Perivascular space fluid diffusivity predicts clinical deterioration in prodromal and early-stage Parkinson's disease

Area of Science:

• Neuroscience
• Neurology
• Biomedical Imaging

Background:

• The glymphatic system clears brain waste, and its dysfunction is implicated in neurodegenerative diseases like Parkinson's disease (PD).
• Early detection of glymphatic system impairment in PD is crucial for developing effective therapies.

Purpose of the Study:

• To assess glymphatic function alterations in prodromal PD (pPD) and de novo PD (dnPD) patients.
• To investigate the correlation between glymphatic function and disease progression in early PD stages.

Main Methods:

• Utilized diffusion tensor imaging to calculate the Aquaporinalpha-linked water conductivity (ALPS) index for glymphatic function assessment.
• Categorized participants into prodromal PD, de novo PD, and healthy control groups, stratified by age.
• Conducted longitudinal analysis to track changes in the ALPS index over time.

Main Results:

• Older pPD and dnPD patients exhibited significantly lower ALPS index values compared to controls.
• A decreased ALPS index correlated with increased severity of both motor and non-motor symptoms.
• Longitudinal data showed a decline in ALPS index in pPD patients who progressed to clinical PD.
• Baseline ALPS index predicted motor and non-motor symptom progression in pPD and motor symptom progression in older dnPD patients.

Conclusions:

• Glymphatic system function, indicated by the ALPS index, is impaired in the early stages of Parkinson's disease.
• The ALPS index serves as a potential biomarker for predicting disease progression and symptom severity in PD.