The glymphatic system cleans amyloid and tau proteins from the brain in animal studies of Alzheimer disease (AD). However, there is no direct evidence showing this in humans.
Participants (n = 50, 62.6 ± 5.4 years old, 36 women) with AD and normal controls underwent amyloid positron emission tomography (PET), tau PET, structural T1‐weighted magnetic resonance imaging, and neuropsychological evaluation. Whole‐brain glymphatic activity was measured by diffusion tensor image analysis along the perivascular space (DTI‐ALPS).
ALPS‐indexes showed negative correlations with deposition of amyloid and tau on PET images and positive correlations with cognitive scores even after adjusting for age, sex, years of education, andAPOE4genotype covariates in multiple AD‐related brain regions (allp< 0.05). Mediation analysis showed that ALPS‐index acted as a significant mediator between regional standardized uptake value ratios of amyloid and tau images and cognitive dysfunction even after correcting for multiple covariates in AD‐related brain regions. These regions are responsible for attention, memory, and executive function, which are vulnerable to sleep deprivation.
Glymphatic system activity may act as a significant mediator in AD‐related cognitive dysfunction even after adjusting for multiple covariates and gray matter volumes. ALPS‐index may provide useful disease progression or treatment biomarkers for patients with AD as an indicator of modulation of glymphatic activity. ANN NEUROL 2023;93:164–174

Jung‐Lung Hsu

Yi‐Chia Wei

Cheng Hong Toh

Ing‐Tsung Hsiao

Kun‐Ju Lin

Tzu‐Chen Yen

Ming‐Feng Liao

Long‐Sun Ro

Annals of Neurology

《神经病学年鉴》发表了对神经病学具有广泛兴趣的文章，尤其是那些对理解人类神经系统疾病的机制和治疗有重大影响的文章。尽管 ANNALS 使用多种临床和基本神经科学方法发表论文，但我们最感兴趣的是学术神经学家普遍感兴趣的那些手稿，包括临床试验和其他为医学实践提供信息的大规模研究。纯粹的基础研究，没有很强的临床或转化潜力，不太可能有足够的优先发表权。

The Annals of Neurology publishes articles on a wide range of topics relevant to neurology, particularly those that have a significant impact on understanding the mechanisms and treatments of human neurological diseases. While the Annals employs various clinical and basic neuroscience methods for publication, we are particularly interested in manuscripts that are of general interest to academic neurologists, including clinical trials and large-scale studies that provide valuable information for medical practice. Purely basic research, lacking strong clinical or translational potential, is less likely to receive priority for publication.

《Annals of Neurology》发表了与神经病学相关的广泛主题文章，特别是那些对理解人类神经系统疾病的机制和治疗具有重要影响的研究。虽然《Annals of Neurology》采用多种临床和基础神经科学方法来发表论文，但我们特别关注那些学术神经学家普遍感兴趣的稿件，包括临床试验和其他为医学实践提供重要信息的大规模研究。纯粹的基础研究，若缺乏明显的临床或转化潜力，通常不具备优先发表的条件。

Category	Quartile
医学	1
医学, 临床神经病学	1
医学, 神经科学	1

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