Moderating effect of education on glymphatic function and cognitive performance in mild cognitive impairment

Liang Zhou; Wenxia Yang; Yang Liu; Yu Zheng; Xin Ge; Kai Ai; Guangyao Liu; Jing Zhang

doi:10.3389/fnagi.2024.1399943

Moderating effect of education on glymphatic function and cognitive performance in mild cognitive impairment

Front Aging Neurosci. 2024 May 2:16:1399943. doi: 10.3389/fnagi.2024.1399943. eCollection 2024.

Authors

Liang Zhou^#^{1

2}, Wenxia Yang^#^{1

2}, Yang Liu^{1

2}, Yu Zheng^{1

2}, Xin Ge^{1

2}, Kai Ai³, Guangyao Liu^{1

4}, Jing Zhang^{1

4}

Affiliations

¹ Department of Magnetic Resonance, The Second Hospital of Lanzhou University, Lanzhou, China.
² Second Clinical Medical School, Lanzhou University, Lanzhou, China.
³ Philips Healthcare, Xi'an, China.
⁴ Gansu Province Clinical Research Center for Functional and Molecular Imaging, Lanzhou, China.

^# Contributed equally.

Abstract

Objective: This research aims to investigate putative mechanisms between glymphatic activity and cognition in mild cognitive impairment (MCI) and analyzes whether the relationship between cognitive reserve (CR) and cognition was mediated by glymphatic activity.

Methods: 54 MCI patients and 31 NCs were enrolled to evaluate the bilateral diffusivity along the perivascular spaces and to acquire an index for diffusivity along the perivascular space (ALPS-index) on diffusion tensor imaging (DTI). The year of education was used as a proxy for CR. The ALPS-index was compared between two groups and correlation analyses among the ALPS-index, cognitive function, and CR were conducted. Mediation analyses were applied to investigate the correlations among CR, glymphatic activity and cognition.

Results: MCI group had a significantly lower right ALPS-index and whole brain ALPS-index, but higher bilateral diffusivity along the y-axis in projection fiber area (Dyproj) than NCs. In MCI group, the left Dyproj was negatively related to cognitive test scores and CR, the whole brain ALPS-index was positively correlated with cognitive test scores and CR. Mediation analysis demonstrated that glymphatic activity partially mediated the correlations between CR and cognitive function.

Conclusion: MCI exhibited decreased glymphatic activity compared to NCs. CR has a protective effect against cognitive decline in MCI, and this effect may be partially mediated by changes in glymphatic activity.

Keywords: cognitive function; cognitive reserve; diffusion tensor image; glymphatic function; mild cognitive impairment.

Grants and funding

The author(s) declare financial support was received for the research, authorship, and/or publication of this article. This research was supported by the Gansu Province Clinical Research Center for Functional and Molecular Imaging, grant/award number: 21JR7RA438.