{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T21:09:27Z","timestamp":1791839367928,"version":"4.3.4"},"reference-count":23,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2025,12,10]],"date-time":"2025-12-10T00:00:00Z","timestamp":1765324800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2025,12,10]],"date-time":"2025-12-10T00:00:00Z","timestamp":1765324800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100003725","name":"National Research Foundation of Korea","doi-asserted-by":"publisher","award":["2018R1C1B6002554"],"award-info":[{"award-number":["2018R1C1B6002554"]}],"id":[{"id":"10.13039\/501100003725","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100003725","name":"National Research Foundation of Korea","doi-asserted-by":"publisher","award":["2021R1A2B5B02087294"],"award-info":[{"award-number":["2021R1A2B5B02087294"]}],"id":[{"id":"10.13039\/501100003725","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100003725","name":"National Research Foundation of Korea","doi-asserted-by":"publisher","award":["2022R1C1C2006405"],"award-info":[{"award-number":["2022R1C1C2006405"]}],"id":[{"id":"10.13039\/501100003725","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100003725","name":"National Research Foundation of Korea","doi-asserted-by":"publisher","award":["RS\u20102024\u201000346342"],"award-info":[{"award-number":["RS\u20102024\u201000346342"]}],"id":[{"id":"10.13039\/501100003725","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Ann Clin Transl Neurol"],"published-print":{"date-parts":[[2026,5]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>Mild traumatic brain injury (mTBI) may alter glymphatic function; however, its progression and variability remain obscure. This study examined glymphatic function following mTBI within 1\u2009month and after 3\u2009months post\u2010injury to determine whether variations in glymphatic function are associated with post\u2010traumatic symptom severity.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Glymphatic function was estimated using diffusion tensor image analysis along the perivascular space (DTI\u2010ALPS). This index was measured in 39 individuals with mTBI (47.21\u2009\u00b1\u200914.88\u2009years) at initial and follow\u2010up assessments, and in 35 age\u2010matched controls (44.62\u2009\u00b1\u200913.12\u2009years), using manually defined regions of interest at the lateral ventricle level. A linear mixed\u2010effects (LME) model was used to compare ALPS indices among groups. Additional LME analyses evaluated continuous associations between the ALPS index and symptom severity, as assessed by the Rivermead Post\u2010Concussion Symptoms Questionnaire (RPCSQ). Based on ALPS changes, patients were classified into increasing and decreasing subgroups, and comparative analyses of RPCSQ trajectories were conducted.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>At baseline, the index did not differ between patients with mTBI and controls; at follow\u2010up, it was significantly lower in the mTBI group. Longitudinal ALPS changes were significantly associated with RPCSQ scores, whereas baseline ALPS showed only a marginal association with initial symptom severity. Individuals in the decreasing ALPS group demonstrated more severe overall symptoms and a slower rate of symptom resolution.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Interpretation<\/jats:title>\n                    <jats:p>Glymphatic dysfunction, as represented by the ALPS index, may be associated with persistent post\u2010traumatic symptoms. A time\u2010dependent approach incorporating individual recovery trajectories may be essential when assessing glymphatic biomarkers in mTBI.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/acn3.70273","type":"journal-article","created":{"date-parts":[[2025,12,11]],"date-time":"2025-12-11T04:49:07Z","timestamp":1765428547000},"page":"924-931","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Glymphatic Dysfunction Reflects Post\u2010Concussion Symptoms: Changes Within 1\u2009Month and After 3\u2009Months"],"prefix":"10.1002","volume":"13","author":[{"given":"Eunkyung","family":"Kim","sequence":"first","affiliation":[{"name":"Department of Rehabilitation Medicine Seoul National University College of Medicine and Seoul National University Hospital  Seoul Republic of Korea"},{"name":"Biomedical Research Institute Seoul National University Hospital  Seoul Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Han Gil","family":"Seo","sequence":"additional","affiliation":[{"name":"Department of Rehabilitation Medicine Seoul National University College of Medicine and Seoul National University Hospital  Seoul Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5625-5921","authenticated-orcid":false,"given":"Roh\u2010Eul","family":"Yoo","sequence":"additional","affiliation":[{"name":"Department of Radiology Seoul National University College of Medicine and Seoul National University Hospital  Seoul Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9353-7541","authenticated-orcid":false,"given":"Byung\u2010Mo","family":"Oh","sequence":"additional","affiliation":[{"name":"Department of Rehabilitation Medicine Seoul National University College of Medicine and Seoul National University Hospital  Seoul 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