Glymphatic Dysfunction in Multiple Sclerosis and Its Association with Disease Pathology and Disability

Overview

Journal Mult Scler

Publisher Sage Publications

Specialty Neurology

Date 2024 Sep 30

PMID 39344166

Authors

Ahmed Bayoumi

Khader M Hasan

Joseph A Thomas

Akram Yazdani

John A Lincoln

Affiliations

Soon will be listed here.

Abstract

Background: The role of the glymphatic system in multiple sclerosis (MS)-related disability remains underexplored. Diffusion-tensor image analysis along the perivascular space (DTI-ALPS) offers a non-invasive method to assess glymphatic function.

Objective: To evaluate glymphatic function in MS patients with lower and higher disability.

Methods: This study included 118 MS patients who underwent structural, diffusion-weighted imaging, and clinical assessment. The participants were divided into lower (MS-L, = 57) and higher disability (MS-H, = 61) subgroups. Brain parenchymal fraction (BPF), lesion load (LL), and DTI-ALPS index were measured. Subgroup differences and correlations between DTI-ALPS index and other measures were explored. Logistic regression was performed to evaluate BPF, LL, and DTI-ALPS index in classifying lower and higher disability patients.

Results: Significant differences in DTI-ALPS index between MS-H and MS-L ( = -0.71, false discovery rate-corrected -value (FDR) = 0.001) were found. The DTI-ALPS index correlated significantly with disease duration ( = -0.29, FDR = 0.002) and EDSS ( = -0.35, FDR = 0.0002). It also showed significant correlations with BPF and LL. DTI-ALPS index and LL were significant predictors of disability subgroup (DTI-ALPS: odds ratio (OR) = 1.77, = 0.04, LL: OR = 0.94, = 0.02).

Conclusion: Our findings highlight DTI-ALPS index as an imaging biomarker in MS, suggesting the involvement of glymphatic impairment in MS pathology, although further research is needed to elucidate its role in contributing to MS-related disability.

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