Evaluation of Imaging Difference in Glymphatic System between Motor Symptoms and Levodopa Responsiveness of Parkinson's Disease

Motivation: Growing evidence has shown that glymphatic dysfunction is closely linked to Parkinson’s disease(PD), yet its imaging in glymphatic system with motor symptoms remains unclear. Goal(s): Using three different imaging metrics to validate the association of the glymphatic system with motor symptoms before and after administration of exogenous levodopa, and levodopa responsiveness in PD. Approach: The calculation of DTI-ALPS index, the automated quantification of PVSs of basal ganglia region (BG-PVSs) and choroid plexus volume (CPV) based on MRI. Results: When DTI-ALPS index decreases and BG-PVSs and CPV increase, motor symptom gets worsen and levodopa effectiveness diminishes. Significant linear correlations were observed (CPV-DTI-ALPS, CPV-PVSs, DTI-ALPS-PVSs). Impact: This study employed three distinct imaging metrics (DTI-ALPS index, automated PVSs quantification, and CPV) to provide a more comprehensive characterization of the glymphatic system, affirming a correlation between glymphatic dysfunction and motor symptoms in Parkinson's patients.