SynthesisFrontiers in aging neuroscience2026
DTI-ALPS index and cognitive impairment in cerebral small vessel disease: a systematic review and meta-analysis.
Synthesis in Frontiers in aging neuroscience, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Objective: The diffusion tensor image analysis along the perivascular space (DTI-ALPS) index is a non-invasive diffusion tensor imaging-based metric proposed to reflect glymphatic processes. This meta-analysis aimed to evaluate the association of the DTI-ALPS index with cerebral small vessel disease (CSVD) and CSVD-associated cognitive impairment. Methods: This meta-analysis was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Eight databases were systematically searched from inception up to February 1, 2026. Study selection and data extraction were performed independently by two reviewers. Study quality was assessed using the Newcastle-Ottawa Scale adapted for cross-sectional studies (NOS-xs). Pooled effect sizes were expressed as weighted mean differences (WMDs) with 95% confidence intervals (CIs). Heterogeneity was evaluated using Cochran's Q (χ Results: A total of 14 studies involving 2,149 participants were included. The median NOS-xs score was 8 (range, 6-9). Heterogeneity was observed across comparisons, with I Conclusion: Patients with CSVD exhibit reduced DTI-ALPS indices, which are associated with the presence of cognitive impairment. Reduced DTI-ALPS indices were observed in patients with CSVD-MCI compared with cognitively normal patients with CSVD, indicating that this association is present at the MCI stage. However, because no significant difference was observed between the CSVD-MCI and CSVD-VaD groups, the value of the DTI-ALPS index for disease staging remains uncertain and requires confirmation in future longitudinal studies. Systematic Review Registration: https://www.crd.york.ac.uk/prospero/ #recordDetails, identifier [CRD420261322688].
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