Acute sleep deprivation induces changes in specific glymphatic-related MRI markers (DTI-ALPS, FW-WM, and gBOLD-CSF coupling) that are largely but not completely reversed by sleep recovery.
Key Findings
Results
The DTI-ALPS index was significantly lower after sleep deprivation compared to normal sleep and increased after sleep recovery but did not fully return to baseline levels.
Study included 32 healthy young adults scanned under three conditions: normal sleep (NS, 8h overnight sleep), sleep deprivation (SD, 24h awake), and sleep recovery (SR, 8h sleep post-SD)
MRI scanning was performed between 7:00-8:00 a.m. to minimize diurnal variations across all three conditions
DTI-ALPS index was significantly lower in the SD group than in the NS group
DTI-ALPS index was higher in the SR group than in the SD group but could not be totally recovered to baseline
DTI-ALPS was identified as a sensitive marker for acute sleep deprivation
Results
White matter free water fraction (FW-WM) was elevated after sleep deprivation and returned to near-baseline levels after sleep recovery.
FW-WM was higher in the SD condition than in the NS condition
FW-WM was lower in the SR condition than in the SD condition
There was no significant difference in FW-WM between the SR and NS conditions, suggesting full recovery
FW-WM was identified as a sensitive marker for both acute sleep deprivation and sleep recovery
Results
Global BOLD-CSF coupling was higher after sleep deprivation and returned to near-baseline levels after sleep recovery.
gBOLD-CSF coupling was evaluated in a subset of 12 participants
gBOLD-CSF coupling was higher in the SD condition than in the NS condition
gBOLD-CSF coupling was lower in the SR condition than in the SD condition
There was no significant difference in gBOLD-CSF coupling between the SR and NS conditions
gBOLD-CSF coupling was identified as a sensitive marker for both acute sleep deprivation and sleep recovery
Results
Perivascular space (PVS) volume and choroid plexus volume (CPvol) showed no significant differences across the three sleep conditions.
Five glymphatic-related MRI markers were evaluated: CPvol, PVS volume, FW-WM, DTI-ALPS index, and gBOLD-CSF coupling
PVS volume showed no intergroup differences across NS, SD, and SR conditions
CPvol showed no intergroup differences across NS, SD, and SR conditions
These two markers were not sensitive to acute 24-hour sleep deprivation or subsequent 8-hour sleep recovery
Results
A robust negative correlation was found between DTI-ALPS mean and FW-WM across the three conditions.
The negative correlation between DTI-ALPS_mean and FW-WM was confirmed by repeated-measures correlation
The correlation was described as 'robust,' suggesting a consistent inverse relationship between these two glymphatic-related markers
This finding links reduced perivascular diffusivity (lower DTI-ALPS) with increased white matter free water content during sleep deprivation
Methods
The study design employed a within-subjects repeated measures approach with standardized scanning times to control for confounders.
32 healthy young adults participated in all three conditions (NS, SD, SR)
All MRI scans were conducted between 7:00-8:00 a.m. to minimize diurnal variations in glymphatic activity
Sleep deprivation was defined as 24 hours of continuous wakefulness
Sleep recovery consisted of 8 hours of sleep following the sleep deprivation period
The gBOLD-CSF subset comprised 12 of the 32 total participants
What This Means
This research suggests that a single night of total sleep deprivation (staying awake for 24 hours) causes measurable changes in the brain's waste-clearance system, known as the glymphatic system, detectable through specialized MRI techniques. The study tracked 32 healthy young adults through three states — normal sleep, 24 hours without sleep, and a recovery sleep night — and found that three specific brain imaging markers (DTI-ALPS, white matter free water fraction, and a measure of brain fluid dynamics called BOLD-CSF coupling) all shifted after sleep deprivation and largely returned toward normal after recovery sleep. Two other markers tested — the size of fluid-filled channels around blood vessels (perivascular spaces) and the volume of the choroid plexus — did not change noticeably under these conditions.
Notably, while most markers recovered after one night of sleep, the DTI-ALPS index — which reflects how well fluid moves through brain tissue along blood vessels — did not fully return to pre-deprivation levels after a single recovery night. This suggests that even one night of total sleep loss may leave a residual trace in glymphatic function that one subsequent night of sleep cannot completely repair. The finding of a consistent inverse relationship between DTI-ALPS and white matter free water also hints that when fluid movement along vessels is impaired, water accumulates more diffusely in white matter tissue.
This research matters because it provides objective, non-invasive brain imaging evidence that sleep loss impairs the brain's ability to clear waste, and that recovery sleep helps but may not be fully restorative after acute total deprivation. The identification of sensitive imaging markers for these states could eventually help researchers and clinicians track glymphatic health in conditions where sleep disturbance plays a role, such as neurodegenerative diseases, though this study was conducted exclusively in healthy young adults under controlled laboratory conditions.
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Wang X, Chen H, Zhang S, Ji T, Liu H, Sang L, et al.. (2026). Dynamic changes in glymphatic-related imaging markers across acute sleep deprivation and recovery in healthy young adults.. NeuroImage. https://doi.org/10.1016/j.neuroimage.2026.122180