusionGlymphatic system impairment is significantly correlated with synaptic density loss. GFAP levels and cerebral Aβ plaques may strengthened this association. These findings suggest a potential link between glymphatic dysfunction and synaptic degeneration in AD, which may have implications for understanding disease mechanisms and therapeutic monitoring.

Indexed as

Cognitive DysfunctionGlymphatic SystemSynapsesAgedAged, 80 and overAmyloid beta-PeptidesBiomarkersDiffusion Tensor ImagingFemaleHumansMaleMiddle AgedPositron Emission Tomography Computed TomographyAmyloid beta-PeptidesBiomarkersAlzheimer’s diseaseAmyloid-βDiffusion tensor imagingGlial fibrillary acidic proteinSynaptic vesicle glycoprotein 2A

Identifiers

PMID41454064

What Socratic holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.