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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Frontiers Media S.A.
2025-04-01
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| 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. |
| format | Article |
| id | doaj-art-903928b54a5b4e6aac988bc6eea90db2 |
| institution | DOAJ |
| issn | 1664-2295 |
| language | English |
| publishDate | 2025-04-01 |
| publisher | Frontiers Media S.A. |
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| series | Frontiers in Neurology |
| 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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