Alzheimer's disease (AD) is the most common cause of dementia and, currently, there
are more than five million people with AD in the US alone. The etiology of Alzheimer's disease
is unknown, and therapies are just starting to be developed. The accumulation of neurotic
plaques (Aβ) and neurofibrillary tangles (NFT), and degeneration of neurons are the major
histopathological hallmarks of AD. However, a diagnosis of AD in the early stages of dementia
cannot be determined simply by amyloid imaging, because many healthy older adults with brain
Aβ deposits never develop dementia. Therefore, additional markers that can provide more
accurate information of neurodegeneration, particular at the early stage, are needed. The brain
lymphatic system, named the glymphatic system, is a recently discovered cerebrospinal fluid
(CSF) circulation system that utilizes the perivascular channels to eliminate soluble proteins and
metabolite. The dysfunction of the glymphatic system promotes Aβ deposition in the
meninges and introduces perfusion reduction and cognitive impairment. A critical barrier for
understanding CSF turnover including the glymphatic system is a lack of noninvasive methods
that can be applied to interrogate multiple aspects of the glymphatic system in vivo.
We recently developed several non-invasive MRI approaches that can assess CSF
secretion and reabsorption in situ with MRI. These include a molecular imaging method,
dynamic glucose-enhanced (DGE) imaging with on-resonance Variable Delay Multiple Pulse
(onVDMP) MRI. as well as a set of spin- labeling based MRI methods, named magnetization
transfer indirect spin labeling (MISL) and phase alternate labeling with null recovery (PALAN).
These latter methods selectively label the paraventricular tissues by exploiting their significantly
different protein concentration and water T1, T2, cand diffusion properties. The PALAN
method can also assess the ISF flow in brain without contrast agents. Our long- term goal is to
develop several clinically translatable MRI schemes that can non-invasively detect CSF and
interstitial fluid water exchange in brain and apply them as potential MRI biomarkers for the
early-stage AD.