{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T22:37:16Z","timestamp":1789598236605,"version":"build-2803163510"},"reference-count":42,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2025,10,25]],"date-time":"2025-10-25T00:00:00Z","timestamp":1761350400000},"content-version":"vor","delay-in-days":24,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100010256","name":"Guangzhou Municipal Science and Technology Project","doi-asserted-by":"publisher","award":["2024A03J1109"],"award-info":[{"award-number":["2024A03J1109"]}],"id":[{"id":"10.13039\/501100010256","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100010883","name":"Traditional Chinese Medicine Bureau of Guangdong Province","doi-asserted-by":"publisher","award":["20251277"],"award-info":[{"award-number":["20251277"]}],"id":[{"id":"10.13039\/501100010883","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":[[2025,10]]},"abstract":"ABSTRACT<\/jats:title>\n \n Background and Objectives<\/jats:title>\n Glymphatic dysfunction occurs in Parkinson's disease (PD), but its status in prodromal PD (pPD) is unclear. Using the diffusion tensor imaging along perivascular spaces (DTI\u2010ALPS) index as an indirect proxy, this study aims to evaluate glymphatic\u2010related changes in a pPD cohort and to explore their relationship with symptoms, gray matter volume, and risk of phenoconversion.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n We analyzed data from the Parkinson's Progression Marker Initiative, including 51 healthy controls (HC), 83 individuals with pPD, and 202 with de novo PD (dnPD). The pPD cohort underwent \u2265\u20094\u2010year follow\u2010up. Cross\u2010sectional analyses compared the DTI\u2010ALPS index across three groups and examined associations between the DTI\u2010ALPS index and clinical features\/gray matter volume in the pPD cohort. For longitudinal analysis, the relationship of DTI\u2010ALPS index with the risk of phenoconversion was assessed via Kaplan\u2013Meier and Cox regression.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n DTI\u2010ALPS index was significantly reduced in pPD and dnPD vs. HC (\n p<\/jats:italic>\n \u2009<\u20090.001). In pPD, lower DTI\u2010ALPS index correlated with: higher anxiety (STAI:\n r<\/jats:italic>\n \u2009=\u2009\u22120.46,\n p<\/jats:italic>\n \u2009=\u20090.02), elevated CSF p\u2010tau (\n r<\/jats:italic>\n \u2009=\u20090.52,\n p<\/jats:italic>\n \u2009=\u20090.04) and\n t<\/jats:italic>\n \u2010tau (\n r<\/jats:italic>\n \u2009=\u20090.42,\n p<\/jats:italic>\n \u2009=\u20090.03), lower volumes of right temporal pole (\n p<\/jats:italic>\n \u2009=\u20090.03), left thalamus (\n p<\/jats:italic>\n \u2009=\u20090.01), right superior occipital gyrus (\n p<\/jats:italic>\n \u2009=\u20090.04), and higher volume of left posterior central gyrus (\n p<\/jats:italic>\n \u2009=\u20090.03). Among 83 pPD subjects, 10 phenoconverted to PD. Each standard deviation decrease in DTI\u2010ALPS increased conversion risk by 13% (adjusted HR\u2009=\u20090.87, 95% CI 0.83\u20130.92;\n p<\/jats:italic>\n \u2009=\u20090.018).\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion<\/jats:title>\n Reduced DTI\u2010ALPS index in pPD\u2014which may reflect altered glymphatic function\u2014is associated with accelerated phenoconversion and correlates with clinical symptoms and cortico\u2010thalamic structural changes.<\/jats:p>\n <\/jats:sec>","DOI":"10.1111\/ene.70389","type":"journal-article","created":{"date-parts":[[2025,10,25]],"date-time":"2025-10-25T07:21:11Z","timestamp":1761376871000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Glymphatic Function in Prodromal Parkinson's Disease: Associations With Symptoms, Gray Matter Volume, and Phenoconversion Risk"],"prefix":"10.1111","volume":"32","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2074-6470","authenticated-orcid":false,"given":"Amei","family":"Chen","sequence":"first","affiliation":[{"name":"Department of Radiology Guangzhou First People's Hospital Affiliated to Guangzhou Medical University, the Second Affiliated Hospital of South China University of Technology Guangzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhanyu","family":"Kuang","sequence":"additional","affiliation":[{"name":"Department of Radiology Guangzhou First People's Hospital Affiliated to Guangzhou Medical University, the Second Affiliated Hospital of South China University of Technology Guangzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pek\u2010Lan","family":"Khong","sequence":"additional","affiliation":[{"name":"Department of Diagnostic Radiology Yong Loo Lin School of Medicine, National University of Singapore Singapore Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Junxiang","family":"Huang","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology Guangzhou Women and Children's Medical Center, Guangzhou Medical University Guangzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jinyu","family":"Wen","sequence":"additional","affiliation":[{"name":"School of Computer Science and Cyber Engineering Guangzhou University Guangzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yoon Seong","family":"Choi","sequence":"additional","affiliation":[{"name":"Department of Diagnostic Radiology Yong Loo Lin School of Medicine, National University of Singapore Singapore Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yongzhou","family":"Xu","sequence":"additional","affiliation":[{"name":"Philips Healthcare Guangzhou 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