Evidence map›Paper›PMID 41593452›Full record

ArticleBMC neurology2026

Glymphatic dysfunction and its association with clinical symptom severity in narcolepsy type 1: a case-control DTI-ALPS study.

Liu Xiaoxi, Zhu Shasha, An Di, Hu Yadong

Abstract read
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Article in BMC neurology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

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

What it found

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2 · The registry

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3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

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4 · The record

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5 · Who and what money

Authors and funding

4 authors.

Liu Xiaoxi *Department of Neurology, Affiliated Hospital of Hebei University, 212 East Yuhua Road, Lianchi District, Baoding, 071000, Hebei, China.
Zhu Shasha *Department of Neurology, Affiliated Hospital of Hebei University, 212 East Yuhua Road, Lianchi District, Baoding, 071000, Hebei, China.
An DiDepartment of Neurology, Affiliated Hospital of Hebei University, 212 East Yuhua Road, Lianchi District, Baoding, 071000, Hebei, China.
Hu YadongDepartment of Neurology, Affiliated Hospital of Hebei University, 212 East Yuhua Road, Lianchi District, Baoding, 071000, Hebei, China. huyadong1032@163.com.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundNarcolepsy type 1 (NT1) is characterized by excessive daytime sleepiness and cataplexy, primarily caused by hypothalamic orexin deficiency. Beyond neurotransmitter dysregulation, recent evidence suggests that impaired metabolic waste clearance may contribute to its pathophysiology. This study aimed to assess glymphatic function in NT1 using diffusion tensor image analysis along the perivascular space (DTI-ALPS) and to explore its relationship with clinical and polysomnographic features.

methodsA total of 92 NT1 patients and 45 age- and sex-matched healthy controls underwent 3.0 T DTI and overnight polysomnography. The ALPS index was calculated to quantify glymphatic efficiency. Correlation and regression analyses examined associations between ALPS values and Epworth Sleepiness Scale (ESS), Multiple Sleep Latency Test (MSLT), and other clinical parameters. Receiver operating characteristic (ROC) analysis evaluated the predictive performance of ALPS for NT1 diagnosis.

resultsThe ALPS index was significantly lower in NT1 patients than in controls (1.24 ± 0.07 vs. 1.33 ± 0.06, P < 0.001), indicating impaired glymphatic function. Reduced ALPS values correlated with higher ESS scores (r = − 0.39, P < 0.001), shorter MSLT latency (r = 0.36, P = 0.002), and greater cataplexy severity. Each 0.1-unit decrease in ALPS increased the odds of NT1 by 2.8-fold (adjusted OR = 2.78, 95% CI 1.43–5.41, P = 0.003). The ALPS index showed good diagnostic accuracy (AUC = 0.81), which improved when combined with MSLT (AUC = 0.87, P = 0.018).

conclusionsNT1 is associated with significant glymphatic dysfunction, and the degree of impairment correlates with symptom severity. The DTI-ALPS index provides a quantitative and noninvasive biomarker that may aid in disease evaluation and individualized management of narcolepsy.

Indexed as

Glymphatic SystemNarcolepsyAdultCase-Control StudiesDiffusion Tensor ImagingFemaleHumansMalePolysomnographySeverity of Illness IndexYoung AdultBiomarkerCataplexyDaytime sleepinessDiffusion tensor imagingDTI-ALPSGlymphatic systemNarcolepsy type 1Orexin deficiencySleep–wake regulation

Identifiers

PMID41593452
PMCPMC12924457

What Socratic holds

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LicenceCC BY-NC-ND
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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.