Abstract：
BACKGROUND: Impaired α-synuclein clearance is pivotal in the pathogenesis of neurodegenerative diseases. We evaluated glymphatic clearance in multiple system atrophy (MSA) patients using advanced imaging.
METHODS: Forty-four MSA patients (11 with MSA-parkinsonian type [MSA-P] and 33 with MSA-cerebellar type [MSA-C]) and 30 healthy controls were studied using diffusion spectrum magnetic resonance imaging (DSI-MRI). Diffusivities were measured along the x-, y-, and z-axes to calculate the Analysis Along the Perivascular Space (ALPS) index. Comparisons of the ALPS index were conducted between MSA patients and controls and among MSA subtypes. The ALPS index correlation with the Unified Multiple System Atrophy Rating Scale (UMSARS) scores was also analyzed.
RESULTS: The ALPS index differed significantly between patients with MSA and healthy controls, with lower values observed in the former (1.46 ± 0.17 versus1.63 ± 0.12, p < 0.001). Both MSA-P and MSA-C patients had lower ALPS-index (1.40 ± 0.13, p < 0.001; 1.47 ± 0.18, p = 0.003, respectively), but there was no significant difference between the two (p = 0.22). No correlation was found between the ALPS index and clinical scores for UMASRS I (r = -0.08, p = 0.61), UMASRS II (r = -0.04, p = 0.81), or UMASRS I + II (r = -0.05, p = 0.74).
CONCLUSIONS: MSA patients show reduced glymphatic clearance as measured by the ALPS index, underscoring the utility of this imaging method in neurodegenerative disease research.
METHODS: Forty-four MSA patients (11 with MSA-parkinsonian type [MSA-P] and 33 with MSA-cerebellar type [MSA-C]) and 30 healthy controls were studied using diffusion spectrum magnetic resonance imaging (DSI-MRI). Diffusivities were measured along the x-, y-, and z-axes to calculate the Analysis Along the Perivascular Space (ALPS) index. Comparisons of the ALPS index were conducted between MSA patients and controls and among MSA subtypes. The ALPS index correlation with the Unified Multiple System Atrophy Rating Scale (UMSARS) scores was also analyzed.
RESULTS: The ALPS index differed significantly between patients with MSA and healthy controls, with lower values observed in the former (1.46 ± 0.17 versus1.63 ± 0.12, p < 0.001). Both MSA-P and MSA-C patients had lower ALPS-index (1.40 ± 0.13, p < 0.001; 1.47 ± 0.18, p = 0.003, respectively), but there was no significant difference between the two (p = 0.22). No correlation was found between the ALPS index and clinical scores for UMASRS I (r = -0.08, p = 0.61), UMASRS II (r = -0.04, p = 0.81), or UMASRS I + II (r = -0.05, p = 0.74).
CONCLUSIONS: MSA patients show reduced glymphatic clearance as measured by the ALPS index, underscoring the utility of this imaging method in neurodegenerative disease research.
摘要：
背景：受损的α-突触核蛋白清除在神经退行性疾病的发病机制中至关重要。我们使用高级成像评估了多系统萎缩（MSA）患者的淋巴清除。
方法：使用扩散谱磁共振成像（DSI-MRI）研究了44例MSA患者（11例MSA-帕金森病型[MSA-P]和33例MSA-小脑型[MSA-C]）和30例健康对照。沿着x-测量扩散率，-,和z轴计算沿着血管周空间(ALPS)指数的分析。在MSA患者和对照组之间以及MSA亚型之间进行了ALPS指数的比较。还分析了ALPS指数与统一多系统萎缩评定量表（UMSARS）评分的相关性。
结果：MSA患者与健康对照组的ALPS指数有显著差异，前者观察到较低的值(1.46±0.17对1.63±0.12，p<0.001)。MSA-P和MSA-C患者的ALPS指数均较低（分别为1.40±0.13，p<0.001；1.47±0.18，p=0.003），但是两者之间没有显着差异（p=0.22）。ALPS指数与UMASRSI的临床评分无相关性(r=-0.08,p=0.61),UMASRSII（r=-0.04，p=0.81），或UMASRSI+II（r=-0.05，p=0.74）。
结论：MSA患者显示ALPS指数测量的淋巴清除降低，强调了这种成像方法在神经退行性疾病研究中的实用性。
方法：使用扩散谱磁共振成像（DSI-MRI）研究了44例MSA患者（11例MSA-帕金森病型[MSA-P]和33例MSA-小脑型[MSA-C]）和30例健康对照。沿着x-测量扩散率，-,和z轴计算沿着血管周空间(ALPS)指数的分析。在MSA患者和对照组之间以及MSA亚型之间进行了ALPS指数的比较。还分析了ALPS指数与统一多系统萎缩评定量表（UMSARS）评分的相关性。
结果：MSA患者与健康对照组的ALPS指数有显著差异，前者观察到较低的值(1.46±0.17对1.63±0.12，p<0.001)。MSA-P和MSA-C患者的ALPS指数均较低（分别为1.40±0.13，p<0.001；1.47±0.18，p=0.003），但是两者之间没有显着差异（p=0.22）。ALPS指数与UMASRSI的临床评分无相关性(r=-0.08,p=0.61),UMASRSII（r=-0.04，p=0.81），或UMASRSI+II（r=-0.05，p=0.74）。
结论：MSA患者显示ALPS指数测量的淋巴清除降低，强调了这种成像方法在神经退行性疾病研究中的实用性。
