Associations among Cognitive Functions, Plasma DNA, and Diffusion Tensor Image along the Perivascular Space (DTI-ALPS) in Patients with Parkinson’s Disease

Figure 1

Illustration of the brain waste clearance between the perivascular space and glymphatic system. The glymphatic system is a waste drainage system in which cerebrospinal fluid (CSF) in the para-arterial space exchanges with interstitial fluid (ISF) with the aid of aquaporin-4 (AQP4) water channels on the astroglial endfeet and is drained into the perivascular space, from which it eventually reaches the lymphatic nodes. The system is driven by para-arterial ISF bulk influx (red arrow), glymphatic ISF bulk influx (blue arrow), and para-venous CSF-ISF efflux (green arrow). In disease status, such as neurodegeneration disorder, neuroinflammation in interaction with systemic oxidative stress can alter the function of BBB and astrocytes and waste clearance efficiency in the glymphatic system.