Assessing neonatal brain glymphatic system development using diffusion tensor imaging along the perivascular space and choroid plexus volume

作者：Ting Peng, Ying Lin, Xin Xu, Jiaqi Li, Miaoshuang Liu, Chaowei Zhang, Xiaohui Liao, Xiaoshan Ji, Zhongmeng Xiong, Zhuoyang Gu, Xinyi Cai, Tianli Tao, Yajuan Zhang, Lixuan Zhu, Deyi Zhuang, Xianghui Huang, Man Xiong, Peng Zhang, Jungang Liu, Guoqiang Cheng · 发表于：BMC Medical Imaging · 年份：2025 · DOI：10.1186/s12880-025-01673-6 · 被引用次数：8 · 研究领域：Cerebrospinal fluid and hydrocephalus、Spinal Dysraphism and Malformations、Fetal and Pediatric Neurological Disorders

PURPOSE: Neonatal brain development constitutes a critical period of structural and functional maturation underpinning sensory, motor, and cognitive capacities. The glymphatic system-a cerebral waste clearance network-remains poorly understood in neonates. We investigated non-invasive magnetic resonance imaging (MRI) biomarkers of glymphatic system and their developmental correlates in neonates. METHODS: In 117 neonates undergoing high-resolution T1-weighted and diffusion MRI, we quantified two glymphatic metrics: (1) diffusion tensor imaging along the perivascular space (DTI-ALPS) index, reflecting perivascular fluid dynamics; (2) choroid plexus (CP) volume, a cerebrospinal fluid (CSF) production marker. Associations with postmenstrual age (PMA) at MRI scan, gestational age (GA), birth weight (BW), and sex were analyzed using covariate-adjusted models. RESULTS: Preterm neonates displayed significantly reduced DTI-ALPS indices versus term neonates (total index: 1.01 vs. 1.05, P = 0.002), with reductions persisting after adjustment (P < 0.05). CP volumes showed right-dominant pre-adjustment differences (preterm: 0.33 vs. term: 0.39, P = 0.039) that attenuated post-adjustment (P = 0.348). DTI-ALPS indices demonstrated transient correlations with PMA/GA/BW in unadjusted analyses (P < 0.05), whereas CP volumes maintained robust PMA associations post-adjustment in all neonates (P = 0.037) and term subgroup (P = 0.013). No significant effects of sex on both metrics were observed. C...