ArticleAlzheimer's research & therapy2025
Perivascular space and white matter hyperintensities in Alzheimer's disease: associations with disease progression and cognitive function.
Article in Alzheimer's research & therapy, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 33 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
33 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Glymphatic dysfunction in Alzheimer's disease: a systematic review and meta-analysis of the DTI-ALPS index as an imaging biomarker.Frontiers in aging neuroscience · 2026Pooled it
- Wasteosomes accumulate in periventricular white matter hyperintensities and exhibit complex relationships with mixed pathology, sclerotic index, and perivascular space.Brain pathology (Zurich, Switzerland) · 2026Article
- Exploring the role of glymphatic system in Alzheimer's disease with insights from MRI-based studies: a systematic review.Neuroradiology · 2026Review
- Diffusion tensor image analysis along the perivascular space (DTI-ALPS): redefining its interpretation and role.Japanese journal of radiology · 2026Review
- Choroid Plexus Microstructural Alterations Link Glymphatic Dysfunction and White Matter Degeneration in Parkinson's Disease.CNS neuroscience & therapeutics · 2026Article
- DTI-ALPS as a marker of glymphatic function: Review of the literature findings, methodology, and interpretation.Neuroimage. Reports · 2026Article
- Change in Amyloid-β Deposition and Diffusion Tensor Image Analysis along the Perivascular Space Index in Incident Neurodegenerative Disease.Annals of neurology · 2026Article
- Imaging study of white matter microstructural damage and glymphatic system dysfunction in patients with primary insomnia: a combined analysis based on PSMD, DTI-ALPS, and EPVS.Quantitative imaging in medicine and surgery · 2026Article
- The glymphatic system and Parkinson's disease: a narrative review.Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology · 2026Review
- White matter microstructural alterations in obstructive sleep apnea assessed by time-dependent diffusion MRI.Japanese journal of radiology · 2026Article
- Longitudinal Patterns of Brain Parenchymal Damage Associated With the ALPS Index in a Community-Based Cohort.CNS neuroscience & therapeutics · 2026Article
- Glymphatic system impairment in neurological disorders: potential mechanisms and therapeutic targets.Molecular biomedicine · 2026Review
- Dysfunction of cerebrospinal fluid circulation and neurovascular decoupling in end-stage renal disease patients with mild cognitive impairment.GeroScience · 2026Article
- White matterAlzheimer's research & therapy · 2026Article
- Altered cerebrospinal fluid-based clearance mechanisms in aging autistic adults.Research square · 2026Article
- Higher glymphatic system activity is linked to longer prodromal stage in isolated REM sleep behavior disorder: a possible protective factor.NPJ Parkinson's disease · 2026Article
- The value of machine learning models in differentiating alzheimer's disease from Moderate-to-Severe cerebral small vessel disease.Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology · 2026Article
- Cerebrospinal fluid dynamics and brain function regulation: from homeostasis to neurological disorders.Frontiers in neuroscience · 2026Article
- Glymphatic dysfunction and neuroinflammation in FXTAS: evidence from DTI-ALPS and gene expression analysis.Frontiers in molecular neuroscience · 2026Article
- The strip-shaped deep white matter hyperintensities may be related to neurodegeneration: A study based on diffusion tensor imaging.PloS one · 2026Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
27 authors.
Funding
Abstract
backgroundAlzheimer's disease (AD) is the leading cause of dementia, characterized by the accumulation of amyloid-beta (Aβ) and neurofibrillary tangles. Recent studies emphasize the role of vascular factors, including the glymphatic system, in AD pathogenesis, particularly in Aβ clearance. The diffusion tensor image analysis along the perivascular space (DTI-ALPS; ALPS-Index) has emerged as a novel, non-invasive method to evaluate the glymphatic system in vivo, showing glymphatic insufficiency in AD. This study aimed to investigate alterations in the function of the glymphatic system in individuals with AD versus healthy controls (HC), and to explore its association with Aβ, cerebrovascular disease (CVD), white matter hyperintensities (WMH), and cognitive function.
methodsDTI MRI data from three independent study cohorts (ActiGliA: AD n = 16, Controls n = 18; DELCODE: AD n = 54, Controls n = 67; ADNI: AD n = 43, Controls n = 49) were used to evaluate the perivascular space (PVS) integrity; a potential biomarker for glymphatic activity. The DTI-Along the Perivascular Space technique was used to measure water diffusion along PVS providing an index to assess the efficiency of the glymphatic system's waste clearance function. WMH load was quantified in FLAIR MRI using the lesion segmentation tool. We quantified WMHs volume within our defined region of interest (ROI) and excluded participants with any WMHs to avoid confounding the ALPS-Index. Associations with cerebrospinal fluid (CSF) AD hallmark biomarkers, cognitive performance (MMSE) and clinical severity (CDR) were assessed.
resultsAD patients had a significantly lower ALPS-Index vs. healthy controls (ActiGliA: AD: mean = 1.22, SD = 0.12; Controls: mean = 1.36, SD = 0.14, p = 0.004; DELCODE: AD: mean = 1.26, SD = 0.18; Controls: mean = 1.34, SD = 0.2, p = 0.035; ADNI: AD: mean = 1.08, SD = 0.24; Controls: mean = 1.19, SD = 0.13, p = 0.008). The ALPS-Index was associated with CSF Aβ concentration, WMH number and MMSE and CDR. WMH, found in the ROIs correlated negatively with the ALPS-Index.
conclusionsThis study highlights the potential of the DTI-ALPS-Index as a biomarker for glymphatic dysfunction in AD. It underscores the importance of considering vascular factors and the glymphatic system in the pathogenesis and diagnosis of AD as WMHs in the ROI could cause disturbances and inaccurate indices.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
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 OpenQuestion graph.