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This study was sponsored by the Spanish Ministry of Economy and Competitiveness (MINECO PID2020-114640GB-I00/AEI/10.13039/501100011033 and PID2023-146932NB-I00 financed by MICIU/AEI/110.13039/5011000111033/FEDER,UE to C.J. and B.S.), Generalitat de Catalunya (SGR 2021SGR00801) and supported by Maria de Maeztu Unit of Excellence (Institute of Neurosciences, University of Barcelona) CEX2021-001159-M, Ministry of Science and Innovation. I.R. was supported by a fellowship from La Caixa Foundation (LCF/BQ/DR22/11950012). J.P. was supported by a fellowship from the Ministry of Science and Innovation (PRE2021-099674). C.M.B. was supported by Maria de Maeztu Unit of Excellence CEX2021-001159-M/ financed by MICIU/AEI/10.13039/501100011033. J.O. was supported by a fellowship from the Ministry of Science, Innovation, and Universities (PRE2018-086675). The funders played no role in study design, data collection, analysis and interpretation of data, or the writing of this manuscript. We would like to thank the cooperation of patients, their relatives, and healthy control participants. We are indebted to the Magnetic Resonance Imaging core facility of the FRCB-IDIBAPS for technical support. We would also like to acknowledge the CERCA Programme/Generalitat de Catalunya.

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Clinical and brain volumetric correlates of decreased DTI-ALPS, suggestive of local glymphatic dysfunction, in iRBD

Publicado en:Npj Parkinsons Dis. 11 (1): 87- - 2025-04-23 11(1), DOI: 10.1038/s41531-025-00942-z

Autores: Roura, Ignacio; Pardo, Jessica; Martin-Barcelo, Cristina; Falcon, Carles; Oltra, Javier; Campabadal, Anna; Bargallo, Nuria; Serradell, Monica; Maya, Gerard; Montini, Angelica; Pont-Sunyer, Claustre; Gaig, Carles; Buongiorno, Mariateresa; Junque, Carme; Iranzo, Alex; Segura, Barbara

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Glymphatic alterations may underlie neurodegeneration in alpha-synucleinopathies. Reduced Diffusion-Tensor Imaging ALong the Perivascular Space (DTI-ALPS), a proxy of perivascular glymphatic activity, has been scarcely studied in isolated REM sleep behaviour disorder (iRBD), a prodromal synucleinopathy stage. Furthermore, its associations with clinical symptoms and brain structural abnormalities remain unexplored. We assessed the DTI-ALPS in sixty-two patients with iRBD and twenty-three healthy controls (HC), exploring its associations with clinical symptoms, cortical thickness and brain volumetric data. iRBD patients exhibited a lower DTI-ALPS and poorer odor identification, semantic fluency and processing speed relative to HC. The DTI-ALPS positively correlated with cognitive performance, olfactory function and amygdalar, hippocampal, brainstem and diencephalic volumes, and negatively with age in iRBD. Perivascular glymphatic activity is compromised in iRBD and is associated with brain atrophy and clinical risk factors of progression to alpha-synucleinopathies, supporting the potential of the DTI-ALPS index as an early imaging neurodegeneration marker.

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