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Longitudinal assessment of glymphatic changes following mild traumatic brain injury: Insights from perivascular space burden and DTI-ALPS imaging.
Zhuo, Jiachen; Raghavan, Prashant; Li, Jiang; Roys, Steven; Njonkou Tchoquessi, Rosy Linda; Chen, Hegang; Wickwire, Emerson M; Parikh, Gunjan Y; Schwartzbauer, Gary T; Grattan, Lynn M; Wang, Ze; Gullapalli, Rao P; Badjatia, Neeraj.
Afiliación
  • Zhuo J; Center for Advanced Imaging Research, University of Maryland School of Medicine, Baltimore, MD, United States.
  • Raghavan P; Department of Diagnostic Radiology and Nuclear Medicine, University of Maryland School of Medicine, Baltimore, MD, United States.
  • Li J; Department of Diagnostic Radiology and Nuclear Medicine, University of Maryland School of Medicine, Baltimore, MD, United States.
  • Roys S; Center for Advanced Imaging Research, University of Maryland School of Medicine, Baltimore, MD, United States.
  • Njonkou Tchoquessi RL; Department of Diagnostic Radiology and Nuclear Medicine, University of Maryland School of Medicine, Baltimore, MD, United States.
  • Chen H; Center for Advanced Imaging Research, University of Maryland School of Medicine, Baltimore, MD, United States.
  • Wickwire EM; Department of Diagnostic Radiology and Nuclear Medicine, University of Maryland School of Medicine, Baltimore, MD, United States.
  • Parikh GY; Center for Advanced Imaging Research, University of Maryland School of Medicine, Baltimore, MD, United States.
  • Schwartzbauer GT; Department of Diagnostic Radiology and Nuclear Medicine, University of Maryland School of Medicine, Baltimore, MD, United States.
  • Grattan LM; Department of Epidemiology and Public Health, University of Maryland School of Medicine, Baltimore, MD, United States.
  • Wang Z; Department of Psychiatry and Medicine, University of Maryland School of Medicine, Baltimore, MD, United States.
  • Gullapalli RP; Program in Trauma, University of Maryland School of Medicine, Baltimore, MD, United States.
  • Badjatia N; Department of Neurology, University of Maryland School of Medicine, Baltimore, MD, United States.
Front Neurol ; 15: 1443496, 2024.
Article en En | MEDLINE | ID: mdl-39170078
ABSTRACT

Introduction:

Traumatic brain injury (TBI) even in the mild form may result in long-lasting post-concussion symptoms. TBI is also a known risk to late-life neurodegeneration. Recent studies suggest that dysfunction in the glymphatic system, responsible for clearing protein waste from the brain, may play a pivotal role in the development of dementia following TBI. Given the diverse nature of TBI, longitudinal investigations are essential to comprehending the dynamic changes in the glymphatic system and its implications for recovery.

Methods:

In this prospective study, we evaluated two promising glymphatic imaging markers, namely the enlarged perivascular space (ePVS) burden and Diffusion Tensor Imaging-based ALPS index, in 44 patients with mTBI at two early post-injury time points approximately 14 days (14Day) and 6-12 months (6-12Mon) post-injury, while also examining their associations with post-concussion symptoms. Additionally, 37 controls, comprising both orthopedic patients and healthy individuals, were included for comparative analysis.

Results:

Our key findings include (1) White matter ePVS burden (WM-ePVS) and ALPS index exhibit significant correlations with age. (2) Elevated WM-ePVS burden in acute mTBI (14Day) is significantly linked to a higher number of post-concussion symptoms, particularly memory problems. (3) The increase in the ALPS index from acute (14Day) to the chronic (6-12Mon) phases in mTBI patients correlates with improvement in sleep measures. Furthermore, incorporating WM-ePVS burden and the ALPS index from acute phase enhances the prediction of chronic memory problems beyond socio-demographic and basic clinical information.

Conclusion:

ePVS burden and ALPS index offers distinct values in assessing glymphatic structure and activity. Early evaluation of glymphatic function could be crucial for understanding TBI recovery and developing targeted interventions to improve patient outcomes.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: Front Neurol Año: 2024 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Suiza
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: Front Neurol Año: 2024 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Suiza