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We also investigated associations between diffusion-based parameters, sleep-related data, and neurofluid-related imaging metrics.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Fifty participants with OSA underwent brain magnetic resonance imaging and polysomnography, including diffusion tensor and structural sequences. Among them, 8 participants had no psychiatric comorbidities, while the remaining 42 had various psychiatric disorders in addition to OSA. Diffusion-based parameters were obtained, and both the original and variant ALPS index were calculated. Correlation analyses were conducted with sleep-related data and neurofluid-related imaging parameters, including choroid plexus volume (CPV) and volume of white matter lesion burden (WMHV). Mediation analyses were also performed to explore the influence of white matter diffusivity on the perivascular diffusivity index.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The ALPS index showed weak to moderate correlations with multiple sleep-related variables. It also correlated with CPV and WMHV. Mediation analyses demonstrated that diffusivity within white matter fibres was associated with the ALPS index. Moreover, variant ALPS indices measured in the corpus callosum may reflect fluid motion in the direction of perivascular spaces.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>These findings suggest that the ALPS index is influenced by both diffusivity along perivascular spaces and white matter microstructure, particularly commissural fibres. Although it should not be regarded as a highly specific marker of perivascular space function, variant indices support partial perivascular contribution. Furthermore, associations with sleep and neurofluid-related metrics imply that white matter architecture and inter-fibre spaces may serve as plausible routes for interstitial fluid flow.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s11604-025-01838-x","type":"journal-article","created":{"date-parts":[[2025,7,24]],"date-time":"2025-07-24T06:54:26Z","timestamp":1753340066000},"page":"1926-1941","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":23,"title":["Contribution of white matter microstructure to diffusion tensor image analysis along perivascular space in obstructive sleep apnea"],"prefix":"10.1007","volume":"43","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9227-0240","authenticated-orcid":false,"given":"Toshiaki","family":"Taoka","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kunihiro","family":"Iwamoto","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Seiko","family":"Miyata","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rintaro","family":"Ito","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Koji","family":"Kamagata","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rei","family":"Nakamichi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Toshiki","family":"Nakane","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mami","family":"Iima","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hiroshige","family":"Fujishiro","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masashi","family":"Ikeda","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kazushige","family":"Ichikawa","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Akifumi","family":"Kamiunten","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nobuyasu","family":"Ichinose","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Junko","family":"Kikuta","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shigeki","family":"Aoki","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shinji","family":"Naganawa","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,7,24]]},"reference":[{"issue":"147","key":"1838_CR1","doi-asserted-by":"publisher","first-page":"147ra11","DOI":"10.1126\/scitranslmed.3003748","volume":"4","author":"JJ Iliff","year":"2012","unstructured":"Iliff JJ, Wang M, Liao Y, Plogg BA, Peng W, Gundersen GA, et al. 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T.T. received JSPS KAKENHI (24K10855). R.N. and R.I. received grants from the Japan Society for the Promotion of Science. M.I. received JSPS KAKENHI (24K02402) and AMED (23he04220250002), and received grants from Himedic Nagoya. K.Iw. received funding from AMED (JP24mk0101227h0003) and JSPS KAKENHI (21K07518, 25K10859), and received honoraria from Eisai, Lundbeck Japan, Meiji Seika Pharma, MSD, Otsuka, Shionogi, Sumitomo Pharma, Takeda, Viatris, and Daiichi Sankyo. M.Ik. received funding from AMED (JP22wm0425008, JP23tm0524001, JP21wm0525024, JP21tm0424220h0001, JP23dk0307123) and JSPS KAKENHI (21H02854, 24K02381), and received speaker honoraria from Sumitomo Pharma, Eisai, Otsuka, Tanabe Mitsubishi, Mochida, Takeda, Meiji Seika Pharma, EA Pharma, Viatris, MSD, Janssen, Lundbeck, and Yoshitomi. A.K. and N.I. are employees of Canon Medical Systems Corporation. All other authors declare no conflicts of interest.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}},{"value":"This study was approved by the Ethics Committee of Nagoya University Graduate School of Medicine (Approval number: 2020-0352). Written informed consent was obtained from all participants prior to enrollment.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical approval"}}]}}