Altered Brain Glymphatic System Impairment in Early Parkinson’s Disease and Atypical Parkinsonism

Motivation: Parkinsonism neurodegeneration is driven by diverse proteinopathies. The brain glymphatic system associates with neurodegenerative disorders characterized by neurotoxic protein aggregation. Goal(s): To find more neuroimaging biomarkers and assist the target treatment of parkinsonism. Approach: We calculated ChP volume, ratio and ALPS index to reflect the brain glymphatic function to grasp the change of brain glymphatic function in early PD, PSP and MSA. Results: The ALPS was lowest in PSP while ChP showed a greater dispersion. When combining PD and MSA groups into α-synucleinopathies group and regarding PSP as tauopathy group, ALPS in tauopathy group was higher with an increasing ChP volume and ratio. Impact: Impaired glymphatic function might be a pathophysiology marker of neurodegeneration disorders. Although the dispersion of ChP implies that this may not be a stabilizing factor, impaired glymphatic hydrodynamic function also support for glymphatic dysfunction in the proteopathy of parkinsonism.