Abnormal glymphatic system in patients with autoimmune encephalitis: Relationship with cognitive performance
Objectives: We aimed to explore the impact of glymphatic function in patients diagnosed with autoimmune encephalitis (AE). Methods: In this prospective longitudinal study, patients were recruited from Xijing Hospital between June 2020 and January 2024. Glymphatic function was evaluated using diffusi...
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| Language: | English |
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Elsevier
2025-02-01
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| Series: | Brain Research Bulletin |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S0361923025000449 |
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| author | Yingchi Zhang Dianwei Wu Zhirong Fan Xiuxiu Leng Ting Wan Xiaodan Shi Xiaomu Wang Xuan Wang Changgeng Song Fang Du Wen Jiang |
| author_facet | Yingchi Zhang Dianwei Wu Zhirong Fan Xiuxiu Leng Ting Wan Xiaodan Shi Xiaomu Wang Xuan Wang Changgeng Song Fang Du Wen Jiang |
| author_sort | Yingchi Zhang |
| collection | DOAJ |
| description | Objectives: We aimed to explore the impact of glymphatic function in patients diagnosed with autoimmune encephalitis (AE). Methods: In this prospective longitudinal study, patients were recruited from Xijing Hospital between June 2020 and January 2024. Glymphatic function was evaluated using diffusion tensor imaging analysis along the perivascular space (DTI-ALPS). Cognitive impairment was defined as a Montreal Cognitive Assessment (MoCA) score below 26 at the 12-month follow-up. Results: A total of 115 individuals were enrolled, including 85 patients with AE and 30 age- and sex-matched healthy controls (HCs). After correcting for age and sex, patients with AE had a significantly lower baseline ALPS index compared to HCs (1.173, 95 % CI [1.135, 1.210] vs. 1.456, 95 % CI [1.371, 1.541]; P < 0.001). The baseline ALPS index was correlated with cognitive performance, including a positive correlation with the Mini-Mental State Examination (MMSE) score (r = 0.568, P < 0.001) and a positive correlation with the MoCA score (r = 0.645, P < 0.001). In the longitudinal study, the ALPS index gradually increased over the follow-up period (P < 0.001), and a low level of the baseline ALPS index was associated with a higher risk of long-term cognitive impairment (HR [95 % CI] = 1.70 [1.12–2.58], P = 0.013). Conclusion: The glymphatic system is impaired in AE patients. A decreased DTI-ALPS index is associated with a decline in cognitive performance. Additionally, a low baseline ALPS index may predict an increased risk of long-term cognitive impairment in AE patients. |
| format | Article |
| id | doaj-art-700a52cfefe8492197cea8361b4f6e08 |
| institution | Kabale University |
| issn | 1873-2747 |
| language | English |
| publishDate | 2025-02-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Brain Research Bulletin |
| spelling | doaj-art-700a52cfefe8492197cea8361b4f6e082025-02-07T04:46:48ZengElsevierBrain Research Bulletin1873-27472025-02-01221111232Abnormal glymphatic system in patients with autoimmune encephalitis: Relationship with cognitive performanceYingchi Zhang0Dianwei Wu1Zhirong Fan2Xiuxiu Leng3Ting Wan4Xiaodan Shi5Xiaomu Wang6Xuan Wang7Changgeng Song8Fang Du9Wen Jiang10Department of Neurology, Xijing Hospital, Air Force Medical University, Xi’an, Shaanxi Province 710038, ChinaDepartment of Neurology, Xijing Hospital, Air Force Medical University, Xi’an, Shaanxi Province 710038, ChinaDepartment of Neurology, Xijing Hospital, Air Force Medical University, Xi’an, Shaanxi Province 710038, ChinaDepartment of Neurology, Xijing Hospital, Air Force Medical University, Xi’an, Shaanxi Province 710038, ChinaDepartment of Neurology, Xijing Hospital, Air Force Medical University, Xi’an, Shaanxi Province 710038, ChinaDepartment of Neurology, Xijing Hospital, Air Force Medical University, Xi’an, Shaanxi Province 710038, ChinaDepartment of Neurology, Xijing Hospital, Air Force Medical University, Xi’an, Shaanxi Province 710038, ChinaDepartment of Neurology, Xijing Hospital, Air Force Medical University, Xi’an, Shaanxi Province 710038, ChinaCorresponding authors.; Department of Neurology, Xijing Hospital, Air Force Medical University, Xi’an, Shaanxi Province 710038, ChinaCorresponding authors.; Department of Neurology, Xijing Hospital, Air Force Medical University, Xi’an, Shaanxi Province 710038, ChinaCorresponding authors.; Department of Neurology, Xijing Hospital, Air Force Medical University, Xi’an, Shaanxi Province 710038, ChinaObjectives: We aimed to explore the impact of glymphatic function in patients diagnosed with autoimmune encephalitis (AE). Methods: In this prospective longitudinal study, patients were recruited from Xijing Hospital between June 2020 and January 2024. Glymphatic function was evaluated using diffusion tensor imaging analysis along the perivascular space (DTI-ALPS). Cognitive impairment was defined as a Montreal Cognitive Assessment (MoCA) score below 26 at the 12-month follow-up. Results: A total of 115 individuals were enrolled, including 85 patients with AE and 30 age- and sex-matched healthy controls (HCs). After correcting for age and sex, patients with AE had a significantly lower baseline ALPS index compared to HCs (1.173, 95 % CI [1.135, 1.210] vs. 1.456, 95 % CI [1.371, 1.541]; P < 0.001). The baseline ALPS index was correlated with cognitive performance, including a positive correlation with the Mini-Mental State Examination (MMSE) score (r = 0.568, P < 0.001) and a positive correlation with the MoCA score (r = 0.645, P < 0.001). In the longitudinal study, the ALPS index gradually increased over the follow-up period (P < 0.001), and a low level of the baseline ALPS index was associated with a higher risk of long-term cognitive impairment (HR [95 % CI] = 1.70 [1.12–2.58], P = 0.013). Conclusion: The glymphatic system is impaired in AE patients. A decreased DTI-ALPS index is associated with a decline in cognitive performance. Additionally, a low baseline ALPS index may predict an increased risk of long-term cognitive impairment in AE patients.http://www.sciencedirect.com/science/article/pii/S0361923025000449Autoimmune encephalitisGlymphatic systemDiffusion tensor imageCognitive performance |
| spellingShingle | Yingchi Zhang Dianwei Wu Zhirong Fan Xiuxiu Leng Ting Wan Xiaodan Shi Xiaomu Wang Xuan Wang Changgeng Song Fang Du Wen Jiang Abnormal glymphatic system in patients with autoimmune encephalitis: Relationship with cognitive performance Brain Research Bulletin Autoimmune encephalitis Glymphatic system Diffusion tensor image Cognitive performance |
| title | Abnormal glymphatic system in patients with autoimmune encephalitis: Relationship with cognitive performance |
| title_full | Abnormal glymphatic system in patients with autoimmune encephalitis: Relationship with cognitive performance |
| title_fullStr | Abnormal glymphatic system in patients with autoimmune encephalitis: Relationship with cognitive performance |
| title_full_unstemmed | Abnormal glymphatic system in patients with autoimmune encephalitis: Relationship with cognitive performance |
| title_short | Abnormal glymphatic system in patients with autoimmune encephalitis: Relationship with cognitive performance |
| title_sort | abnormal glymphatic system in patients with autoimmune encephalitis relationship with cognitive performance |
| topic | Autoimmune encephalitis Glymphatic system Diffusion tensor image Cognitive performance |
| url | http://www.sciencedirect.com/science/article/pii/S0361923025000449 |
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