Glymphatic dysfunction evidenced by DTI-ALPS is related to obstructive sleep apnea intensity in newly diagnosed Parkinson’s disease

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Abstract Glymphatic dysfunction can contribute to Parkinson’s disease (PD). Obstructive sleep apnea (OSA) disturbs sleep, which is necessary for its proper function, and is frequent in PD. We investigated the glymphatic function in de novo PD and its relation to OSA. Fifty-four PD patients (mean age 58.9 ± 12.2 years) and 32 controls (mean age 59.4 ± 8.3 years) underwent polysomnography and 3T magnetic resonance imaging of the brain. Diffusion tensor imaging along the perivascular space (DTI-ALPS) was calculated using atlas-based automatic regions of interest selection. In PD ALPS-index negatively correlated with apnea-hypopnea index (rho=-0.41; p = 0.002), oxygen desaturation index (rho=-0.38; p = 0.006), sleep stage N1 (rho=-0.42; p = 0.002), and arousal index (rho=-0.24; p = 0.018), and positively correlated with sleep stage R (rho = 0.32; p = 0.023), while in controls no such correlations were observed. Glymphatic dysfunction is related to OSA severity in de novo PD but not in controls. We imply that OSA contributes to neurodegeneration via glymphatic impairment in PD.

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