{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T00:49:38Z","timestamp":1786927778814,"version":"build-2736575974"},"reference-count":27,"publisher":"Cambridge University Press (CUP)","license":[{"start":{"date-parts":[[2026,7,7]],"date-time":"2026-07-07T00:00:00Z","timestamp":1783382400000},"content-version":"unspecified","delay-in-days":187,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["cambridge.org"],"crossmark-restriction":true},"short-container-title":["Psychol. Med."],"published-print":{"date-parts":[[2026]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec id=\"S0033291726105005_sec1\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Glymphatic system dysfunction has been increasingly implicated in Alzheimer\u2019s disease (AD), yet its relationships with cerebral small vessel disease (CSVD), plasma biomarkers, and cognitive impairment across the AD remain incompletely understood.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S0033291726105005_sec2\" sec-type=\"methods\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We prospectively recruited 216 participants from Hainan General Hospital, including healthy controls (HC), individuals with subjective cognitive decline (SCD), mild cognitive impairment (MCI), and AD dementia. All participants underwent brain magnetic resonance imaging, plasma biomarker testing, and neuropsychological assessments. White matter hyperintensity (WMH) volume from T2-weighted fluid-attenuated inversion recovery images served as a marker of CSVD. The diffusion tensor image analysis along the perivascular space (DTI-ALPS) index assessed glymphatic function. Plasma amyloid \u03b2-protein (A\u03b2) concentrations measured peripheral A\u03b2 levels as a surrogate indicator of amyloid pathology.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S0033291726105005_sec3\" sec-type=\"results\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The ALPS index was significantly lower in AD patients compared with HC, SCD, and MCI groups (all\n                      <jats:italic>P<\/jats:italic>\n                      \u00a0&lt;\u00a00.01) and tended to be lower in the MCI group relative to SCD. After controlling for demographics and APOE4 status, ALPS positively correlated with the plasma A\u03b242\/A\u03b240 ratio (\n                      <jats:italic>r<\/jats:italic>\n                      \u00a0=\u00a00.16,\n                      <jats:italic>P<\/jats:italic>\n                      \u00a0=\u00a00.038). ALPS index showed significant negative correlations with log-transformed juxtaventricular and juxtacortical WMH volumes (\n                      <jats:italic>r<\/jats:italic>\n                      \u00a0=\u00a0\u22120.32,\n                      <jats:italic>P<\/jats:italic>\n                      \u00a0&lt;\u00a00.001;\n                      <jats:italic>r<\/jats:italic>\n                      \u00a0=\u00a0\u22120.19,\n                      <jats:italic>P<\/jats:italic>\n                      \u00a0=\u00a00.010), with marginal correlation for periventricular WMH (\n                      <jats:italic>r<\/jats:italic>\n                      \u00a0=\u00a0\u22120.13,\n                      <jats:italic>P<\/jats:italic>\n                      \u00a0=\u00a00.052).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S0033291726105005_sec4\" sec-type=\"conclusions\">\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Plasma A\u03b2 levels and regional WMH burden are associated with glymphatic dysfunction as indicated by reduced ALPS. Impaired glymphatic clearance also correlates with cognitive impairment, providing theoretical support for novel pathophysiological hypotheses and potential therapeutic targets in AD pathogenesis.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1017\/s0033291726105005","type":"journal-article","created":{"date-parts":[[2026,7,7]],"date-time":"2026-07-07T06:42:18Z","timestamp":1783406538000},"update-policy":"https:\/\/doi.org\/10.1017\/policypage","source":"Crossref","is-referenced-by-count":1,"title":["Glymphatic dysfunction associates with regional white matter hyperintensities and plasma amyloid-\u03b2 burden across the Alzheimer\u2019s disease continuum"],"prefix":"10.1017","volume":"56","author":[{"given":"Hui Juan","family":"Chen","sequence":"first","affiliation":[{"id":[{"id":"https:\/\/ror.org\/030sr2v21","id-type":"ROR","asserted-by":"publisher"}],"name":"Hainan General Hospital, Hainan Affiliated Hospital of Hainan Medical University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yihao","family":"Guo","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/030sr2v21","id-type":"ROR","asserted-by":"publisher"}],"name":"Hainan General Hospital, Hainan Affiliated Hospital of Hainan Medical University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Weiyuan","family":"Huang","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/030sr2v21","id-type":"ROR","asserted-by":"publisher"}],"name":"Hainan General Hospital, Hainan Affiliated Hospital of Hainan Medical University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anquan","family":"Hu","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/030sr2v21","id-type":"ROR","asserted-by":"publisher"}],"name":"Hainan General Hospital, Hainan Affiliated Hospital of Hainan Medical 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Published by Cambridge University Press","name":"copyright","label":"Copyright","group":{"name":"copyright_and_licensing","label":"Copyright and Licensing"}},{"value":"This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (http:\/\/creativecommons.org\/licenses\/by\/4.0), which permits unrestricted re-use, distribution and reproduction, provided the original article is properly cited.","name":"license","label":"License","group":{"name":"copyright_and_licensing","label":"Copyright and Licensing"}},{"value":"This content has been made available to all.","name":"free","label":"Free to read"}],"article-number":"e220"}}