ArticleEuropean journal of neurology2025
Alterations of Glymphatic System Before and After Shunt Surgery in Patients With Idiopathic Normal Pressure Hydrocephalus: A Longitudinal Study.
Article in European journal of neurology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.
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Who cites it
4 citing papers in PubMed.
- Glymphatic System Dysfunction and its Associated Factors in Wilson's Disease: A DTI-ALPS Study.Brain and behavior · 2026Article
- MRI-Based ALPS Index as a Biomarker of Glymphatic Dysfunction and Prognosis After Aneurysmal Subarachnoid Hemorrhage.Stroke (Hoboken, N.J.) · 2026Article
- Glymphatic System Dysfunction in Central Nervous System Diseases.CNS neuroscience & therapeutics · 2026Review
- The glymphatic system in neurodegenerative diseases and brain tumors: mechanistic insights, biomarker advances, and therapeutic opportunities.Acta neuropathologica communications · 2025Review
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Authors and funding
5 authors.
Funding
Abstract
aimsThis study aimed to assess the glymphatic dysfunction in idiopathic normal pressure hydrocephalus (iNPH) patients and its recovery post-shunt surgery using diffusion tensor image analysis along perivascular spaces (DTI-ALPS).
methodsThirty-five iNPH patients and forty healthy controls (HC) underwent MRI scans and neuropsychological assessments at baseline. A follow-up study, conducted three months post-shunt surgery, included fifteen iNPH patients. The DTI-ALPS index was calculated to assess the glymphatic system status. Group differences were evaluated using the Mann-Whitney U test, while the paired Wilcoxon signed-rank test was employed to compare pre-operative and post-operative ALPS indices. Multiple linear regression was utilized to analyze the association between changes in the ALPS index (ΔALPS) and alterations in clinical scores.
resultsBaseline examinations disclosed iNPH patients had a lower ALPS index than HC (p < 0.0001). We found a significantly increased ALPS index at 3 months after surgery compared to baseline (p < 0.0001). Positive correlations between theΔALPS and the increments of MMSE score (ΔMMSE) were found in all iNPH patients. Baseline age and ΔALPS emerged as significant predictors of ΔMMSE, with the model explaining 68.13% of the variance (R
conclusionGlymphatic function in iNPH was enhanced following shunt surgery, which positively impacted cognitive recovery. The DTI-ALPS index may serve as a useful predictor of shunting efficacy in iNPH patients.
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