The left DTI-ALPS index: a potential glymphatic mediator of cognitive and motor dysfunction in Parkinson’s disease
Bibliographic record
Abstract
Introduction This study employed the Diffusion Tensor Imaging Along the Perivascular Space (DTI-ALPS) index to evaluate glymphatic function in patients with Parkinson’s disease (PD) and investigated its association with cognitive and motor functions. Methods Clinical data from the PD group ( n = 64) and the healthy control group (HC, n = 30), matched for age, sex, and education years, were included. Based on Montreal Cognitive Assessment (MoCA) scale, PD patients were further categorized into subgroups. All participants underwent DTI scan and scale assessments. Results Compared with the HC group, the PD group exhibited increased diffusivity of both the left projection (Dzzproj) and association fibers (Dzzassoc) along the z -axis ( p < 0.05) and a reduced left DTI-ALPS index ( p < 0.05). The left Dzzproj was negatively correlated with MoCA score ( r = −0.299, p = 0.024, q = 0.048). The left Dzzassoc was negatively correlated with MoCA score ( r = −0.280, p = 0.035, q = 0.035), and Movement Disorder Society-Unified Parkinson’s Disease Rating Scale III (MDS-UPDRS III) score ( r = 0.333, p = 0.011, q = 0.022). The left DTI-ALPS index showed positive correlations with MoCA score ( r = 0.350, p = 0.008, q = 0.015) and a negative correlation with MDS-UPDRS III score ( r = −0.322, p = 0.015, q = 0.015). Within the PD subgroup analysis, when compared to the HC group, and throughout the progression from PD with cognition normal (PDCN) to PD with dementia (PDD), left Dzzproj ( F = 10.240, P < 0.001), and left Dzzassoc ( F = 11.060, p < 0.001) all demonstrated a stepwise increasing trend. Conversely, the MoCA total score ( F = 259.985, P < 0.001) and the left DTI-ALPS index ( F = 11.060, P < 0.001) exhibited a stepwise decreasing trend. Mediation analysis revealed that the left DTI-ALPS index mediated the effect of MoCA scores on MDS-UPDRS III scores. Conclusion Abnormalities in the left DTI-ALPS index and diffusivity reflect underlying glymphatic system (GS) dysfunction and white matter microstructural damage in PD patients. These neuropathological changes are significantly associated with, and collectively contribute to, the progression of motor and cognitive decline. Furthermore, the left DTI-ALPS index shows promise as a novel biomarker for identifying cognitive impairment in PD patients.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".