Clinical and brain volumetric correlates of decreased DTI-ALPS, suggestive of local glymphatic dysfunction, in iRBD
Glymphatic alterations may underlie neurodegeneration in alpha-synucleinopathies. Reduced Diffusion-Tensor Imaging ALong the Perivascular Space (DTI-ALPS), a proxy of perivascular glymphatic activity, has been scarcely studied in isolated REM sleep behaviour disorder (iRBD), a prodromal synucleinopathy stage. Furthermore, its associations with clinical symptoms and brain structural abnormalities remain unexplored. We assessed the DTI-ALPS in sixty-two patients with iRBD and twenty-three healthy controls (HC), exploring its associations with clinical symptoms, cortical thickness and brain volumetric data. iRBD patients exhibited a lower DTI-ALPS and poorer odor identification, semantic fluency and processing speed relative to HC. The DTI-ALPS positively correlated with cognitive performance, olfactory function and amygdalar, hippocampal, brainstem and diencephalic volumes, and negatively with age in iRBD. Perivascular glymphatic activity is compromised in iRBD and is associated with brain atrophy and clinical risk factors of progression to alpha-synucleinopathies, supporting the potential of the DTI-ALPS index as an early imaging neurodegeneration marker.
Authors
- Claustre Pont‐Sunyer (ORCID: https://orcid.org/0000-0003-1102-7746)
- Mónica Serradell (ORCID: https://orcid.org/0000-0002-2954-3020)
- A. Iranzo (ORCID: https://orcid.org/0000-0002-5618-8271)
- Jèssica Pardo (ORCID: https://orcid.org/0000-0003-4665-4213)
- Bàrbara Segura (ORCID: https://orcid.org/0000-0002-9673-5479)
- Carme Junqué (ORCID: https://orcid.org/0000-0002-6381-3063)
- Carles Falcón (ORCID: https://orcid.org/0000-0001-5564-2025)
- Javier Oltra (ORCID: https://orcid.org/0000-0002-9268-4504)
- Anna Campabadal (ORCID: https://orcid.org/0000-0002-2833-4884)
- Angelica Montini (ORCID: https://orcid.org/0000-0001-5625-8850)
- Núria Bargalló (ORCID: https://orcid.org/0000-0001-6284-5402)
- Ignacio Roura (ORCID: https://orcid.org/0000-0001-8877-899X)
- Maríateresa Buongiorno (ORCID: https://orcid.org/0000-0002-1745-5744)
- Gerard Mayà (ORCID: https://orcid.org/0000-0002-5025-2615)
- Carles Gaig (ORCID: https://orcid.org/0000-0002-7113-8125)
- Cristina Martín‐Barceló (ORCID: https://orcid.org/0009-0000-4445-8556)
Institutions
- Stockholm University (SE)
- Karolinska Institutet (SE)
- Biomedical Research Networking Center on Neurodegenerative Diseases (ES)
- Biomedical Research Networking Center in Bioengineering, Biomaterials and Nanomedicine (ES)
- Hospital General de Granollers (ES)
- Centro de Investigación Biomédica en Red (ES)
- Hospital Clínic de Barcelona (ES)
- Corporació Sanitària Parc Taulí (ES)
- Vall d'Hebron Hospital Universitari (ES)
- Hospital Universitari de Vic (ES)
- Consorci Institut D'Investigacions Biomediques August Pi I Sunyer (ES)
- Universitat de Barcelona (ES)
Publication Details
- Journal
- npj Parkinson s Disease
- Published
- 2025-04-23
- DOI
- https://doi.org/10.1038/s41531-025-00942-z
- Citations
- 8
- Primary Topic
- Cerebrospinal fluid and hydrocephalus
- Type
- article
- Field-Weighted Citation Impact
- 7.27
Funders
- “la Caixa” Foundation
- Centres de Recerca de Catalunya
- Generalitat de Catalunya
- Ministerio de Economía y Competitividad
- Ministerio de Ciencia e Innovación
- Universitat de Barcelona
- Agencia Estatal de Investigación