Evidence map›Paper›PMID 41817788›Full record

ArticleJournal of neuro-oncology2026

Longitudinal changes of neurocognitive function and ALPS-index in patients with brain tumors receiving brain irradiation.

Anurag Saraf, Jeremy Ford, Michael Parsons, Janet Sherman, Nora K Horick, Beow Y Yeap, Irene Wang, Jorg Dietrich, Helen A Shih

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Article in Journal of neuro-oncology, 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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1 · What the graph read from it

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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.

2 · The registry

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3 · Its place in the literature

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4 · The record

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5 · Who and what money

Authors and funding

9 authors.

Anurag SarafDepartment of Radiation Oncology, Massachusetts General Hospital/Mass General Brigham, 100 Blossom St., Cox 3, Boston, MA, 02114, USA.
Jeremy FordDepartment of Radiology, Massachusetts General Hospital, Boston, MA, USA.
Michael ParsonsDepartment of Psychiatry, Massachusetts General Hospital, Boston, MA, USA.
Janet ShermanDepartment of Psychiatry, Massachusetts General Hospital, Boston, MA, USA.
Nora K HorickDepartment of Medicine, Massachusetts General Hospital, Boston, MA, USA.
Beow Y YeapDepartment of Medicine, Massachusetts General Hospital, Boston, MA, USA.
Irene WangDepartment of Radiation Oncology, Massachusetts General Hospital/Mass General Brigham, 100 Blossom St., Cox 3, Boston, MA, 02114, USA.
Jorg DietrichDivision of Neuro-Oncology, Department of Neurology, Massachusetts General Hospital, Boston, MA, USA.
Helen A ShihDepartment of Radiation Oncology, Massachusetts General Hospital/Mass General Brigham, 100 Blossom St., Cox 3, Boston, MA, 02114, USA. hshih@mgh.harvard.edu.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundNeurocognitive decline is common after brain radiotherapy (RT), but underlying mechanisms remain unclear. Altered glymphatic flow has been implicated in cognitive impairment in other neurologic conditions. Diffusion Tensor Imaging (DTI) Analysis along the Perivascular Space (ALPS)-index is a candidate biomarker of glymphatic function. We evaluated changes in ALPS-index and neurocognition following whole brain radiation therapy (WBRT) and partial brain radiation therapy (PBRT).

methodsA prospective, single-arm study was conducted in patients receiving fractionated brain RT from 2015 to 2019. Patients had comprehensive brain imaging and formal neurocognitive testing (Trails B z-score) at baseline and follow-up. Due to the limited sample size, associations between baseline characteristics, ALPS-index, and Trails B z-score were summarized descriptively.

resultsOf 15 enrolled patients, 7 had suitable diffusion imaging for ALPS-index analysis. Four patients received WBRT (23.4–35 Gy/13–14 fractions) and three received PBRT (30–39 Gy/10–13 fractions). At 2 months, ALPS-index declined after WBRT (median − 4.0%, range − 18.6% to -0.6%) and increased after PBRT (median + 3.3%, range 0.0% to + 5.0%). Greater ALPS-index change was observed with lower KPS and multiple metastases. Median Trails B z-score decreased by -3.35 after WBRT versus − 0.15 after PBRT. Among patients with 24-month follow-up, ALPS-indices increased by median 2.2% after WBRT and declined by 0.4% after PBRT; Trails B z-score declined by 1.40 after WBRT and improved by 0.61 after PBRT.

conclusionsEarly decrease in ALPS-index and worse neurocognitive change is observed after WBRT as compared to PBRT. The contribution of ALPS-index and glymphatic dysfunction to cognitive changes after brain RT merit further investigation.

Indexed as

Brain NeoplasmsCranial IrradiationGlymphatic SystemAdultAgedDiffusion Tensor ImagingFemaleFollow-Up StudiesHumansLongitudinal StudiesMaleMiddle AgedNeuropsychological TestsPrognosisProspective StudiesALPS-indexBrain radiationDTI-ALPSGlymphatic changesNeurocognitive changes

Identifiers

PMID41817788

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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.