Evidence map›Paper›PMID 42257804›Full record

ArticleTranslational stroke research2026

Impaired Glymphatic Function and Post-stroke Cognitive Decline after Intracerebral Hemorrhage: A Serial Neuroimaging Study.

Nina H Nariman, Md Faruk Hossain, Khader M Hasan, Vahed Maroufy, Seth B Boren, Spencer Solberg, Robert Suchting, Clark Sitton, Sean I Savitz, Muhammad E Haque

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Article in Translational stroke research, 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

What it found

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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

10 authors.

Nina H NarimanInstitute for Stroke and Cerebrovascular Diseases and Department of Neurology, McGovern Medical School, The University of Texas Health Science Center at Houston (UTHealth), Houston, USA.
Md Faruk HossainDepartment of Biostatistics and Data Science, UTHealth Houston School of Public Health, McGovern Medical School, The University of Texas Health Science Center at Houston (UTHealth), Houston, USA.
Khader M HasanDepartment of Interventional Diagnostic Radiology, McGovern Medical School, The University of Texas Health Science Center at Houston (UTHealth), Houston, USA.
Vahed MaroufyDepartment of Biostatistics and Data Science, UTHealth Houston School of Public Health, McGovern Medical School, The University of Texas Health Science Center at Houston (UTHealth), Houston, USA.
Seth B BorenInstitute for Stroke and Cerebrovascular Diseases and Department of Neurology, McGovern Medical School, The University of Texas Health Science Center at Houston (UTHealth), Houston, USA.
Spencer SolbergInstitute for Stroke and Cerebrovascular Diseases and Department of Neurology, McGovern Medical School, The University of Texas Health Science Center at Houston (UTHealth), Houston, USA.
Robert SuchtingDepartment of Psychiatry and Behavioral Sciences, McGovern Medical School, The University of Texas Health Science Center at Houston (UTHealth), Houston, USA.
Clark SittonDepartment of Interventional Diagnostic Radiology, McGovern Medical School, The University of Texas Health Science Center at Houston (UTHealth), Houston, USA.
Sean I SavitzInstitute for Stroke and Cerebrovascular Diseases and Department of Neurology, McGovern Medical School, The University of Texas Health Science Center at Houston (UTHealth), Houston, USA.
Muhammad E HaqueInstitute for Stroke and Cerebrovascular Diseases and Department of Neurology, McGovern Medical School, The University of Texas Health Science Center at Houston (UTHealth), Houston, USA. Muhammad.E.Haque@uth.tmc.edu.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

After an intracerebral hemorrhage (ICH), impaired glymphatic function (GF) can result in neurotoxin buildup in the brain. In this serial MRI imaging study, we investigated the association between impaired GF and post-stroke cognitive impairment (PSCI). The glymphatic system is a waste clearance mechanism in the brain, consisting of the perivascular space (PVS) formed by astroglial end-feet surrounding arteries and veins. Glymphatic dysfunction has been associated with cognitive decline in patients with neurodegenerative diseases. The diffusion tensor imaging along the perivascular space (DTI-ALPS) index is a non-invasive imaging biomarker to monitor GF. The progression of PSCI in patients after ICH has not been well reported. Here, we serially evaluated GF via measuring the DTI-ALPS index and its association with PSCI after ICH. We serially imaged 18 patients with deep ICH at 9.3 ± 9.1 (V1) and 109 ± 28 (V2) days after stroke on a 3T MRI system. Cognitive assessment and stroke severity were obtained via the Montreal Cognitive Assessment (MoCA) and NIHSS, respectively. The DTI-ALPS index was calculated by measuring diffusivity in three regions of interest (ROI) orthogonal to the PVS surrounding the medullary veins. Hematoma (HV) and edema (EV) volumes were measured. The ipsilesional DTI-ALPS index was correlated with MoCA, HV, and NIHSS. The contralesional DTI-ALPS index was used as a control. Normality of all continuous variables was assessed using the Shapiro-Wilk test. As several key variables were non-normally distributed, non-parametric analyses were used, including Wilcoxon signed-rank tests for paired comparisons, Mann-Whitney U tests for group comparisons, and partial Spearman rank correlations (rS) to examine associations between the DTI-ALPS index and clinical or volumetric measures while adjusting for age and hematoma volume. We enrolled 12 M/6F with an average age of 49 ± 13y. The ipsilesional DTI-ALPS index was significantly lower than the contralesional DTI-ALPS index (p = 0.041) at V2. Temporally, NIHSS (median [IQR] 8.5 [1.0-13.8] to 2.5 [1.0-4.0], p = 0.002), HV (5.03 [3.31-12.62] to 1.28 [0.80-2.73] mL, p < 0.001), and EV (20.34 [9.62-35.44] to 1.09 [0.41-4.79] mL, p < 0.001) were significantly decreased. After adjustment for age and hematoma volume using partial Spearman correlation, the ipsilesional DTI-ALPS index showed a near-significant negative association with NIHSS (partial rS = - 0.48, p = 0.057) and a positive but non-significant association with MoCA (partial rS = 0.28, p = 0.301) at V2. Our finding demonstrated that the DTI-ALPS index is a feasible imaging biomarker for assessing glymphatic dysfunction and it is positively associated with cognitive impairment following intracerebral hemorrhage.

Indexed as

Cerebral HemorrhageCognitive DysfunctionGlymphatic SystemStrokeAgedDiffusion Tensor ImagingFemaleHumansMagnetic Resonance ImagingMaleMiddle AgedNeuroimagingDTI-ALPSGlymphatic systemIntracerebral hemorrhagePost-stroke cognitive impairmentQuantitative serial MRIStroke

Identifiers

PMID42257804

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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.