Glymphatic System Impairment in Different Stages of Parkinson's Disease: Evidence from DTI-ALPS Imaging

Motivation: Understanding the role of brain glymphatic dysfunction in Parkinson's disease (PD) is crucial for exploring potential therapeutic targets. Goal(s): To evaluate the abnormality of ALPS-index and its association with clinical parameters in PD patients. Approach: 71 PD patients and 102 healthy controls underwent MRI scans. The ALPS index was calculated using DTI-ALPS. PD patients were classified into early and advanced stages using k-means. Statistical analyses compared groups and correlations. Results: 44 early PD and 27 advanced PD patients. Advanced PD showed significantly lower ALPS-index compared to HCs and early PD, with better diagnostic performance (AUC=0.71) and significant correlations with age and disease severity. Impact: Alps-index changes intensify in advanced PD stages, indicating potential as a progression marker. This emphasizes the need for longitudinal studies to validate it as a tool for monitoring PD progression and assessing therapeutic interventions.