To examine the associations among glymphatic function, cognitive performance, and cerebrospinal fluid proteins in patients with tuberculous meningitis (TBM), highlighting the significance of these associations in understanding cognitive decline.
Key Findings:
All patients showed smaller hippocampal PVS volume fraction and larger CPV compared to healthy controls, indicating potential cognitive implications.
The TBM-MCI group exhibited lower ALPS and higher basal ganglia PVS, suggesting a link to cognitive decline.
ALPS indices positively correlated with cognitive measures, while CPV exhibited opposite correlations, highlighting the complexity of these relationships.
The right CPV fully mediated the relationship between the right ALPS-MMSE and the right ALPS index, emphasizing its role in cognitive assessment.
The left ALPS index predicted cognitive prognosis at 6 to 12 months, indicating its potential as a clinical tool.
Interpretation:
The study highlights the association between imaging markers of altered perivascular clearance and cognitive decline in TBM, suggesting the ALPS index as a potential biomarker for cognitive dysfunction and its implications for patient management.
Limitations:
The study does not explore the underlying molecular mechanisms in CSF in detail, which may limit understanding of the findings.
The sample size may limit the generalizability of the findings, suggesting caution in applying results to broader populations.
Conclusion:
The findings suggest that glymphatic dysfunction may play a role in cognitive decline in TBM, with the ALPS index serving as a promising biomarker, potentially guiding future clinical interventions.
