Diffusion-Tensor MRI Study of the relationship between glymphatic system asymmetry and onset lateralization in Parkinson's disease

Motivation: The relationship between glymphatic system asymmetry and the side of motor symptom onset in PD remains unclear Goal(s): To explore the asymmetrical features of the glymphatic system in PD patients with different onset sides Approach: Using diffusion tensor image analysis along perivascular spaces (DTI-ALPS) method, bilateral hemispheric ALPS indices were calculated to assess glymphatic function, and an asymmetry index (AI) was derived to quantify the asymmetry of the glymphatic system. Results: PD patients with different onset sides have different patterns of glymphatic system function. The right-sided onset in PD patients may be associated with glymphatic system impairment. Impact: This study provides insights into the expected symptom profile of PD patients with different onset sides, allow for improved accuracy in predicting disease progression and outcomes, and potentially enable personalized treatments for PD in the future.