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September 17, 2025

Investigation of the glymphatic system associated with post-stroke fatigue utilizing diffusion tensor imaging along the perivascular space

Key Points

The glymphatic system function is closely related to post-stroke fatigue severity.
A negative correlation exists between DTI-ALPS index and HAMD scores, indicating higher fatigue.
Assessments using diffusion tensor imaging captured glymphatic functionality over three-month follow-up.
Findings highlight the glymphatic system as a potential therapeutic target for post-stroke fatigue.

Abstract

Motivation: The damage of brain tissue after stroke can cause the dysfunction of the glymphatic system. Goal(s): This study aimed to investigate the association between glymphatic system functionality and post-stroke fatigue. Approach: For a total of 161 stroke patients, the function of the glymphatic system was assessed using the diffusion tensor imaging (DTI) derived perivascular space (ALPS) index and correlated with Hamilton Depression Scale (HAMD) scores between the baseline time and three months' follow-up. Results: The DTI-ALPS index was negatively correlated with HAMD scores reflecting fatigue severity. The growth trajectory of DTI-ALPS index was also significantly correlated with the growth trajectory of HAMD scores. Impact: The glymphatic system function is closely related to the occurrence and progression of post-stroke fatigue, which may be a potential therapeutic target for the treatment and prevention of post-stroke fatigue.

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