Diffusion tensor imaging and the analysis along the perivascular space (ALPS) index in sleep disorders

Abstract Background Insomnia, the most common sleep disorder, is mainly defined by deficits in daytime functioning and challenges in keeping and starting sleep. The investigation of the white matter (WM) networks of the brain may yield respected insights into the fundamental neural approach of insomnia. The analysis lengthwise the perivascular space (ALPS) index and diffusion tensor imaging (DTI) have lately been presented as non-harmful instruments to evaluate these changes. Consequently, the purpose of this study was to judge WM microstructural modifications and glymphatic system function in adults with insomnia utilizing DTI-derived parameters and the ALPS index. Methods This prospective case–control study included 50 adults analyzed with insomnia and fifty gender and age-matched healthy controls. All participants endured brain MRI with DTI acquisition. Quantitative analysis of mean diffusivity (MD), radial diffusivity (RD), fractional anisotropy (FA), and axial diffusivity (AD) was achieved in different WM areas, involving the corona radiata, internal capsule, thalamic radiation, superior longitudinal fasciculus, and corpus callosum. Glymphatic function was measured utilizing the DTI-ALPS index. Results Adults with insomnia demonstrated significantly decreased FA and improved RD and MD principles across many WM tracts, involving the anterior limb of the internal capsule, superior longitudinal fasciculus, superior corona radiata, and corpus callosum. Dyy, Dzz, and Dxx diffusivities were significantly increased, whereas the DTI-ALPS index was significantly reduced, representing glymphatic dysfunction. ROC analysis demonstrated excellent diagnostic performance of MD and RD parameters, particularly within the SLF and SCR. These results recommend that insomnia is related to both impaired glymphatic function and WM microstructural abnormalities. Conclusions Insomnia is related to WM microstructural abnormalities and impaired glymphatic system function. The combination of DTI metrics and the ALPS index provides valuable, non-invasive biomarkers for early detection and characterization of neural alterations in insomnia.