ArticleCNS neuroscience & therapeutics2025
Chronic Glymphatic Dysfunction Modulates Domain-Specific Cognitive Recovery After Stroke: A DTI-ALPS Lesion Stratification Study.
Article in CNS neuroscience & therapeutics, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers, 1 of them a synthesis that pooled it.
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Who cites it
7 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Clinical and preclinical evidence of meningeal immunity and glymphatic pathways in stroke: a systematic review.Frontiers in immunology · 2026Pooled it
- Impact of enlarged perivascular spaces on endovascular therapy outcomes in patients with large ischaemic core: A post-hoc analysis of the ANGEL-ASPECT trial.Journal of translational internal medicine · 2026Article
- Association between perivascular diffusion and white matter microstructural integrity, free water, Aβ burden, and cognition: diffusion tensor vs. kurtosis tensor.Frontiers in aging neuroscience · 2026Article
- Diffusion Tensor Imaging Along the Perivascular Space (DTI-ALPS) in Ischemic Stroke: A Systematic Review of Diagnostic and Prognostic Performance for Post-Stroke Cognitive Impairment.Diagnostics (Basel, Switzerland) · 2025Review
- Chronic Glymphatic Dysfunction Modulates Domain-Specific Cognitive Recovery After Stroke: A DTI-ALPS Lesion Stratification Study.CNS neuroscience & therapeutics · 2025Article
- Glymphatic system function in patients with ischemic stroke evaluated by the DTI-ALPS method: a comprehensive review.Frontiers in neurology · 2025Review
- Longitudinal changes in the ALPS index and its clinical correlates in patients with basal ganglia hemorrhage.Frontiers in neurologyArticle
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Authors and funding
5 authors.
Funding
Abstract
BACKGROUND AND
aimsGlymphatic dysfunction may exacerbate post-stroke cognitive impairment (PSCI) via impaired metabolic waste clearance. However, longitudinal dynamics of glymphatic function during the chronic stroke phase (3-12 months) and links to cognitive recovery remain unclear. This study aimed to characterize chronic glymphatic remodeling dynamics using the DTI-ALPS index while exploring its temporal associations with cognitive outcomes and assessing lesion location effects.
methodsIn this retrospective cohort study, 51 chronic stroke patients (3-12 months post-stroke) and 27 matched healthy controls underwent DTI scans and neuropsychological assessments (evaluating language, memory, motor, attention) at 3 months (3 M-S) and 1 year (1Y-S) post-stroke. The DTI-ALPS index was calculated for lesioned/contralateral hemispheres. Patients were stratified by lesion location (cortical [n = 17] vs. subcortical [n = 34]). Group comparisons and Spearman correlations (FDR-corrected) were performed.
resultsStroke patients showed significantly lower DTI-ALPS index versus controls at both 3 M-S and 1Y-S (FDR-p < 0.001). At 3 M-S, the lesioned hemisphere ALPS index was significantly lower than the contralateral hemisphere (FDR-p < 0.05); this difference resolved by 1Y-S. No significant differences existed between cortical/subcortical subgroups. Weak correlations emerged at 3 M-S between lesioned-hemisphere ALPS index and Motor/Memory scores (r = 0.280-0.316, uncorrected p < 0.05), but these did not survive FDR correction and disappeared by 1Y-S. Lesion volume did not correlate with ALPS index.
conclusionsChronic stroke patients exhibit persistent glymphatic dysfunction. The affected hemisphere showed more severe impairment at 3 months post-stroke, with partial improvement observed by the 1-year mark. Transient cognitive associations observed at 3 months diminished by the 1-year follow-up, suggesting stabilization of recovery patterns in later stages. Despite study limitations, these findings validate the utility of the DTI-ALPS index for chronic-phase assessments and highlight the importance of targeting glymphatic dysfunction as a therapeutic strategy for PSCI.
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