ArticleFrontiers in neurology
Diffusion tensor imaging along the perivascular space and choroid plexus volume for assessing the brain glymphatic system in overt hypothyroidism.
Article in Frontiers in neurology. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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Who cites it
1 citing paper in PubMed.
- Anatomical determinants of DTI-ALPS: effects of ROI definition, ventricular morphology, and periventricular deformation.bioRxiv : the preprint server for biology · 2026Article
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Authors and funding
10 authors.
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Abstract
Introduction: The neurocognitive impairment in overt hypothyroidism (OH) is well-recognized, but its underlying mechanisms remain unclear. The glymphatic system, a recently discovered brain waste-clearance pathway, represents a promising yet unexplored target in this context. This study aimed to non-invasively assess glymphatic function in OH patients using the DTI-ALPS index and choroid plexus (CP) volume, and to investigate their relationships with thyroid function and cognitive performance. Methods: We enrolled 40 patients with overt hypothyroidism (OH) and 42 healthy controls. All participants underwent 3D-T1 weighted imaging (3D-T1WI) and diffusion tensor imaging (DTI). Glymphatic activity was assessed using the DTI-ALPS index, and choroid plexus (CP) volume was segmented from 3D-T1WI images. After adjusting for covariates, correlations between these imaging markers and thyroid hormones as well as neuropsychological scale scores were analyzed. Results: After confounder adjustment, OH patients demonstrated a significantly reduced DTI-ALPS index and enlarged CP volume compared to controls. Critically, a lower DTI-ALPS index was associated with a larger CP volume. Serum FT3 levels and MoCA scores showed strong positive correlations with the DTI-ALPS index but negative correlations with CP volume. Discussion: Our study provides the first direct evidence of glymphatic system dysfunction in OH, linking it to thyroid hormone levels and cognitive deficits. The DTI-ALPS index and CP volume emerge as novel and promising neuroimaging biomarkers, offering new insights into the pathophysiology of hypothyroidism-related neurocognitive decline and potential targets for future interventions.
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