ArticleImaging neuroscience (Cambridge, Mass.)2026
Multimodal MRI insights into glymphatic clearance and blood-brain barrier integrity in healthy aging.
Article in Imaging neuroscience (Cambridge, Mass.), 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
Aging is associated with impaired CSF clearance in preclinical models, but its impact on blood-brain barrier (BBB) health and glymphatic function in humans remains unclear. The BBB and glymphatic functions are complementary and may partially overlap, yet their interaction is yet to be fully elucidated. In this study, we aimed to compare BBB integrity, extracellular free water, and glymphatic function between healthy young and older adults, and to examine mechanistic relationships among these measures using multimodal MRI techniques. 30 healthy participants with no known neurological or psychiatric disorders, including 12 younger (26 ± 3 years) and 18 older individuals (75 ± 7 years), underwent MRI scans on a 3T Siemens Prisma scanner. Multimodal MRI techniques were used, including diffusion-prepared arterial spin labeling to measure the water exchange rate (Kw) across the blood-brain barrier (BBB); free water (FW) imaging to quantify extracellular free water in white matter; and diffusion tensor imaging along perivascular spaces (DTI-ALPS) to assess glymphatic function. These measures were compared between younger and older individuals. Mediation analysis was performed to assess the mechanistic relationship between BBB integrity and glymphatic function and to test whether this relationship was mediated by free water. Older individuals showed reduced whole-brain Kw (p = 0.021), increased white matter FW (p = 0.002), and reduced DTI-ALPS (p < 0.001) compared to younger adults. Kw was positively associated with DTI-ALPS (β = 0.402 × 10
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