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This study employed MR diffusion tensor imaging (DTI) to evaluate glymphatic system function and its correlation with brain amyloid accumulation levels measured using [<jats:sup>11<\/jats:sup>C]Pittsburgh compound-B (PiB) PET\/MRI. Fifty-six patients with mild cognitive impairment and early Alzheimer\u2019s disease (AD: 70\u2009\u00b1\u200911\u00a0y) underwent [<jats:sup>11<\/jats:sup>C]PiB PET\/MRI to assess amyloid deposition and were compared with 27 age-matched cognitively normal volunteers (CN: 69\u2009\u00b1\u200910y). All participants were evaluated for cognitive function using the Mini Mental State Examination (MMSE) before [<jats:sup>11<\/jats:sup>C]PiB PET\/MRI. DTI images were acquired during the PET\/MRI scan with several other MR sequences. The DTI analysis along the perivascular space index (DTI-ALPS index) was calculated to estimate the functional activity of the glymphatic system. Centiloid scale was applied to quantify amyloid deposition levels from [<jats:sup>11<\/jats:sup>C]PiB PET images. All patients in the AD group showed positive [<jats:sup>11<\/jats:sup>C]PiB accumulation, whereas all CN participants were negative. ALPS-index for all subjects linearly correlated with PiB centiloid, MMSE scores, and hippocampal volume. The correlation between the ALPS-index and PiB accumulation was more pronounced than with any other biomarkers. These findings suggest that glymphatic system dysfunction is a significant factor in the early stages of Alzheimer\u2019s disease.<\/jats:p>","DOI":"10.1038\/s41598-024-62806-5","type":"journal-article","created":{"date-parts":[[2024,5,29]],"date-time":"2024-05-29T08:02:01Z","timestamp":1716969721000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":50,"title":["PET\/MRI multimodality imaging to evaluate changes in glymphatic system function and biomarkers of Alzheimer\u2019s disease"],"prefix":"10.1038","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7046-3383","authenticated-orcid":false,"given":"Hidehiko","family":"Okazawa","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Munenobu","family":"Nogami","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shota","family":"Ishida","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Akira","family":"Makino","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tetsuya","family":"Mori","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yasushi","family":"Kiyono","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masamichi","family":"Ikawa","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2024,5,29]]},"reference":[{"issue":"147","key":"62806_CR1","doi-asserted-by":"publisher","first-page":"14711","DOI":"10.1126\/scitranslmed.3003748","volume":"4","author":"JJ Iliff","year":"2012","unstructured":"Iliff, J. 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