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@INPROCEEDINGS{Piechowiak:283046,
      author       = {Piechowiak, Christiane and Müller, Patrick and Moyano,
                      Jose Bernal and Kunz, Naomi and Al-Zawity, Suzann and
                      Hubert, Patrick and Nathania, Brigitta Patricia and Kunz,
                      Matthias and Lading, Yves and Duarte, Roberto and Valdes
                      Hernandez, Maria del C. and Wardlaw, Joanna M and Mattern,
                      Hendrik and Behme, Daniel and Neumann, Katja and
                      Braun-Dullaeus, Rüdiger and Schreiber, Stefanie},
      title        = {{A}cute physical exercise can exert measurable changes on
                      perivascular spaces volumetry},
      journal      = {Alzheimer's and dementia},
      volume       = {21},
      number       = {S1},
      issn         = {1552-5260},
      reportid     = {DZNE-2025-01453},
      pages        = {e101885},
      year         = {2025},
      abstract     = {Background: Physical activity has been shown to reduce the
                      risk of dementia and the pathological accumulation of
                      amyloid in both animals and humans. One potential
                      explanation for this outcome is that physical activity
                      enhances glymphatic function. In this study we investigated
                      whether a single session of physical exercise, could alter
                      the glymphatic system, operationalized here as the
                      visibility of perivascular spaces (PVS) on magnetic
                      resonance imaging (MRI).Method:In this prospective cohort
                      study, we included 20 young participants (mean age 25.8±3.5
                      years, female $50\%),$ who underwent repeated MRI scans at
                      three different time points: baseline, immediately after
                      cardiopulmonary exercise testing until exhaustion, and 24
                      hours later (Figure 1). We estimated PVS volumes in the
                      centrum semiovale (CSO) and basal ganglia (BG) using a
                      well-validated software. For each subject, we first aligned
                      all T2-weighted images using FreeSurfer's
                      $mri_robust_template$ tool. Using SynthSeg on T1-weighted
                      images, we obtained white matter parcellations and
                      aggregated them to create time-point-specific BG and CSO ROI
                      masks. To ensure consistency across time points, we limited
                      the analysis to regions that were consistent across all time
                      points. We then segmented PVS on T2-weighted images using
                      the RORPO filter followed by thresholding. All segmentations
                      were visually assessed and manually corrected. We tested for
                      differences using the Wilcoxon signed-rank test.Result:PVS
                      volumes measured at the three time points had high agreement
                      with one another (Lin's concordance in BG ROI > 0.94 and in
                      CSO ROI > 0.98).Average BG-PVS volumes at baseline were
                      133.38 mm3 $[95\%-CI:$ 109.19,157.57]. Following acute
                      exercise, these decreased to 123.10 mm3 $[95\%-CI:$
                      99.62,146.57], showing a significant reduction of 10.28 mm3
                      $[95\%-CI:$ 3.24,17.33] (Figure 2; W=181, p = 0.003). After
                      24 hours, BG-PVS volumes increased to 130.34 mm3 $[95\%-CI:$
                      107.96,152.72], similar to baseline levels (Figure 2; W=107,
                      p = 0.644). CSO-PVS volumes, on the other hand, showed no
                      significant changes between baseline and after exercise or
                      24 hours later (Figure 2).Conclusion:Our work indicates that
                      a single bout of physical exercise can exert subtle yet
                      measurable volumetric changes on PVS in young participants.
                      Whether this change reflects enhanced cerebrovascular or
                      glymphatic function or not remains unclear, but will be
                      explored in future research.},
      month         = {Jul},
      date          = {2025-07-27},
      organization  = {Alzheimer’s Association
                       International Conference, Toronto
                       (Canada), 27 Jul 2025 - 31 Jul 2025},
      keywords     = {Humans / Female / Magnetic Resonance Imaging / Male / Adult
                      / Prospective Studies / Glymphatic System: diagnostic
                      imaging / Glymphatic System: physiology / Exercise:
                      physiology / White Matter: diagnostic imaging / Basal
                      Ganglia: diagnostic imaging / Young Adult / Brain:
                      diagnostic imaging / Cohort Studies},
      cin          = {AG Schreiber / AG Müller / AG Düzel / AG Reymann},
      ddc          = {610},
      cid          = {I:(DE-2719)1310010 / I:(DE-2719)1310003 /
                      I:(DE-2719)5000006 / I:(DE-2719)1310005},
      pnm          = {353 - Clinical and Health Care Research (POF4-353)},
      pid          = {G:(DE-HGF)POF4-353},
      typ          = {PUB:(DE-HGF)1 / PUB:(DE-HGF)16},
      doi          = {10.1002/alz70855_101885},
      url          = {https://pub.dzne.de/record/283046},
}