DTI-ALPS Associations with Regional Amyloid Deposition and Glucose Metabolism in Mild Cognitive Impairment and Alzheimer's Disease.

Authors

Chang Yi, Weineng Chen, Xinchong Shi, Yuhao Lin, Yifan Zheng, Ganhua Luo, Zhong Pei, Xiangsong Zhang

Published in

Journal of neuroradiology = Journal de neuroradiologie. Pages 101586. Jun 30, 2026. Epub Jun 30, 2026.

Abstract

The DTI analysis along the perivascular space (DTI-ALPS) index is widely used to assess water diffusion alterations in Alzheimer's disease (AD), yet its biological interpretation remains debated. We investigated DTI-ALPS associations with regional amyloid-β (Aβ) deposition, glucose metabolism, and cognitive function in Chinese patients with AD and mild cognitive impairment (MCI), offering finer-grained imaging evidence for its pathophysiological interpretation.
34 AD dementia (ADD) patients, 40 MCI patients, and 52 cognitively normal controls (NCs) underwent MRI, ¹⁸F-florbetapir (¹⁸F-AV45) (standardized uptake value ratio, SUVR; centiloid values, CL), and ¹⁸F-FDG (SUVR) imaging. MRI volumetry and PET quantification used Neurophet SCALE PET software. Mediation analysis tested ALPS effects between pathology/metabolism and cognition.
ALPS differed significantly across groups (ADD:1.152±0.113; MCI:1.247±0.122; NC:1.302±0.121; p<0.001). Adjusted for age, sex, education, and APOE4, ALPS correlated positively with MMSE (r=0.324, p<0.001) and MoCA (r=0.311, p<0.001) and negatively with CL (r=-0.415, p<0.001). The ALPS index showed negative correlations with ¹⁸F-AV45 PET SUVR in nearly all brain regions, with the strongest negative associations observed in the posterior cingulate (r=-0.459), paracentral (r=-0.445), superior frontal (r=-0.441), and inferior temporal (r=-0.433) regions. For ¹⁸F-FDG PET SUVR, the ALPS index demonstrated bidirectional correlations: positive in regions including the inferior parietal (r=0.396), isthmus of cingulate (r=0.376), and precuneus (r=0.369), but negative in the paracentral (r=-0.418), precentral (r=-0.406), and cerebellar white matter (r=-0.374) (all p<0.001). Mediation analysis revealed that the ALPS index mediates the relationships between glucose metabolism/Aβ accumulation and both abstract thinking and memory. Parietal/cingulate isthmus/precuneus FDG metabolism showed significant ALPS-mediated indirect effects across cognitive domains (p<0.05).
The ALPS index correlates with Aβ deposition and exhibits region-specific metabolic associations in AD, mediating amyloid-metabolism-cognition pathways and predicting cognitive decline. These findings provide a region-wise correlation map of perivascular water diffusion alterations in AD, informing future research directions, though underlying mechanisms require validation.

PMID:
42379471
Bibliographic data and abstract were imported from PubMed on 01 Jul 2026.

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