Glymphatic System Alterations in Thyroid Eye Disease: Evidence from DTI-ALPS Analysis

Motivation: Thyroid eye disease (TED) patients show brain abnormalities with unclear mechanisms. Glymphatic system dysfunction, responsible for brain waste clearance, may contribute to these changes. Goal(s): To assess glymphatic function differences across TED phases and their correlation with clinical features. Approach: We analyzed data from 47 TED patients (20 active, 27 inactive) and 24 controls using diffusion tensor imaging along the perivascular space (DTI-ALPS) and performed correlation analyses with clinical features. Results: TED patients, especially inactive ones, had significantly lower left ALPS values than controls. Lower ALPS values correlated with longer disease duration and larger lid aperture. Impact: This study highlights the glymphatic system's potential role in TED-related brain changes, emphasizing the need for further exploration of its pathophysiological mechanisms. Future validation of these findings may open new avenues for understanding and managing neurological impacts in TED.