{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,17]],"date-time":"2026-06-17T04:57:07Z","timestamp":1781672227140,"version":"3.54.5"},"reference-count":44,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,6,17]],"date-time":"2026-06-17T00:00:00Z","timestamp":1781654400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Neurol."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Middle cerebral artery stenosis (MCA-S) impairs cerebral perfusion and vascular pulsatility, potentially disrupting cerebrospinal fluid dynamics. We evaluated perivascular diffusivity in MCA-S using diffusion tensor image analysis along the perivascular space (DTI-ALPS) index and the redirected ALPS (ro-ALPS) index, and assessed their clinical correlations.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Thirty-seven patients with MCA-S and 41 matched healthy controls (HCs) underwent MRI and cognitive function testing. We compared the DTI-ALPS index and ro-ALPS indices between the two groups and performed correlation analyses with cognitive scores and clinical indicators, including high-density lipoprotein, homocysteine, and choroid plexus (CP) volume.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The results showed that both DTI-ALPS index and ro-ALPS index were significantly lower in the MCA-S group than in the HC group (both\n                      <jats:italic>p<\/jats:italic>\n                      &amp;lt;\u202f0.001). In MCA-S patients, the DTI-ALPS index was negatively correlated with CP volume (\n                      <jats:italic>r<\/jats:italic>\n                      =\u202f\u22120.541,\n                      <jats:italic>\n                        p\n                        <jats:sub>FDR<\/jats:sub>\n                      <\/jats:italic>\n                      =\u202f0.012), and the ro-ALPS index showed a negative correlation with CP volume (\n                      <jats:italic>r<\/jats:italic>\n                      =\u202f\u22120.568,\n                      <jats:italic>\n                        p\n                        <jats:sub>FDR<\/jats:sub>\n                      <\/jats:italic>\n                      &amp;lt;\u202f0.001).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>These findings suggest that perivascular clearance is impaired in patients with MCA-S, as reflected by lower ALPS indices. These ALPS indices, as imaging biomarkers, show significant associations with CP volume, suggesting their potential utility in monitoring disease progression.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fneur.2026.1826663","type":"journal-article","created":{"date-parts":[[2026,6,17]],"date-time":"2026-06-17T04:45:25Z","timestamp":1781671525000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Non-invasive assessment of glymphatic dysfunction in middle cerebral artery stenosis based on DTI-ALPS and ro-ALPS"],"prefix":"10.3389","volume":"17","author":[{"given":"Yidi","family":"Zhu","sequence":"first","affiliation":[{"name":"School of Medical Imaging, Hangzhou Medical College","place":["Hangzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luoyu","family":"Wang","sequence":"additional","affiliation":[{"name":"School of Biomedical Engineering, ShanghaiTech University","place":["Shanghai, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Liqing","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Radiology, Affiliated Hangzhou First People\u2019s Hospital, School of Medicine, Westlake University","place":["Hangzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xue","family":"Tang","sequence":"additional","affiliation":[{"name":"School of Medical Imaging, Hangzhou Medical College","place":["Hangzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maoling","family":"Liu","sequence":"additional","affiliation":[{"name":"School of Medical Imaging, Hangzhou Medical College","place":["Hangzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qingqing","family":"Wen","sequence":"additional","affiliation":[{"name":"MR Research, GE Healthcare","place":["Beijing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Darong","family":"Zhu","sequence":"additional","affiliation":[{"name":"Department of Radiology, Affiliated Hangzhou First People\u2019s Hospital, School of Medicine, Westlake University","place":["Hangzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Han","family":"Zhang","sequence":"additional","affiliation":[{"name":"School of Biomedical Engineering, ShanghaiTech University","place":["Shanghai, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiufang","family":"Xu","sequence":"additional","affiliation":[{"name":"School of Medical Imaging, Hangzhou Medical College","place":["Hangzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhongxiang","family":"Ding","sequence":"additional","affiliation":[{"name":"Department of Radiology, Affiliated Hangzhou First People\u2019s Hospital, School of Medicine, Westlake University","place":["Hangzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,6,17]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"663","DOI":"10.1161\/STROKEAHA.113.003508","article-title":"Prevalence and outcomes of symptomatic intracranial large artery Stenoses and occlusions in China: the Chinese intracranial atherosclerosis (CICAS) study","volume":"45","author":"Wang","year":"2014","journal-title":"Stroke"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"140","DOI":"10.3389\/fnagi.2017.00140","article-title":"A high-resolution MRI study of relationship between remodeling patterns and ischemic stroke in patients with atherosclerotic middle cerebral artery stenosis","volume":"9","author":"Zhang","year":"2017","journal-title":"Front Aging Neurosci"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"532","DOI":"10.1161\/hs0202.102602","article-title":"Progression of middle cerebral artery occlusive 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