Iliff JJ, Wang M, Liao Y et al (2012) A paravascular pathway facilitates CSF flow through the brain parenchyma and the clearance of interstitial solutes, including amyloid β. Sci Transl Med 4:147ra111

Article  PubMed  PubMed Central  Google Scholar 

Jessen NA, Munk ASF, Lundgaard I, Nedergaard M (2015) The glymphatic system: a beginner’s guide. Neurochem Res 40:2583–2599

Article  CAS  PubMed  PubMed Central  Google Scholar 

Jungwon J, Lee JH, Choi C-H, Lee J (2025) DTI-ALPS index as a predictor of cognitive decline over 1 year. Neuroradiology 67:163–170

Article  PubMed  Google Scholar 

Kamagata K, Andica C, Takabayashi K et al (2022) Association of MRI indices of glymphatic system with amyloid deposition and cognition in mild cognitive impairment and Alzheimer disease. Neurology 99:e2648–e2660

Article  CAS  PubMed  PubMed Central  Google Scholar 

Zhuo J, Raghavan P, Li J et al (2024) Longitudinal assessment of glymphatic changes following mild traumatic brain injury: insights from perivascular space burden and DTI-ALPS imaging. Front Neurol 15:1443496

Article  PubMed  PubMed Central  Google Scholar 

Bouffard MA, Avanaki MA, Ford JN et al (2024) MRI indices of glymphatic function correlate with disease duration in idiopathic intracranial hypertension. J Neuro-Ophthalmol. https://doi.org/10.1097/WNO.0000000000002259

Article  Google Scholar 

Li X, Lin Z, Liu C et al (2024) Glymphatic imaging in pediatrics. J Magn Reson Imaging 59:1523–1541

Article  PubMed  Google Scholar 

Zhang W, Zhou Y, Wang J et al (2021) Glymphatic clearance function in patients with cerebral small vessel disease. Neuroimage 238:118257

Article  PubMed  Google Scholar 

Wang L, Hu J, Li J-X et al (2025) Association between glymphatic system function and cognitive impairment in elderly patients with late-onset epilepsy. Epilepsy Behav 164:110258

Article  PubMed  Google Scholar 

Li X, Ruan C, Zibrila AI et al (2022) Children with autism spectrum disorder present glymphatic system dysfunction evidenced by diffusion tensor imaging along the perivascular space. Medicine (Baltimore) 101:e32061

Article  PubMed  PubMed Central  Google Scholar 

Costa T, Manuello J, Premi E et al (2024) Evaluating the robustness of DTI-ALPS in clinical context: a meta-analytic parallel on Alzheimer’s and Parkinson’s diseases. Sci Rep 14:26381

Article  CAS  PubMed  PubMed Central  Google Scholar 

Huang S, Lin L, Gao X et al (2026) Glymphatic system dysfunction in pediatric growth hormone deficiency evidenced by multiple MRI metrics. Quant Imaging Med Surg 16:58–58

Article  CAS  PubMed  Google Scholar 

Mun-Ching WA, Siow T-Y, Chiang M-C et al (2026) Disrupted age-related glymphatic patterns in children with deep gray matter hypoxic-ischemic encephalopathy: a diffusion tensor imaging analysis along the perivascular space study. Neuroradiology. https://doi.org/10.1007/s00234-025-03899-1

Article  Google Scholar 

Margoni M, Pagani E, Meani A et al (2024) Cognitive impairment is related to glymphatic system dysfunction in pediatric multiple sclerosis. Ann Neurol 95:1080–1092

Article  CAS  PubMed  Google Scholar 

Taoka T, Masutani Y, Kawai H et al (2017) Evaluation of glymphatic system activity with the diffusion MR technique: diffusion tensor image analysis along the perivascular space (DTI-ALPS) in Alzheimer’s disease cases. Jpn J Radiol 35:172–178

Article  PubMed  Google Scholar 

Lin S, Guo M, Liang Q et al (2024) Evaluation of glymphatic system development in neonatal brain via diffusion analysis along the perivascular space index. Ann Neurol 96:970–980

Article  PubMed  Google Scholar 

Peng T, Lin Y, Xu X et al (2025) Assessing neonatal brain glymphatic system development using diffusion tensor imaging along the perivascular space and choroid plexus volume. BMC Med Imaging 25:126

Article  PubMed  PubMed Central  Google Scholar 

Howell BR, Styner MA, Gao W et al (2019) The UNC/UMN baby connectome project (BCP): an overview of the study design and protocol development. Neuroimage 185:891–905

Article  PubMed  Google Scholar 

Yeh, Fang-Cheng (2025) DSI Studio: an integrated tractography platform and fiber data hub for accelerating brain research. Nat Methods. https://doi.org/10.1038/s41592-025-02762-8

Yeh F-C, Verstynen TD, Wang Y et al (2013) Deterministic diffusion fiber tracking improved by quantitative anisotropy. PLoS ONE 8:e80713

Article  PubMed  PubMed Central  Google Scholar 

Taoka T, Ito R, Nakamichi R et al (2022) Diffusion-weighted image analysis along the perivascular space (DWI-ALPS) for evaluating interstitial fluid status: age dependence in normal subjects. Jpn J Radiol 40:894–902

Article  PubMed  PubMed Central  Google Scholar 

Jenkinson M, Bannister P, Brady M, Smith S (2002) Improved optimization for the robust and accurate linear registration and motion correction of brain images. Neuroimage 17:825–841

Article  PubMed  Google Scholar 

Bethlehem RAI, Seidlitz J, White SR et al (2022) Brain charts for the human lifespan. Nature 604:525–533

Article  CAS  PubMed  PubMed Central  Google Scholar 

Chen Y, Wang M, Su S et al (2023) Assessment of the glymphatic function in children with attention-deficit/hyperactivity disorder. Eur Radiol 34:1444–1452

Article  PubMed  Google Scholar 

Zhao X, Zhou Y, Li Y et al (2023) The asymmetry of glymphatic system dysfunction in patients with temporal lobe epilepsy: a DTI-ALPS study. J Neuroradiol J Neuroradiol 50:562–567

Article  PubMed  Google Scholar 

Wong A-C, Siow T-Y, Cheng Y-T et al (2025) Age-related change of glymphatic function in normative children assessed using diffusion tensor imaging-analysis along the perivascular space. Magn Reson Imaging 120:110398

Article  CAS  PubMed  Google Scholar 

Chiron C, Jambaque I, Nabbout R et al (1997) The right brain hemisphere is dominant in human infants. Brain J Neurol 120:1057–1065

Article  Google Scholar 

Cheng P, Li Y, Wang S et al (2025) Coupling analysis of diffusion tensor imaging analysis along the perivascular space (DTI-ALPS) with abnormal cerebral blood flow in methamphetamine-dependent patients and its application in machine-learning-based classification. J Affect Disord 376:463–472

Article  PubMed  Google Scholar 

Lu Y, Liu Y, Zhang H et al (2025) Relationship between impaired cerebral lymphatic function and iron deposition, blood flow in VaD: a clinical MRI study. Front Neurosci 19:1666038

Article  PubMed  PubMed Central  Google Scholar 

Kipnis J, Benveniste H, Eichmann A et al (2025) Resolving the mysteries of brain clearance and immune surveillance. Neuron 113:3908–3923

Article  CAS  PubMed  PubMed Central  Google Scholar 

Fultz NE, Bonmassar G, Setsompop K et al (2019) Coupled electrophysiological, hemodynamic, and cerebrospinal fluid oscillations in human sleep. Science 366:628–631

Article  CAS  PubMed  PubMed Central  Google Scholar 

Lin L-P, Su S, Hou W et al (2023) Glymphatic system dysfunction in pediatric acute lymphoblastic leukemia without clinically diagnosed central nervous system infiltration: a novel DTI-ALPS method. Eur Radiol 33:3726–3734

Article  CAS  PubMed  Google Scholar 

Yendiki A, Koldewyn K, Kakunoori S et al (2014) Spurious group differences due to head motion in a diffusion MRI study. Neuroimage 88:79–90

Article  PubMed  Google Scholar 

Liu X, Ba