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Neurol."],"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>The aim of this study was to evaluate the water diffusivity changes along the perivascular space after lumboperitoneal shunt (LPS) surgery in idiopathic normal pressure hydrocephalus.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Nine patients diagnosed with idiopathic normal pressure hydrocephalus (iNPH; three men and six women, mean age \u00b1 SD = 75.22 \u00b1 5.12 years) according to the guidelines for iNPH in Japan were included in the study. Post-LPS surgery, six patients with iNPH who exhibited improvement in symptoms were defined as responder subjects, while three patients with iNPH who did not were defined as non-responder subjects. We calculated the mean analysis along the perivascular space (ALPS) index of the left and right hemispheres and compared the differences between pre- and post-LPS surgery mean ALPS indices in iNPH patients. In the responder or non-responder subjects, the mean ALPS indices in the pre- and post-operative iNPH groups were compared using Wilcoxon signed-rank tests. Next, correlation analyses between pre- and post-operation changes in the mean ALPS index and clinical characteristics were conducted.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The mean ALPS index of the post-operative iNPH group was significantly higher than that of the pre-operative iNPH group (<jats:italic>p<\/jats:italic> = 0.021). In responder subjects, the mean ALPS index of the post-operative iNPH group was significantly higher than that of the pre-operative iNPH group (<jats:italic>p<\/jats:italic> = 0.046). On the other hand, in the non-responder subjects, the mean ALPS index of the post-operative iNPH group was not significantly different compared to the pre-operative iNPH group (<jats:italic>p<\/jats:italic> = 0.285). The mean ALPS index change was not significantly correlated with changes in the Mini-Mental State Examination (MMSE) score (<jats:italic>r<\/jats:italic> = \u22120.218, <jats:italic>p<\/jats:italic> = 0.574), Frontal Assessment Battery (FAB) score (<jats:italic>r<\/jats:italic> = 0.185, <jats:italic>p<\/jats:italic> = 0.634), Trail Making Test A (TMTA) score (<jats:italic>r<\/jats:italic> = 0.250, <jats:italic>p<\/jats:italic> = 0.516), and Evans' index (<jats:italic>r<\/jats:italic> = 0.109, <jats:italic>p<\/jats:italic> = 0.780). In responder subjects, the mean ALPS index change was significantly correlated with Evans' index in pre-operative patients with iNPH (<jats:italic>r<\/jats:italic> = 0.841, <jats:italic>p<\/jats:italic> = 0.036).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>This study demonstrates the improved water diffusivity along perivascular space in patients with iNPH after LPS surgery. This could be indicative of glymphatic function recovery following LPS surgery.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fneur.2022.843883","type":"journal-article","created":{"date-parts":[[2022,2,28]],"date-time":"2022-02-28T05:02:17Z","timestamp":1646024537000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":36,"title":["Water Diffusivity Changes Along the Perivascular Space After Lumboperitoneal Shunt Surgery in Idiopathic Normal Pressure 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