Observational analysis identifies correlations between delayed gadolinium clearance and cognitive impairments in traumatic brain injury patients, suggesting potential for improved neurodegenerative assessments.
Motivation: Impaired waste clearance through the glymphatic pathway may contribute to neurodegeneration after traumatic brain injury (TBI). Goal(s): Our goal is to assess glymphatic dysfunction by tracking gadolinium clearance following intravenous injection in TBI patients and correlating it with cognitive impairments. Approach: We conducted MRI scans on 38 chronic TBI patients, using T1 mapping at immediate and 6-hour post-injection intervals. Results: Results indicate that slower gadolinium clearance at delayed 6hr time point, seen as higher T1 reduction, correlates with older age and worse cognitive scores. These findings could establish delayed T1 mapping as a marker for glymphatic health. Impact: Intravenous T1 mapping provides a non-invasive alternative to intrathecal gadolinium injection for glymphatic system assessment. This method may help validate other contrast-free glymphatic markers, facilitating broader clinical research and improving non-invasive neurodegenerative risk assessments in patients.
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Zhuo et al. (2025) studied this question.
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