Vascular risk factors and astrocytic marker for the glymphatic system activity

Author:

Wei Yi-ChiaORCID,Hsu Chih-Chin Heather,Huang Wen-Yi,Lin Chemin,Chen Chih-Ken,Chen Yao-Liang,Chen Pin-Yuan,Shyu Yu-Chiau,Lin Ching-Po

Abstract

Abstract Objectives Glymphatic system maintains brain fluid circulation via active transportation of astrocytic aquaporin-4 in perivascular space. The diffusion tensor imaging analysis along the perivascular space (DTI-ALPS) is an established method measuring perivascular glymphatic activity, but comprehensive investigations into its influential factors are lacking. Methods Community-dwelling older adults underwent brain MRI scans, neuropsychiatric, and multi-domain assessments. Blood biomarker tests included glial fibrillary acidic protein (GFAP) for astrocyte injury. Results In 71 enrolled participants, the DTI-ALPS index was associated with modifiable factors, including lipid profile (high-density lipoprotein, r = 0.396; very-low-density lipoprotein, r =  − 0.342), glucose intolerance (diabetes mellitus, standardized mean difference (SMD) = 0.7662; glycated hemoglobin, r =  − 0.324), obesity (body mass index, r =  − 0.295; waist, r =  − 0.455), metabolic syndrome (SMD =   − 0.6068), cigarette-smoking (SMD =  − 0.6292), and renal clearance (creatinine, r =  − 0.387; blood urea nitrogen, r =  − 0.303). Unmodifiable associative factors of DTI-ALPS were age (r =  − 0.434) and sex (SMD = 1.0769) (all p < 0.05). A correlation of DTI-ALPS and blood GFAP was noticed (r =  − 0.201, one-tailed t-test for the assumption that astrocytic injury impaired glymphatic activity, p = 0.046). Their cognitive correlations diverged, domain-specific for DTI-ALPS (Facial Memory Test, r = 0.272, p = 0.022) but global cognition-related for blood GFAP (MoCA, r =  − 0.264, p = 0.026; ADAS-cog, r = 0.304, p = 0.010). Conclusion This correlation analysis revealed multiple modifiable and unmodifiable association factors to the glymphatic image marker. The DTI-ALPS index correlated with various metabolic factors that are known to increase the risk of vascular diseases such as atherosclerosis. Furthermore, the DTI-ALPS index was associated with renal indices, and this connection might be a link of water regulation between the two systems. In addition, the astrocytic biomarker, plasma GFAP, might be a potential marker of the glymphatic system; however, more research is needed to confirm its effectiveness.

Funder

Chang Gung Memorial Hospital

Ministry of Science and Technology, Taiwan

Center for Big Data Analytics and Statistics, Chang Gung Memorial Hospital

Publisher

Springer Science and Business Media LLC

Subject

Radiology, Nuclear Medicine and imaging,General Medicine

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