{"doi":"10.1002/mds.29908","title":"<scp>Diffusion Tensor Imaging‐Along the Perivascular‐Space</scp> Index Is Associated with Disease Progression in Parkinson's Disease","abstract":"BACKGROUND: The glymphatic clearance pathway is a waste clearance system that allows for removal of soluble proteins such as amyloid β (Aβ) from the brain. Higher Aβ levels are associated with cognitive dysfunction in Parkinson's disease (PD). Diffusion tensor imaging-along the perivascular space (DTI-ALPS) is an imaging measure proposed to indirectly measure glymphatic function. OBJECTIVES: Evaluate differences in DTI-ALPS-index between PD and healthy controls (HC) and characterize relationships between this proposed measure of glymphatic clearance, cognition, and disease severity in PD. METHODS: PD (n = 32) and HC (n = 23) participants underwent brain imaging to assess DTI-ALPS. PD participants were classified as PD-normal cognition (PD-NC; n = 20) or PD-mild cognitive impairment (PD-MCI; n = 12) based on a Level II comprehensive cognitive assessment. A subgroup of PD participants (n = 21) returned for annual assessments for up to 4 years after baseline. Longitudinal outcomes included changes in performance on the comprehensive cognitive assessment and changes in the Movement Disorders Society Unified Parkinson's Disease Rating Scale (MDS-UPDRS). RESULTS: PD participants had lower DTI-ALPS-index compared to HC. PD participants classified as PD-MCI had significantly lower DTI-ALPS-index compared to PD-NC. Lower DTI-ALPS-index at baseline was associated with longitudinal cognitive decline and worse longitudinal disease severity. CONCLUSIONS: Glymphatic clearance, as measured with DTI-ALPS, has potential to serve as a marker of longitudinal disease progression. Interventions targeting glymphatic function should be explored for potential to slow cognitive decline in PD. © 2024 International Parkinson and Movement Disorder Society.","journal":"Movement Disorders","year":2024,"id":417184,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":78,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.9555,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2024-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":1092813,"name":"Rodolphe Nenert","orcid":null,"position":1,"is_corresponding":false},{"id":1202673,"name":"Aya M. Miften","orcid":"0000-0002-9679-3724","position":2,"is_corresponding":false},{"id":1203441,"name":"George W. Kent","orcid":null,"position":3,"is_corresponding":false},{"id":1203442,"name":"Madison Sleyster","orcid":null,"position":4,"is_corresponding":false},{"id":942356,"name":"Raima Memon","orcid":"0000-0002-4341-8816","position":5,"is_corresponding":false},{"id":942357,"name":"Allen Joop","orcid":"0000-0002-8852-9464","position":6,"is_corresponding":false},{"id":942798,"name":"Jennifer Pilkington","orcid":null,"position":7,"is_corresponding":false},{"id":798556,"name":"Adeel Memon","orcid":null,"position":8,"is_corresponding":false},{"id":1203443,"name":"Riis N. Wilson","orcid":null,"position":9,"is_corresponding":false},{"id":942797,"name":"Corina Catiul","orcid":null,"position":10,"is_corresponding":false},{"id":311438,"name":"Jerzy P. Szaflarski","orcid":"0000-0002-5936-6627","position":11,"is_corresponding":false},{"id":230244,"name":"Amy W. Amara","orcid":"0000-0003-0762-9656","position":12,"is_corresponding":false},{"id":729230,"name":"Kimberly H. Wood","orcid":null,"position":0,"is_corresponding":true}],"reference_count":37,"raw_metadata":null,"created_at":"2026-07-19T01:56:50.743370Z","pmid":"38988232","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}