{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,4]],"date-time":"2026-11-04T17:13:38Z","timestamp":1793812418310,"version":"4.6.1"},"reference-count":57,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2025,5,14]],"date-time":"2025-05-14T00:00:00Z","timestamp":1747180800000},"content-version":"vor","delay-in-days":13,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100003399","name":"Science and Technology Commission of Shanghai Municipality","doi-asserted-by":"publisher","award":["23Y11907700"],"award-info":[{"award-number":["23Y11907700"]}],"id":[{"id":"10.13039\/501100003399","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Euro J of Neurology"],"published-print":{"date-parts":[[2025,5]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>This study aimed to assess the glymphatic dysfunction in idiopathic normal pressure hydrocephalus (iNPH) patients and its recovery post\u2010shunt surgery using diffusion tensor image analysis along perivascular spaces (DTI\u2010ALPS).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      Thirty\u2010five iNPH patients and forty healthy controls (HC) underwent MRI scans and neuropsychological assessments at baseline. A follow\u2010up study, conducted three months post\u2010shunt surgery, included fifteen iNPH patients. The DTI\u2010ALPS index was calculated to assess the glymphatic system status. Group differences were evaluated using the Mann\u2013Whitney\n                      <jats:italic>U<\/jats:italic>\n                      test, while the paired Wilcoxon signed\u2010rank test was employed to compare pre\u2010operative and post\u2010operative ALPS indices. Multiple linear regression was utilized to analyze the association between changes in the ALPS index (\u0394ALPS) and alterations in clinical scores.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Baseline examinations disclosed iNPH patients had a lower ALPS index than HC (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.0001). We found a significantly increased ALPS index at 3\u2009months after surgery compared to baseline (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.0001). Positive correlations between the\u0394ALPS and the increments of MMSE score (\u0394MMSE) were found in all iNPH patients. Baseline age and \u0394ALPS emerged as significant predictors of \u0394MMSE, with the model explaining 68.13% of the variance (\n                      <jats:italic>R<\/jats:italic>\n                      <jats:sup>2<\/jats:sup>\n                      \u2009=\u20090.6813).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Glymphatic function in iNPH was enhanced following shunt surgery, which positively impacted cognitive recovery. The DTI\u2010ALPS index may serve as a useful predictor of shunting efficacy in iNPH patients.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/ene.70200","type":"journal-article","created":{"date-parts":[[2025,5,14]],"date-time":"2025-05-14T05:20:14Z","timestamp":1747200014000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":14,"title":["Alterations of Glymphatic System Before and After Shunt Surgery in Patients With Idiopathic Normal Pressure Hydrocephalus: A Longitudinal Study"],"prefix":"10.1111","volume":"32","author":[{"ORCID":"https:\/\/orcid.org\/0009-0006-7195-0670","authenticated-orcid":false,"given":"Yifeng","family":"Yang","sequence":"first","affiliation":[{"name":"Department of Radiology Huadong Hospital, Fudan University  Shanghai China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Meijing","family":"Yan","sequence":"additional","affiliation":[{"name":"Department of Radiology Huadong Hospital, Fudan University  Shanghai China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiao","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Radiology Huadong Hospital, Fudan University  Shanghai China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shihong","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Radiology Huadong Hospital, Fudan University  Shanghai China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guangwu","family":"Lin","sequence":"additional","affiliation":[{"name":"Department of Radiology Huadong Hospital, Fudan University  Shanghai China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,5,14]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1136\/jnnp-2012-302924"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.i3974"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.3389\/fnagi.2022.866313"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/cns.13526"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1126\/scitranslmed.3003748"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1002\/ana.24271"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0000000000013215"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1474-4422(18)30318-1"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1111\/cns.14458"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1111\/cns.13984"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1093\/brain\/awx191"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1177\/0271678X18760974"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.1172\/jci.insight.121537"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.1167\/iovs.61.13.24"},{"key":"e_1_2_9_16_1","doi-asserted-by":"publisher","DOI":"10.3174\/ajnr.A7841"},{"key":"e_1_2_9_17_1","doi-asserted-by":"publisher","DOI":"10.3389\/fneur.2022.857328"},{"key":"e_1_2_9_18_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11604-017-0617-z"},{"key":"e_1_2_9_19_1","doi-asserted-by":"publisher","DOI":"10.2463\/mrms.rev.2023-0175"},{"key":"e_1_2_9_20_1","doi-asserted-by":"publisher","DOI":"10.1002\/ana.26516"},{"key":"e_1_2_9_21_1","doi-asserted-by":"publisher","DOI":"10.1155\/2019\/5675014"},{"key":"e_1_2_9_22_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.parkreldis.2020.11.009"},{"key":"e_1_2_9_23_1","doi-asserted-by":"publisher","DOI":"10.2147\/CIA.S290709"},{"key":"e_1_2_9_24_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13195-022-00999-5"},{"key":"e_1_2_9_25_1","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0000000000201300"},{"key":"e_1_2_9_26_1","doi-asserted-by":"publisher","DOI":"10.3389\/fnmol.2017.00144"},{"key":"e_1_2_9_27_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bbi.2020.07.022"},{"key":"e_1_2_9_28_1","doi-asserted-by":"publisher","DOI":"10.1002\/jmri.28797"},{"issue":"3","key":"e_1_2_9_29_1","first-page":"415","article-title":"Early Improvement in Interstitial Fluid Flow in Patients With Severe Carotid Stenosis After Angioplasty and Stenting","volume":"26","author":"Wu C. 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