Reduced DTI-ALPS in H-type hypertension: insights into perivascular space function

Recent studies suggest that glymphatic dysfunction plays a significant role in vascular cognitive impairment (VCI). Both hypertension and hyperhomocysteinemia are independent risk factors for VCI, and their combination is referred to as H-type hypertension (HHT). However, the impact of HHT on glymph...

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Main Authors: Chun Zhang, Caihong Song, Shiying Sheng, Liang Pan, Lingling Sun, Wei Xing
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-04-01
Series:Frontiers in Neurology
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Online Access:https://www.frontiersin.org/articles/10.3389/fneur.2025.1536001/full
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author Chun Zhang
Chun Zhang
Caihong Song
Shiying Sheng
Liang Pan
Lingling Sun
Wei Xing
author_facet Chun Zhang
Chun Zhang
Caihong Song
Shiying Sheng
Liang Pan
Lingling Sun
Wei Xing
author_sort Chun Zhang
collection DOAJ
description Recent studies suggest that glymphatic dysfunction plays a significant role in vascular cognitive impairment (VCI). Both hypertension and hyperhomocysteinemia are independent risk factors for VCI, and their combination is referred to as H-type hypertension (HHT). However, the impact of HHT on glymphatic function remains unclear. This study used the recently popular indirect marker, diffusion tensor imaging along the perivascular space (DTI-ALPS) to assess potential changes in glymphatic function in patients with HHT. We recruited 58 HHT patients and 50 healthy controls without hypertension, collecting clinical, cognitive, biochemical, and diffusion MRI data. Behaviorally, HHT patients scored lower on global cognitive tests compared to controls. DTI-ALPS analysis revealed a bilateral reduction in DTI-ALPS in HHT patients. Correlation analysis showed strong associations between lower DTI-ALPS values, reduced cognitive scores, and elevated homocysteine (Hcy) levels in HHT patients. Mediation analysis further indicated that DTI-ALPS largely mediates the relationship between Hcy levels and cognitive performance. These findings suggest that hypertension and elevated Hcy levels contribute to DTI-ALPS reduction, which may underlie the cognitive decline observed in HHT.
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issn 1664-2295
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publishDate 2025-04-01
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spelling doaj-art-903928b54a5b4e6aac988bc6eea90db22025-08-20T03:07:31ZengFrontiers Media S.A.Frontiers in Neurology1664-22952025-04-011610.3389/fneur.2025.15360011536001Reduced DTI-ALPS in H-type hypertension: insights into perivascular space functionChun Zhang0Chun Zhang1Caihong Song2Shiying Sheng3Liang Pan4Lingling Sun5Wei Xing6Department of Radiology, Third Affiliated Hospital of Soochow University, Changzhou, ChinaDepartment of Radiology, Huai’an Maternity and Child Healthcare Hospital, Huai’an, ChinaDepartment of Laboratory Medicine, The Fifth People's Hospital of Huaian, Huai’an, ChinaDepartment of Neurology, Third Affiliated Hospital of Soochow University, Changzhou, ChinaDepartment of Radiology, Third Affiliated Hospital of Soochow University, Changzhou, ChinaDepartment of Radiology, Third Affiliated Hospital of Soochow University, Changzhou, ChinaDepartment of Radiology, Third Affiliated Hospital of Soochow University, Changzhou, ChinaRecent studies suggest that glymphatic dysfunction plays a significant role in vascular cognitive impairment (VCI). Both hypertension and hyperhomocysteinemia are independent risk factors for VCI, and their combination is referred to as H-type hypertension (HHT). However, the impact of HHT on glymphatic function remains unclear. This study used the recently popular indirect marker, diffusion tensor imaging along the perivascular space (DTI-ALPS) to assess potential changes in glymphatic function in patients with HHT. We recruited 58 HHT patients and 50 healthy controls without hypertension, collecting clinical, cognitive, biochemical, and diffusion MRI data. Behaviorally, HHT patients scored lower on global cognitive tests compared to controls. DTI-ALPS analysis revealed a bilateral reduction in DTI-ALPS in HHT patients. Correlation analysis showed strong associations between lower DTI-ALPS values, reduced cognitive scores, and elevated homocysteine (Hcy) levels in HHT patients. Mediation analysis further indicated that DTI-ALPS largely mediates the relationship between Hcy levels and cognitive performance. These findings suggest that hypertension and elevated Hcy levels contribute to DTI-ALPS reduction, which may underlie the cognitive decline observed in HHT.https://www.frontiersin.org/articles/10.3389/fneur.2025.1536001/fullhypertensionhomocysteineglymphatic functiondiffusion imagingvascular cognitive impairment
spellingShingle Chun Zhang
Chun Zhang
Caihong Song
Shiying Sheng
Liang Pan
Lingling Sun
Wei Xing
Reduced DTI-ALPS in H-type hypertension: insights into perivascular space function
Frontiers in Neurology
hypertension
homocysteine
glymphatic function
diffusion imaging
vascular cognitive impairment
title Reduced DTI-ALPS in H-type hypertension: insights into perivascular space function
title_full Reduced DTI-ALPS in H-type hypertension: insights into perivascular space function
title_fullStr Reduced DTI-ALPS in H-type hypertension: insights into perivascular space function
title_full_unstemmed Reduced DTI-ALPS in H-type hypertension: insights into perivascular space function
title_short Reduced DTI-ALPS in H-type hypertension: insights into perivascular space function
title_sort reduced dti alps in h type hypertension insights into perivascular space function
topic hypertension
homocysteine
glymphatic function
diffusion imaging
vascular cognitive impairment
url https://www.frontiersin.org/articles/10.3389/fneur.2025.1536001/full
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