A novel early imaging biomarker for glymphatic function: Cerebral cortical arterial pulsatility index from 2-Minute phase-contrast MRI

초록

BACKGROUND: Arterial pulsatility is one of the driving forces of glymphatic flow. OBJECTIVE: To evaluate the feasibility of the pulsatility index (PI) of cortical arteries in the centrum semiovale (PICSO) as a novel non-invasive imaging biomarker for Alzheimer's disease (AD) in the context of glymphatic function. METHODS: Retrospective cross-sectional study. METHODS: Single tertiary academic center equipped with both 3.0 T MRI systems. METHODS: A total of 160 individuals were enrolled: 50 healthy volunteers, 46 cognitively normal controls, and 64 AD patients who underwent diffusion tensor imaging (DTI) and 2D phase-contrast MRI. METHODS: Diffusion Tensor Imaging Analysis along the Perivascular Space (DTI-ALPS) index and PICSO were assessed using 2D phase-contrast MRI. Correlations with age, DTI-ALPS index, and Mini-Mental State Examination (MMSE) scores were analyzed. RESULTS: PICSO was significantly higher in the AD group than those in healthy volunteers (P<0.001) and cognitively normal aging (P=0.001) groups. PICSO correlated positively with age (rho=0.613, P<0.001) and negatively with both the DTI-ALPS index (rho=-0.439, P<0.001) and MMSE scores (rho=-0.486, P<0.001) in total group. CONCLUSIONS: PICSO derived from 2D phase-contrast 3.0T MRI may serve as a novel imaging biomarker for Alzheimer's disease in relation to glymphatic function. Copyright © 2025. Published by Elsevier Masson SAS.

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