Evaluation of Surgery for Improving Brain Glymphatic Circulation in Slowing Advanced Alzheimer’s Disease Progression by Glymphatic MRI

Motivation: MRI technology can be used to assess glymphatic system function and to determine if it can detect changes before and after surgery. Goal(s): This study examines changes in perivascular networks in AD patients before and after surgery as measured by MRI. Approach: Using MRI, we measured brain volume in healthy controls and in AD patients before and after surgery, focusing on PVSVF, FW-WM, and ALPS index. Results: Preoperative AD patients, compared to controls, showed reduced brain volume, increased cerebrospinal fluid volume, elevated FW-WM, and decreased ALPS index. Postoperatively, one patient exhibited reduced FW-WM and an increase in ALPS. Impact: A decrease in ALPS indicates a lower cerebrospinal fluid clearance rate in AD patients, while increased FW-WM suggests fluid accumulation in the brain's interstitial space. Postoperative changes imply improved cerebrospinal fluid clearance and a reduction in prior accumulation.