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Glymphatic system impairment in patients with status epilepticus

  • Functional Neuroradiology
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Abstract

Objective

The aim of this study was to compare the function of the glymphatic system in patients with status epilepticus (SE) with that in healthy controls by diffusion tensor image analysis along the perivascular space (DTI-ALPS) method. We also investigated the association between glymphatic system function and the clinical characteristics of SE.

Methods

We retrospectively enrolled 28 patients with SE and 31 healthy controls matched for age and sex. All study participants underwent diffusion tensor imaging using the same 3-T MRI scanner, and the DTI-ALPS index was calculated. We compared the DTI-ALPS index between the SE group and the control group. We also evaluated the associations of the DTI-ALPS index with etiology and type of SE, age, putative duration of seizure, time interval until MRI, seizure-related changes on diffusion-weighted imaging, and any previous structural lesions.

Results

The DTI-ALPS index was significantly lower in the SE group than in the control group (1.462 ± 0.297 vs. 1.632 ± 0.270, p = 0.026) and was negatively correlated with age (r =  − 0.280, p = 0.032) in the SE group. However, there were no significant between-group differences in the DTI-ALPS index according to other clinical factors.

Significance

The finding of a significantly lower DTI-ALPS index in the SE group suggests that the glymphatic system is impaired in patients with SE. DTI-ALPS is a useful tool for evaluation of the function of the glymphatic system in these patients.

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Data availability

Data that support the findings of this study are available upon reasonable request.

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Funding

This work was supported by the Ministry of Science and ICT of the Republic of Korea (NRF-2021R1F1A1049605).

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Author notes

  1. Dong Ah Lee and Joonwon Lee contributed equally to this work.

Authors and Affiliations

  1. Department of Neurology, Haeundae Paik Hospital, Inje University College of Medicine, Haeundae-ro 875, Haeundae-gu, Busan, 48108, Korea

    Dong Ah Lee, Joonwon Lee & Kang Min Park

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  1. Dong Ah Lee
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Correspondence to Kang Min Park.

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Lee, D.A., Lee, J. & Park, K.M. Glymphatic system impairment in patients with status epilepticus. Neuroradiology 64, 2335–2342 (2022). https://doi.org/10.1007/s00234-022-03018-4

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