TY - JOUR
T1 - Novel developments in non-contrast enhanced MRI of the perivascular clearance system
T2 - What are the possibilities for Alzheimer's disease research?
AU - van der Thiel, Merel M
AU - Backes, Walter H
AU - Ramakers, Inez H G B
AU - Jansen, Jacobus F A
N1 - Copyright © 2022 The Authors. Published by Elsevier Ltd.. All rights reserved.
PY - 2023/1
Y1 - 2023/1
N2 - The cerebral waste clearance system (i.e, glymphatic or intramural periarterial drainage) works through a network of perivascular spaces (PVS). Dysfunction of this system likely contributes to aggregation of Amyloid-β and subsequent toxic plaques in Alzheimer's disease (AD). A promising, non-invasive technique to study this system is MRI, though applications in dementia are still scarce. This review focusses on recent non-contrast enhanced (non-CE) MRI techniques which determine and visualise physiological aspects of the clearance system at multiple levels, i.e., cerebrospinal fluid flow, PVS-flow and interstitial fluid movement. Furthermore, various MRI studies focussing on aspects of the clearance system which are relevant to AD are discussed, such as studies on ageing, sleep alterations, and cognitive decline. Additionally, the complementary function of non-CE to CE methods is elaborated upon. We conclude that non-CE studies have great potential to determine which parts of the waste clearance system are affected by AD and in which stages of cognitive impairment dysfunction of this system occurs, which could allow future clinical trials to target these specific mechanisms.
AB - The cerebral waste clearance system (i.e, glymphatic or intramural periarterial drainage) works through a network of perivascular spaces (PVS). Dysfunction of this system likely contributes to aggregation of Amyloid-β and subsequent toxic plaques in Alzheimer's disease (AD). A promising, non-invasive technique to study this system is MRI, though applications in dementia are still scarce. This review focusses on recent non-contrast enhanced (non-CE) MRI techniques which determine and visualise physiological aspects of the clearance system at multiple levels, i.e., cerebrospinal fluid flow, PVS-flow and interstitial fluid movement. Furthermore, various MRI studies focussing on aspects of the clearance system which are relevant to AD are discussed, such as studies on ageing, sleep alterations, and cognitive decline. Additionally, the complementary function of non-CE to CE methods is elaborated upon. We conclude that non-CE studies have great potential to determine which parts of the waste clearance system are affected by AD and in which stages of cognitive impairment dysfunction of this system occurs, which could allow future clinical trials to target these specific mechanisms.
KW - Humans
KW - Alzheimer Disease/diagnostic imaging
KW - Glymphatic System/diagnostic imaging
KW - Amyloid beta-Peptides/metabolism
KW - Cognitive Dysfunction/diagnostic imaging
KW - Magnetic Resonance Imaging/methods
KW - Brain
U2 - 10.1016/j.neubiorev.2022.104999
DO - 10.1016/j.neubiorev.2022.104999
M3 - (Systematic) Review article
C2 - 36529311
SN - 0149-7634
VL - 144
JO - Neuroscience and Biobehavioral Reviews
JF - Neuroscience and Biobehavioral Reviews
IS - 1
M1 - 104999
ER -