The Glymphatic System: Impacts on Cognitive Function in Cerebral Small Vessel Disease

Published on June 24, 2022

Imagine your brain as a bustling city, with information flowing through its streets. But what happens when those streets get clogged? That’s where the glymphatic system comes in. In patients with cerebral small vessel disease (CSVD), researchers have found that dysfunction in the glymphatic system is linked to cognitive impairment. Using fancy imaging techniques, they discovered that the glymphatic clearance dysfunction can be evaluated by analyzing the perivascular space. A group of 133 CSVD patients were split into two groups based on cognitive impairment. The results showed that the ALPS index, which measures glymphatic function, was significantly different between the cognitively impaired and normal groups. Even after accounting for common risk factors and CSVD markers, the link was still strong. These findings suggest that impaired glymphatic function is independently associated with cognitive decline in CSVD patients. So, it’s like a traffic jam in your brain – when the glymphatic system isn’t working properly, vital information gets stuck and cognitive function suffers. If you want to dive deeper into the research and learn more about how the glymphatic system affects our brains, check out the full article!

The mechanism of cognitive impairment in patients with cerebral small vessel disease (CSVD) remains unknown. The glymphatic system dysfunction, which has been demonstrated to influence cognitive impairment, can be evaluated by diffusion tensor image analysis along the perivascular space (ALPS index). We explored whether cognitive impairment in CSVD is associated with glymphatic clearance dysfunction. In this study, 133 patients with CSVD were enrolled and underwent neuropsychological test batteries as well as magnetic resonance imaging (MRI). They were then categorized into a CSVD with cognitive impairment (CSVD-CI) group and a cognitively normal CSVD (CSVD-CN) group. The ALPS index and four CSVD markers [white matter lesions (WMLs), cerebral microbleeds (CMBs), lacunes, and perivascular spaces (PVSs)] were also assessed. Univariate analysis showed that the ALPS index was significantly different between the CSVD-CN (n = 50) and CSVD-CI groups (n = 83) (p < 0.001). This difference remained significant (95% CI < 0.001–0.133) after adjusting for six common risk factors (age, education, hypertension, diabetes, smoking, and alcohol abuse) as well as CSVD markers. The ALPS index was independently linearly correlated with global cognitive function, executive function, attention function, and memory after adjusting for the aforementioned six risk factors or CSVD markers. Our results suggest that glymphatic system impairment is independently related to cognitive impairment in patients with CSVD.

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