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We aimed to evaluate the glymphatic system of adult moyamoya disease (MMD) by measuring diffusion along the perivascular space (DTI-ALPS index). We evaluated 46 patients using diffusion MRI, perfusion parameters of 15O-gas PET, and cognitive tests, and 34 age-sex-matched normal controls. Compared to normal controls, patients with MMD showed significantly lower DTI-ALPS index. DTI-ALPS index in MMD revealed the correlation between perfusion and freewater parameters, and executive dysfunction, and suggested that dysfunction of the glymphatic system may exist, correlate with the degree of hemodynamic disturbance, lead to increased parenchymal free water, and relate to cognitive dysfunction in adult MMD.
Hara et al. (Wed,) studied this question.