{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,3]],"date-time":"2026-04-03T19:18:17Z","timestamp":1775243897062,"version":"3.50.1"},"reference-count":34,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2025,11,20]],"date-time":"2025-11-20T00:00:00Z","timestamp":1763596800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.springernature.com\/gp\/researchers\/text-and-data-mining"},{"start":{"date-parts":[[2025,11,20]],"date-time":"2025-11-20T00:00:00Z","timestamp":1763596800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/www.springernature.com\/gp\/researchers\/text-and-data-mining"}],"funder":[{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"crossref","award":["82171913"],"award-info":[{"award-number":["82171913"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"crossref","award":["82171913"],"award-info":[{"award-number":["82171913"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"crossref","award":["82171913"],"award-info":[{"award-number":["82171913"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"crossref","award":["82171913"],"award-info":[{"award-number":["82171913"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"crossref","award":["82171913"],"award-info":[{"award-number":["82171913"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"crossref","award":["82171913"],"award-info":[{"award-number":["82171913"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"crossref","award":["82171913"],"award-info":[{"award-number":["82171913"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"crossref"}]},{"name":"Shenzhen Science and Technology Program","award":["JCYJ 20220818101816036"],"award-info":[{"award-number":["JCYJ 20220818101816036"]}]},{"name":"Shenzhen Science and Technology Program","award":["JCYJ 20220818101816036"],"award-info":[{"award-number":["JCYJ 20220818101816036"]}]},{"name":"Shenzhen Science and Technology Program","award":["JCYJ 20220818101816036"],"award-info":[{"award-number":["JCYJ 20220818101816036"]}]},{"name":"Shenzhen Science and Technology Program","award":["JCYJ 20220818101816036"],"award-info":[{"award-number":["JCYJ 20220818101816036"]}]},{"name":"Shenzhen Science and Technology Program","award":["JCYJ 20220818101816036"],"award-info":[{"award-number":["JCYJ 20220818101816036"]}]},{"name":"Shenzhen Science and Technology Program","award":["JCYJ 20220818101816036"],"award-info":[{"award-number":["JCYJ 20220818101816036"]}]},{"name":"Shenzhen Science and Technology Program","award":["JCYJ 20220818101816036"],"award-info":[{"award-number":["JCYJ 20220818101816036"]}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Neurosurg Rev"],"DOI":"10.1007\/s10143-025-03949-5","type":"journal-article","created":{"date-parts":[[2025,11,20]],"date-time":"2025-11-20T09:10:33Z","timestamp":1763629833000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Prognostic value of perivascular spaces, diffusion tensor imaging-derived indices, and choroid plexus in idiopathic normal pressure hydrocephalus"],"prefix":"10.1007","volume":"49","author":[{"given":"Wenjie","family":"He","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zekai","family":"Chen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pujie","family":"Qiu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jialing","family":"Lv","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Qizhong","family":"Xu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jun","family":"Xia","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Guihua","family":"Jiang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2025,11,20]]},"reference":[{"key":"3949_CR1","doi-asserted-by":"publisher","first-page":"S4","DOI":"10.1227\/01.NEU.0000168185.29659.C5","volume":"57","author":"N Relkin","year":"2005","unstructured":"Relkin N, Marmarou A, Klinge P, Bergsneider M, Black PM (2005) Diagnosing idiopathic normal-pressure hydrocephalus. Neurosurgery 57:S4\u2013S16","journal-title":"Neurosurgery"},{"key":"3949_CR2","doi-asserted-by":"publisher","first-page":"63","DOI":"10.2176\/nmc.st.2020-0292","volume":"61","author":"M Nakajima","year":"2021","unstructured":"Nakajima M, Yamada S, Miyajima M et al (2021) Guidelines for management of idiopathic normal pressure hydrocephalus (third edition): endorsed by the Japanese society of normal pressure hydrocephalus. Neurol Med Chir (Tokyo) 61:63\u201397","journal-title":"Neurol Med Chir (Tokyo)"},{"key":"3949_CR3","doi-asserted-by":"publisher","first-page":"1436","DOI":"10.3171\/2016.9.JNS161080","volume":"127","author":"N Shinoda","year":"2017","unstructured":"Shinoda N, Hirai O, Hori S et al (2017) Utility of MRI-based disproportionately enlarged subarachnoid space hydrocephalus scoring for predicting prognosis after surgery for idiopathic normal pressure hydrocephalus: clinical research. J Neurosurg 127:1436\u20131442","journal-title":"J Neurosurg"},{"key":"3949_CR4","doi-asserted-by":"publisher","first-page":"7800","DOI":"10.1007\/s00330-022-08733-3","volume":"32","author":"J Chen","year":"2022","unstructured":"Chen J, He W, Zhang X et al (2022) Value of MRI-based semi-quantitative structural neuroimaging in predicting the prognosis of patients with idiopathic normal pressure hydrocephalus after shunt surgery. Eur Radiol 32:7800\u20137810","journal-title":"Eur Radiol"},{"key":"3949_CR5","doi-asserted-by":"publisher","first-page":"78","DOI":"10.1016\/j.jns.2016.01.028","volume":"362","author":"M Mihalj","year":"2016","unstructured":"Mihalj M, Doli\u0107 K, Koli\u0107 K, Ledenko V (2016) CSF tap test - obsolete or appropriate test for predicting shunt responsiveness? A systemic review. J Neurol Sci 362:78\u201384","journal-title":"J Neurol Sci"},{"key":"3949_CR6","doi-asserted-by":"publisher","first-page":"50","DOI":"10.1126\/science.abb8739","volume":"370","author":"M Nedergaard","year":"2020","unstructured":"Nedergaard M, Goldman SA (2020) Glymphatic failure as a final common pathway to dementia. Science 370:50\u201356","journal-title":"Science"},{"key":"3949_CR7","doi-asserted-by":"publisher","first-page":"502","DOI":"10.1148\/radiol.2021202043","volume":"301","author":"JM Klostranec","year":"2021","unstructured":"Klostranec JM, Vucevic D, Bhatia KD et al (2021) Current concepts in intracranial interstitial fluid transport and the glymphatic system: Part I-anatomy and physiology. Radiology 301:502\u2013514","journal-title":"Radiology"},{"key":"3949_CR8","doi-asserted-by":"publisher","first-page":"516","DOI":"10.1148\/radiol.2021204088","volume":"301","author":"JM Klostranec","year":"2021","unstructured":"Klostranec JM, Vucevic D, Bhatia KD et al (2021) Current concepts in intracranial interstitial fluid transport and the glymphatic system: Part II-imaging techniques and clinical applications. Radiology 301:516\u2013532","journal-title":"Radiology"},{"key":"3949_CR9","doi-asserted-by":"publisher","first-page":"137","DOI":"10.1038\/s41582-020-0312-z","volume":"16","author":"JM Wardlaw","year":"2020","unstructured":"Wardlaw JM, Benveniste H, Nedergaard M et al (2020) Perivascular spaces in the brain: anatomy, physiology and pathology. Nat Rev Neurol 16:137\u2013153","journal-title":"Nat Rev Neurol"},{"key":"3949_CR10","doi-asserted-by":"publisher","first-page":"e2648","DOI":"10.1212\/WNL.0000000000201300","volume":"99","author":"K Kamagata","year":"2022","unstructured":"Kamagata K, Andica C, Takabayashi K et al (2022) Association of MRI indices of glymphatic system with amyloid deposition and cognition in mild cognitive impairment and Alzheimer disease. Neurology 99:e2648\u2013e2660","journal-title":"Neurology"},{"key":"3949_CR11","doi-asserted-by":"publisher","first-page":"e209306","DOI":"10.1212\/WNL.0000000000209306","volume":"102","author":"H Li","year":"2024","unstructured":"Li H, Jacob MA, Cai M et al (2024) Perivascular spaces, diffusivity along perivascular spaces, and free water in cerebral small vessel disease. Neurology 102:e209306","journal-title":"Neurology"},{"key":"3949_CR12","doi-asserted-by":"publisher","first-page":"e232274","DOI":"10.1148\/radiol.232274","volume":"311","author":"S Lin","year":"2024","unstructured":"Lin S, Lin X, Chen S et al (2024) Association of MRI indexes of the perivascular space network and cognitive impairment in patients with obstructive sleep apnea. Radiology 311:e232274","journal-title":"Radiology"},{"key":"3949_CR13","doi-asserted-by":"publisher","first-page":"182","DOI":"10.1002\/ana.26648","volume":"94","author":"Y Li","year":"2023","unstructured":"Li Y, Zhou Y, Zhong W et al (2023) Choroid plexus enlargement exacerbates white matter hyperintensity growth through glymphatic impairment. Ann Neurol 94:182\u2013195","journal-title":"Ann Neurol"},{"key":"3949_CR14","doi-asserted-by":"publisher","first-page":"585","DOI":"10.1016\/S1474-4422(15)00046-0","volume":"14","author":"H Kazui","year":"2015","unstructured":"Kazui H, Miyajima M, Mori E, Ishikawa M (2015) Lumboperitoneal shunt surgery for idiopathic normal pressure hydrocephalus (SINPHONI-2): an open-label randomised trial. Lancet Neurol 14:585\u2013594","journal-title":"Lancet Neurol"},{"key":"3949_CR15","doi-asserted-by":"publisher","first-page":"56","DOI":"10.1016\/j.parkreldis.2020.11.009","volume":"82","author":"YJ Bae","year":"2021","unstructured":"Bae YJ, Choi BS, Kim JM, Choi JH, Cho SJ, Kim JH (2021) Altered glymphatic system in idiopathic normal pressure hydrocephalus. Parkinsonism Relat Disord 82:56\u201360","journal-title":"Parkinsonism Relat Disord"},{"key":"3949_CR16","doi-asserted-by":"publisher","first-page":"1849","DOI":"10.1177\/0271678X19874790","volume":"40","author":"PK Eide","year":"2020","unstructured":"Eide PK, Valnes LM, Pripp AH, Mardal KA, Ringstad G (2020) Delayed clearance of cerebrospinal fluid tracer from choroid plexus in idiopathic normal pressure hydrocephalus. J Cereb Blood Flow Metab 40:1849\u20131858","journal-title":"J Cereb Blood Flow Metab"},{"key":"3949_CR17","doi-asserted-by":"publisher","first-page":"5675014","DOI":"10.1155\/2019\/5675014","volume":"2019","author":"H Yokota","year":"2019","unstructured":"Yokota H, Vijayasarathi A, Cekic M et al (2019) Diagnostic performance of glymphatic system evaluation using diffusion tensor imaging in idiopathic normal pressure hydrocephalus and mimickers. Curr Gerontol Geriatr Res 2019:5675014","journal-title":"Curr Gerontol Geriatr Res"},{"key":"3949_CR18","doi-asserted-by":"publisher","first-page":"e232899","DOI":"10.1148\/radiol.232899","volume":"310","author":"S Haller","year":"2024","unstructured":"Haller S, Moy L, Anzai Y (2024) Evaluation of diffusion tensor imaging analysis along the perivascular space as a marker of the glymphatic system. Radiology 310:e232899","journal-title":"Radiology"},{"key":"3949_CR19","doi-asserted-by":"publisher","first-page":"157","DOI":"10.1007\/s00234-023-03270-2","volume":"66","author":"G Ringstad","year":"2024","unstructured":"Ringstad G (2024) Glymphatic imaging: a critical look at the DTI-ALPS index. Neuroradiology 66:157\u2013160","journal-title":"Neuroradiology"},{"key":"3949_CR20","doi-asserted-by":"publisher","first-page":"9","DOI":"10.1186\/s12987-021-00282-z","volume":"19","author":"SB Hladky","year":"2022","unstructured":"Hladky SB, Barrand MA (2022) The glymphatic hypothesis: the theory and the evidence. Fluids Barriers CNS 19:9","journal-title":"Fluids Barriers CNS"},{"key":"3949_CR21","doi-asserted-by":"publisher","first-page":"268","DOI":"10.2463\/mrms.rev.2023-0175","volume":"23","author":"T Taoka","year":"2024","unstructured":"Taoka T, Ito R, Nakamichi R, Nakane T, Kawai H, Naganawa S (2024) Diffusion tensor image analysis along the perivascular space (DTI-ALPS): revisiting the meaning and significance of the method. Magn Reson Med Sci 23:268\u2013290","journal-title":"Magn Reson Med Sci"},{"key":"3949_CR22","doi-asserted-by":"publisher","first-page":"35","DOI":"10.1186\/s12987-020-00196-2","volume":"17","author":"P Sol\u00e1r","year":"2020","unstructured":"Sol\u00e1r P, Zamani A, Kub\u00ed\u010dkov\u00e1 L, Dubov\u00fd P, Joukal M (2020) Choroid plexus and the blood-cerebrospinal fluid barrier in disease. Fluids Barriers CNS 17:35","journal-title":"Fluids Barriers CNS"},{"key":"3949_CR23","doi-asserted-by":"publisher","first-page":"3215","DOI":"10.1007\/s00415-024-12248-w","volume":"271","author":"K Andr\u00e9n","year":"2024","unstructured":"Andr\u00e9n K, Wikkels\u00f8 C, Laurell K, Koll\u00e9n L, Hellstr\u00f6m P, Tullberg M (2024) Symptoms and signs did not predict outcome after surgery: a prospective study of 143 patients with idiopathic normal pressure hydrocephalus. J Neurol 271:3215\u20133226","journal-title":"J Neurol"},{"key":"3949_CR24","doi-asserted-by":"publisher","first-page":"1573","DOI":"10.1212\/WNL.0000000000000916","volume":"83","author":"NR Graff-Radford","year":"2014","unstructured":"Graff-Radford NR (2014) Alzheimer CSF biomarkers May be misleading in normal-pressure hydrocephalus. Neurology 83:1573\u20131575","journal-title":"Neurology"},{"key":"3949_CR25","doi-asserted-by":"publisher","first-page":"1385","DOI":"10.1212\/WNL.0b013e31828c2fda","volume":"80","author":"A Jeppsson","year":"2013","unstructured":"Jeppsson A, Zetterberg H, Blennow K, Wikkels\u00f8 C (2013) Idiopathic normal-pressure hydrocephalus: pathophysiology and diagnosis by CSF biomarkers. Neurology 80:1385\u20131392","journal-title":"Neurology"},{"key":"3949_CR26","doi-asserted-by":"publisher","first-page":"959450","DOI":"10.3389\/fneur.2022.959450","volume":"13","author":"WJ He","year":"2022","unstructured":"He WJ, Zhang XJ, Xu QZ et al (2022) Are preoperative phase-contrast CSF flow parameters ideal for predicting the outcome of shunt surgery in patients with idiopathic normal pressure hydrocephalus? Front Neurol 13:959450","journal-title":"Front Neurol"},{"key":"3949_CR27","doi-asserted-by":"publisher","first-page":"569","DOI":"10.1111\/jon.12837","volume":"31","author":"CE Steward","year":"2021","unstructured":"Steward CE, Venkatraman VK, Lui E et al (2021) Assessment of the DTI-ALPS parameter along the perivascular space in older adults at risk of dementia. J Neuroimaging 31:569\u2013578","journal-title":"J Neuroimaging"},{"key":"3949_CR28","doi-asserted-by":"publisher","first-page":"172","DOI":"10.1007\/s11604-017-0617-z","volume":"35","author":"T Taoka","year":"2017","unstructured":"Taoka T, Masutani Y, Kawai H et al (2017) Evaluation of glymphatic system activity with the diffusion MR technique: diffusion tensor image analysis along the perivascular space (DTI-ALPS) in Alzheimer\u2019s disease cases. Jpn J Radiol 35:172\u2013178","journal-title":"Jpn J Radiol"},{"key":"3949_CR29","doi-asserted-by":"publisher","first-page":"56","DOI":"10.1007\/s12975-021-00899-0","volume":"13","author":"P Huang","year":"2022","unstructured":"Huang P, Zhang R, Jiaerken Y et al (2022) White matter free water is a composite marker of cerebral small vessel degeneration. Transl Stroke Res 13:56\u201364","journal-title":"Transl Stroke Res"},{"key":"3949_CR30","doi-asserted-by":"publisher","first-page":"173","DOI":"10.1007\/s10143-023-02078-1","volume":"46","author":"V Sedl\u00e1k","year":"2023","unstructured":"Sedl\u00e1k V, Buben\u00edkov\u00e1 A, Skalick\u00fd P et al (2023) Diffusion tensor imaging helps identify shunt-responsive normal pressure hydrocephalus patients among probable iNPH cohort. Neurosurg Rev 46:173","journal-title":"Neurosurg Rev"},{"key":"3949_CR31","doi-asserted-by":"publisher","first-page":"774638","DOI":"10.3389\/fnins.2021.774638","volume":"15","author":"Y Tang","year":"2021","unstructured":"Tang Y, Yuan X, Duan J et al (2021) White matter characteristics of cognitive impairment in tap-test positive idiopathic normal pressure hydrocephalus: a diffusion tensor tract-based spatial study. Front Neurosci 15:774638","journal-title":"Front Neurosci"},{"key":"3949_CR32","doi-asserted-by":"publisher","first-page":"312","DOI":"10.1016\/j.neurad.2019.04.003","volume":"47","author":"A Saito","year":"2020","unstructured":"Saito A, Kamagata K, Ueda R et al (2020) Ventricular volumetry and free-water corrected diffusion tensor imaging of the anterior thalamic radiation in idiopathic normal pressure hydrocephalus. J Neuroradiol 47:312\u2013317","journal-title":"J Neuroradiol"},{"key":"3949_CR33","doi-asserted-by":"publisher","first-page":"55","DOI":"10.1177\/1971400920975153","volume":"34","author":"I Grazzini","year":"2021","unstructured":"Grazzini I, Venezia D, Cuneo GL (2021) The role of diffusion tensor imaging in idiopathic normal pressure hydrocephalus: a literature review. Neuroradiol J 34:55\u201369","journal-title":"Neuroradiol J"},{"key":"3949_CR34","doi-asserted-by":"publisher","first-page":"794046","DOI":"10.3389\/fnins.2021.794046","volume":"15","author":"W Huang","year":"2021","unstructured":"Huang W, Fang X, Li S et al (2021) Preliminary exploration of the sequence of nerve fiber bundles involvement for idiopathic normal pressure hydrocephalus: a correlation analysis using diffusion tensor imaging. Front Neurosci 15:794046","journal-title":"Front Neurosci"}],"container-title":["Neurosurgical Review"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s10143-025-03949-5.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s10143-025-03949-5\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s10143-025-03949-5.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,11,20]],"date-time":"2025-11-20T09:10:38Z","timestamp":1763629838000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s10143-025-03949-5"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,11,20]]},"references-count":34,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2026,12]]}},"alternative-id":["3949"],"URL":"https:\/\/doi.org\/10.1007\/s10143-025-03949-5","relation":{"has-preprint":[{"id-type":"doi","id":"10.21203\/rs.3.rs-6549231\/v1","asserted-by":"object"}]},"ISSN":["1437-2320"],"issn-type":[{"value":"1437-2320","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,11,20]]},"assertion":[{"value":"28 April 2025","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"17 August 2025","order":2,"name":"revised","label":"Revised","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"8 November 2025","order":3,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"20 November 2025","order":4,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The cohort and MRI protocols were approved by the Bioethics Committee of our hospital (approval no. KS20190114001). All procedures were performed in accordance with the tenets of the Declaration of Helsinki. Informed consent was obtained from all study participants or their legal guardians before study commencement.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"The authors declare no competing interests.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}},{"value":"Not applicable.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Clinical trial number"}}],"article-number":"15"}}