{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T16:42:09Z","timestamp":1790095329184,"version":"4.0.1"},"reference-count":36,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"21","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2025,11,4]]},"abstract":"<jats:sec xml:lang=\"en\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p xml:lang=\"en\">Cerebral amyloid angiopathy\u2013related hemorrhage is associated with both cerebral small vessel disease (CSVD) pathology and long\u2010term cognitive decline. The role of glymphatic dysfunction in mediating this relationship remains unclear.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p xml:lang=\"en\">A total of 111 participants (64 patients with cerebral amyloid angiopathy\u2013related hemorrhage, 47 healthy controls) underwent 7T magnetic resonance imaging at a stable postintracerebral hemorrhage stage. Imaging analyses included the Analysis Along the Perivascular Space (ALPS) index derived from diffusion tensor imaging, volumetric quantification of perivascular spaces, and choroid plexus segmentation. Hierarchical regression assessed group differences and associations with CSVD markers and cognition. Mediation analyses tested whether ALPS mediated the effect of CSVD on cognition.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p xml:lang=\"en\">\n                      Patients with cerebral amyloid angiopathy\u2013related hemorrhage showed significantly enlarged perivascular spaces in white matter and total brain (both\n                      <jats:italic toggle=\"no\">P<\/jats:italic>\n                      &lt;0.001) and reduced ALPS indices (\n                      <jats:italic toggle=\"no\">P<\/jats:italic>\n                      &lt;0.001). Group differences in ALPS remained significant after adjusting for total intracranial volume (\n                      <jats:italic toggle=\"no\">P<\/jats:italic>\n                      &lt;0.001) but not after further controlling for CSVD burden (\n                      <jats:italic toggle=\"no\">P<\/jats:italic>\n                      =0.191). In contrast, perivascular space abnormalities remained robust across all models. ALPS indices were negatively associated with white matter hyperintensity volume (contralateral side\u2010ALPS: \u03b2=\u22120.619,\n                      <jats:italic toggle=\"no\">P<\/jats:italic>\n                      &lt;0.001; ipsilateral side\u2010ALPS: \u03b2=\u22120.443,\n                      <jats:italic toggle=\"no\">P<\/jats:italic>\n                      &lt;0.01) and lobar cerebral microbleeds (ipsilateral side\u2010ALPS: \u03b2=\u22120.502,\n                      <jats:italic toggle=\"no\">P<\/jats:italic>\n                      =0.006), with white matter hyperintensity emerging as the strongest predictor of glymphatic dysfunction. Mean\u2010ALPS also correlated with deficits in global cognition, executive control, and processing speed. Mediation analyses indicated that ALPS statistically mediated the association between white matter hyperintensities and processing speed and executive function.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p xml:lang=\"en\">Noninvasively measured glymphatic dysfunction in cerebral amyloid angiopathy\u2013related hemorrhage reflects chronic CSVD burden and contributes to cognitive decline, highlighting ALPS as a sensitive and practical functional marker.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1161\/jaha.125.043072","type":"journal-article","created":{"date-parts":[[2025,10,28]],"date-time":"2025-10-28T10:49:01Z","timestamp":1761648541000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":6,"title":["From Vessels to Cognition: Glymphatic Alterations Following Hemorrhage in Cerebral Amyloid Angiopathy Are Associated With Small Vessel Disease Burden"],"prefix":"10.1161","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0009-0005-6664-4313","authenticated-orcid":false,"given":"Yijun","family":"Lin","sequence":"first","affiliation":[{"name":"Capital Medical University","place":["Beijing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0944-7613","authenticated-orcid":false,"given":"Sijia","family":"Li","sequence":"additional","affiliation":[{"name":"Beijing Hospital, National Center of Gerontology","place":["Beijing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6863-8850","authenticated-orcid":false,"given":"Yang","family":"Du","sequence":"additional","affiliation":[{"name":"Capital Medical University","place":["Beijing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-9974-7402","authenticated-orcid":false,"given":"Mengyao","family":"Li","sequence":"additional","affiliation":[{"name":"Capital Medical University","place":["Beijing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1083-5880","authenticated-orcid":false,"given":"Yanfang","family":"Liu","sequence":"additional","affiliation":[{"name":"Capital Medical University","place":["Beijing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8345-5147","authenticated-orcid":false,"given":"Xingquan","family":"Zhao","sequence":"additional","affiliation":[{"name":"Capital Medical University","place":["Beijing, China"]},{"name":"China National Clinical Research Center for Neurological Diseases","place":["Beijing, China"]},{"name":"Chinese Academy of Medical Sciences","place":["Beijing, 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