Diffusion MRI-based analysis of functional alterations of the glymphatic system in children with non-lesional epilepsy

Objective: Based on diffusion tensor imaging (DTI) data, we used DTI-analysis along the perivascular space (DTI-ALPS) and free-water mapping to investigate the function of the glymphatic system and its relationship with clinical features among pediatric patients with magnetic resonance imaging (MRI)...

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Main Authors: Bixia Wu, Gengbiao Zhang, Yanting Wang, Hongyi Zheng, Hui Tan, Wenbin Zheng
Format: Article
Language:English
Published: Elsevier 2025-03-01
Series:Neuroimage: Reports
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Online Access:http://www.sciencedirect.com/science/article/pii/S2666956025000054
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author Bixia Wu
Gengbiao Zhang
Yanting Wang
Hongyi Zheng
Hui Tan
Wenbin Zheng
author_facet Bixia Wu
Gengbiao Zhang
Yanting Wang
Hongyi Zheng
Hui Tan
Wenbin Zheng
author_sort Bixia Wu
collection DOAJ
description Objective: Based on diffusion tensor imaging (DTI) data, we used DTI-analysis along the perivascular space (DTI-ALPS) and free-water mapping to investigate the function of the glymphatic system and its relationship with clinical features among pediatric patients with magnetic resonance imaging (MRI)-negative non-lesional epilepsy (NLE). Methods: A total of 83 NLE children (mean age 9.25 ± 4.07 years) and 45 matched healthy controls (mean age 9.36 ± 3.89 years) were recruited. All eligible patients were routinely scanned by 3.0T MRI to rule out organic lesions, and DTI data were collected at the same time. The ALPS index and fractional volume of free water in white matter (FW-WM) in the brain were calculated to analyze the differences between groups and the correlation between the corresponding parameters and clinical indicators such as age of onset, duration of the disease, seizure frequency, and seizure duration. Results: The NLE group had significantly lower ALPS indexes in the left (ALPS-L, F = 4.415, p = 0.038) and right (ALPS-R, F = 12.673, p = 0.001) cerebral hemispheres compared to the HC group. ALPS-L was positively correlated with age of onset (r = 0.322, p = 0.008) and negatively correlated with FW-WM (r = −0.337, p < 0.001). Free-water mapping revealed substantially higher FW-WM in the NLE group compared to the HC group (F = 4.666, p = 0.033). Additionally, FW-WM was negatively correlated with age of onset (r = −0.463, p < 0.001) and positively associated with seizure control in children with NLE (r = 0.306, p = 0.012). Conclusion: Children with NLE have reduced glymphatic system function, and the underlying pathophysiologic mechanisms may be due to impaired interstitial fluid clearance and retention in the brain. DTI-ALPS and free-water mapping are useful noninvasive approaches for examining glymphatic function in children with NLE, with the FW-WM potentially serving as an imaging marker for disease progression and predicting clinical prognosis in children with NLE.
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spelling doaj-art-89bde3da3b89438b813c56d056cb14902025-01-31T05:12:35ZengElsevierNeuroimage: Reports2666-95602025-03-0151100237Diffusion MRI-based analysis of functional alterations of the glymphatic system in children with non-lesional epilepsyBixia Wu0Gengbiao Zhang1Yanting Wang2Hongyi Zheng3Hui Tan4Wenbin Zheng5Department of Radiology, Meizhou People's Hospital, Meizhou, ChinaDepartment of Radiology, The Second Affiliated Hospital, Shantou University Medical College, Shantou, ChinaDepartment of Radiology, The Second Affiliated Hospital, Shantou University Medical College, Shantou, ChinaDepartment of Radiology, The Second Affiliated Hospital, Shantou University Medical College, Shantou, ChinaDepartment of Radiology, The Second Affiliated Hospital, Shantou University Medical College, Shantou, ChinaDepartment of Radiology, The Second Affiliated Hospital, Shantou University Medical College, Shantou, China; Corresponding author. No.63, Dongxia North Road, Jinping District, Shantou City, Guangdong Province, 515041, China.Objective: Based on diffusion tensor imaging (DTI) data, we used DTI-analysis along the perivascular space (DTI-ALPS) and free-water mapping to investigate the function of the glymphatic system and its relationship with clinical features among pediatric patients with magnetic resonance imaging (MRI)-negative non-lesional epilepsy (NLE). Methods: A total of 83 NLE children (mean age 9.25 ± 4.07 years) and 45 matched healthy controls (mean age 9.36 ± 3.89 years) were recruited. All eligible patients were routinely scanned by 3.0T MRI to rule out organic lesions, and DTI data were collected at the same time. The ALPS index and fractional volume of free water in white matter (FW-WM) in the brain were calculated to analyze the differences between groups and the correlation between the corresponding parameters and clinical indicators such as age of onset, duration of the disease, seizure frequency, and seizure duration. Results: The NLE group had significantly lower ALPS indexes in the left (ALPS-L, F = 4.415, p = 0.038) and right (ALPS-R, F = 12.673, p = 0.001) cerebral hemispheres compared to the HC group. ALPS-L was positively correlated with age of onset (r = 0.322, p = 0.008) and negatively correlated with FW-WM (r = −0.337, p < 0.001). Free-water mapping revealed substantially higher FW-WM in the NLE group compared to the HC group (F = 4.666, p = 0.033). Additionally, FW-WM was negatively correlated with age of onset (r = −0.463, p < 0.001) and positively associated with seizure control in children with NLE (r = 0.306, p = 0.012). Conclusion: Children with NLE have reduced glymphatic system function, and the underlying pathophysiologic mechanisms may be due to impaired interstitial fluid clearance and retention in the brain. DTI-ALPS and free-water mapping are useful noninvasive approaches for examining glymphatic function in children with NLE, with the FW-WM potentially serving as an imaging marker for disease progression and predicting clinical prognosis in children with NLE.http://www.sciencedirect.com/science/article/pii/S2666956025000054ChildrenNon-lesional pediatric epilepsyGlymphatic systemDTI-ALPSFree-water mappingMRI
spellingShingle Bixia Wu
Gengbiao Zhang
Yanting Wang
Hongyi Zheng
Hui Tan
Wenbin Zheng
Diffusion MRI-based analysis of functional alterations of the glymphatic system in children with non-lesional epilepsy
Neuroimage: Reports
Children
Non-lesional pediatric epilepsy
Glymphatic system
DTI-ALPS
Free-water mapping
MRI
title Diffusion MRI-based analysis of functional alterations of the glymphatic system in children with non-lesional epilepsy
title_full Diffusion MRI-based analysis of functional alterations of the glymphatic system in children with non-lesional epilepsy
title_fullStr Diffusion MRI-based analysis of functional alterations of the glymphatic system in children with non-lesional epilepsy
title_full_unstemmed Diffusion MRI-based analysis of functional alterations of the glymphatic system in children with non-lesional epilepsy
title_short Diffusion MRI-based analysis of functional alterations of the glymphatic system in children with non-lesional epilepsy
title_sort diffusion mri based analysis of functional alterations of the glymphatic system in children with non lesional epilepsy
topic Children
Non-lesional pediatric epilepsy
Glymphatic system
DTI-ALPS
Free-water mapping
MRI
url http://www.sciencedirect.com/science/article/pii/S2666956025000054
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