학술논문
Longitudinal Assessment of Glymphatic Changes Following Mild Traumatic Brain Injury: Insights from PVS burden and DTI-ALPS Imaging.
Document Type
Academic Journal
Author
Zhuo J; Center for Advanced Imaging Research, University of Maryland School of Medicine, Baltimore, MD.; Department of Diagnostic Radiology and Nuclear Medicine, University of Maryland School of Medicine, Baltimore, MD.; Raghavan P; Department of Diagnostic Radiology and Nuclear Medicine, University of Maryland School of Medicine, Baltimore, MD.; Jiang L; Center for Advanced Imaging Research, University of Maryland School of Medicine, Baltimore, MD.; Department of Diagnostic Radiology and Nuclear Medicine, University of Maryland School of Medicine, Baltimore, MD.; Roys S; Center for Advanced Imaging Research, University of Maryland School of Medicine, Baltimore, MD.; Department of Diagnostic Radiology and Nuclear Medicine, University of Maryland School of Medicine, Baltimore, MD.; Tchoquessi RLN; Center for Advanced Imaging Research, University of Maryland School of Medicine, Baltimore, MD.; Department of Diagnostic Radiology and Nuclear Medicine, University of Maryland School of Medicine, Baltimore, MD.; Chen H; Department of Epidemiology & public Health, University of Maryland School of Medicine, Baltimore, MD.; Wickwire EM; Department of Psychiatry & Medicine, University of Maryland School of Medicine, Baltimore, MD.; Parikh GY; Program in Trauma, University of Maryland School of Medicine, Baltimore, MD.; Department of Neurology, University of Maryland School of Medicine, Baltimore, MD.; Schwartzbauer GT; Program in Trauma, University of Maryland School of Medicine, Baltimore, MD.; Department of Neurosurgery, University of Maryland School of Medicine, Baltimore, MD.; Grattan LM; Department of Neurology, University of Maryland School of Medicine, Baltimore, MD.; Wang Z; Center for Advanced Imaging Research, University of Maryland School of Medicine, Baltimore, MD.; Department of Diagnostic Radiology and Nuclear Medicine, University of Maryland School of Medicine, Baltimore, MD.; Gullapalli RP; Center for Advanced Imaging Research, University of Maryland School of Medicine, Baltimore, MD.; Department of Diagnostic Radiology and Nuclear Medicine, University of Maryland School of Medicine, Baltimore, MD.; Badjatia N; Program in Trauma, University of Maryland School of Medicine, Baltimore, MD.; Department of Neurology, University of Maryland School of Medicine, Baltimore, MD.
Source
Country of Publication: United States NLM ID: 101767986 Publication Model: Electronic Cited Medium: Internet NLM ISO Abbreviation: medRxiv Subsets: PubMed not MEDLINE
Subject
Language
English
Abstract
Traumatic brain injury (TBI) even in the mild form may result in long-lasting post-concussion symptoms. TBI is also a known risk to late-life neurodegeneration. Recent studies suggest that dysfunction in the glymphatic system, responsible for clearing protein waste from the brain, may play a pivotal role in the development of dementia following TBI. Given the diverse nature of TBI, longitudinal investigations are essential to comprehending the dynamic changes in the glymphatic system and its implications for recovery. In this prospective study, we evaluated two promising glymphatic imaging markers, namely the enlarged perivascular space (ePVS) burden and Diffusion Tensor Imaging-based ALPS index, in 44 patients with mTBI at two early post-injury time points: approximately 14 days (14Day) and 6-12 months (6-12Mon) post-injury, while also examining their associations with post-concussion symptoms. Additionally, 37 controls, comprising both orthopedic patients and healthy individuals, were included for comparative analysis. Our key findings include: 1) White matter ePVS burden (WM-ePVS) and ALPS index exhibit significant correlations with age. 2) Elevated WM-ePVS burden in acute mTBI (14Day) is significantly linked to a higher number of post-concussion symptoms, particularly memory problems. 3) The increase in the ALPS index from acute (14Day) to the chronic (6-12Mon) phases in mTBI patients correlates with improvement in sleep measures. Furthermore, incorporating WM-ePVS burden and the ALPS index from acute phase enhances the prediction of chronic memory problems beyond socio-demographic and basic clinical information, highlighting their distinct roles in assessing glymphatic structure and activity. Early evaluation of glymphatic function could be crucial for understanding TBI recovery and developing targeted interventions to improve patient outcomes.