AUTHOR=Toh Cheng Hong , Siow Tiing Yee 

TITLE=Factors Associated With Dysfunction of Glymphatic System in Patients With Glioma

JOURNAL=Frontiers in Oncology

VOLUME=11

YEAR=2021

URL=https://www.frontiersin.org/journals/oncology/articles/10.3389/fonc.2021.744318

DOI=10.3389/fonc.2021.744318

ISSN=2234-943X

ABSTRACT=<sec><title>Objectives</title><p>Rodent experiments have provided some insights into the changes of glymphatic function associated with glioma growth. The diffusion tensor image analysis along the perivascular space (DTI-ALPS) method offers an opportunity for the noninvasive investigation of the glymphatic system in patients with glioma. We aimed to investigate the factors associated with glymphatic function changes in patients with glioma.</p></sec><sec><title>Materials and Methods</title><p>A total of 201 glioma patients (mean age = 47.4 years, 116 men; 86 grade II, 52 grade III, and 63 grade IV) who had preoperative diffusion tensor imaging for calculation of the ALPS index were retrospectively included. Information collected from each patient included sex, age, tumor grade, <italic>isocitrate dehydrogenase 1</italic> (<italic>IDH1</italic>) mutation status, peritumoral brain edema volume, tumor volume, and ALPS index. Group differences in the ALPS index according to sex, tumor grade, and <italic>IDH1</italic> mutation status were assessed using analysis of covariance with age adjustment. Linear regression analyses were performed to identify the factors associated with the ALPS index.</p></sec><sec><title>Results</title><p>Group comparisons revealed that the ALPS index of grade II/III gliomas was significantly higher than that of grade IV gliomas (<italic>p</italic> &lt; 0.001). The ALPS index of <italic>IDH1</italic> mutant gliomas was significantly higher than that of <italic>IDH1</italic> wild-type gliomas (<italic>p</italic> &lt; 0.001). On multivariable linear regression analysis, <italic>IDH1</italic> mutation (<italic>β</italic> = 0.308, <italic>p</italic> &lt; 0.001) and peritumoral brain edema volume (<italic>β</italic> = −0.353, <italic>p</italic> &lt; 0.001) were the two independent factors associated with the ALPS index.</p></sec><sec><title>Conclusion</title><p><italic>IDH1</italic> wild-type gliomas and gliomas with larger peritumoral brain edema volumes were associated with a lower ALPS index, which may reflect impaired glymphatic function.</p></sec>