Faculty, Staff and Student Publications
Language
English
Publication Date
11-1-2024
Journal
Multiple Sclerosis Journal
DOI
10.1177/13524585241280842
PMID
39344166
PMCID
PMC11568644
PubMedCentral® Posted Date
9-29-2024
PubMedCentral® Full Text Version
Post-print
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, n = 57) and higher disability (MS-H, n = 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 (d = -0.71, false discovery rate-corrected p-value (p-FDR) = 0.001) were found. The DTI-ALPS index correlated significantly with disease duration (rp = -0.29, p-FDR = 0.002) and EDSS (rsp = -0.35, p-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, p = 0.04, LL: OR = 0.94, p = 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.
Keywords
Humans, Female, Male, Adult, Multiple Sclerosis, Middle Aged, Glymphatic System, Diffusion Tensor Imaging, Brain, Severity of Illness Index, Multiple sclerosis, glymphatic system, DTI-ALPS, disability, neurodegeneration, neuroinflammation
Published Open-Access
yes
Recommended Citation
Bayoumi, Ahmed; Hasan, Khader M; Thomas, Joseph A; et al., "Glymphatic Dysfunction in Multiple Sclerosis and Its Association With Disease Pathology and Disability" (2024). Faculty, Staff and Student Publications. 1073.
https://digitalcommons.library.tmc.edu/uthmed_docs/1073