{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,31]],"date-time":"2026-08-31T11:20:43Z","timestamp":1788175243465,"version":"build-2803163510"},"reference-count":57,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,8,31]],"date-time":"2026-08-31T00:00:00Z","timestamp":1788134400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,8,31]],"date-time":"2026-08-31T00:00:00Z","timestamp":1788134400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Annals of Neurology"],"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To characterize magnetic resonance imaging (MRI)\u2010based glymphatic surrogates in Huntington's disease (HD) using MRI measures of perivascular diffusivity and structural perivascular alterations across multiple large cohorts.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We analyzed 2,731 MRI sessions from 880 participants across 3 large retrospective HD cohorts. HD gene carriers were grouped by the HD Integrated Staging System into stage 0 to 3. We assessed the diffusion tensor image analysis along the perivascular space (DTI\u2010ALPS) index and MRI\u2010visible enlarged perivascular spaces (EPVS). Linear mixed\u2010effects models examined group differences and associations with motor, cognitive, and functional measures. Likelihood ratio tests evaluated their added explanatory value beyond established imaging, genetic, and demographic variables.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Left ALPS indices were lower at more advanced disease stages (stage 1: \u22123.71%, Cohen's\n                      <jats:italic>d<\/jats:italic>\n                      : \u22120.25; stage 2: \u22124.33%, Cohen's\n                      <jats:italic>d<\/jats:italic>\n                      : \u22120.31; Stage 3: \u22126.43%, Cohen's\n                      <jats:italic>d<\/jats:italic>\n                      : \u22120.46; all\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.05) compared with controls, independent of demographic and clinical variables. EPVS burden showed region\u2010specific patterns, with subcortical EPVS volume fraction increased in HD (stage 1\u20133: +49.9% to +63.7%, Cohen's\n                      <jats:italic>d<\/jats:italic>\n                      : 0.47 to 0.55,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.0001), whereas white matter EPVS volume fraction decreased at Stage 3 (\u221213.8%, Cohen's\n                      <jats:italic>d<\/jats:italic>\n                      : \u22120.21,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.05). Lower ALPS indices correlated with higher motor impairment (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.0001) and reduced functional capacity (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.01). Both ALPS and EPVS improved prediction of composite HD progression beyond CAG\u2010Age Product Score and striatal volume.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Interpretation<\/jats:title>\n                    <jats:p>Multimodal MRI revealed stage\u2010dependent alterations in MRI\u2010based glymphatic surrogates with low to moderate effect sizes. These findings suggest that DTI\u2010ALPS and EPVS metrics offer complementary, noninvasive indicators of HD pathology derivable from routine imaging protocols. ANN NEUROL 2026<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ana.78344","type":"journal-article","created":{"date-parts":[[2026,8,31]],"date-time":"2026-08-31T11:02:26Z","timestamp":1788174146000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Multimodal Characterization of Glymphatic\u2010Related\n                    <scp>Magnetic Resonance Imaging<\/scp>\n                    Markers in Huntington's Disease: A Multi\u2010Cohort Retrospective Study"],"prefix":"10.1002","author":[{"given":"Alexia","family":"Solomon","sequence":"first","affiliation":[{"name":"Department of Radiological Sciences David Geffen School of Medicine, University of California, Los Angeles  Los Angeles CA USA"},{"name":"Department of Immunology and Immune Therapeutics Keck School of Medicine, University of Southern California  Los Angeles CA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zexi","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Radiological Sciences David Geffen School of Medicine, University of California, Los Angeles  Los Angeles CA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesco","family":"Sanvito","sequence":"additional","affiliation":[{"name":"Department of Radiological Sciences David Geffen School of Medicine, University of California, Los Angeles  Los Angeles CA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zheng","family":"Zhou","sequence":"additional","affiliation":[{"name":"Department of Radiological Sciences David Geffen School of Medicine, University of California, Los Angeles  Los Angeles CA USA"},{"name":"Department of Mathematics, Division of Physical Sciences University of California, Los Angeles  Los Angeles CA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adys","family":"Mendizabal","sequence":"additional","affiliation":[{"name":"Department of Neurology, David Geffen School of Medicine University of California, Los Angeles  Los Angeles CA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8828-1841","authenticated-orcid":false,"given":"Jingwen","family":"Yao","sequence":"additional","affiliation":[{"name":"Department of Radiological Sciences David Geffen School of Medicine, University of California, Los Angeles  Los Angeles CA USA"},{"name":"Department of Bioengineering, Henry Samueli School of Engineering and Applied Science University of California, Los Angeles  Los Angeles CA 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