Growing　evidence　highlights　the　roles　of　glymphatic　system　and　peripheral　inflammation　in　Parkinson＇s　disease　(PD).　We　evaluated　their　interrelationship　and　potential　mechanisms　contributing　to　motor　symptoms　using　DTI-ALPS　and　inflammatory　markers　(leukocyte,　lymphocyte,　neutrophil　counts,　neutrophil-to-lymphocyte　ratio　[NLR],　and　platelet-to-lymphocyte　ratio　[PLR])　in　134　PD　patients　(52　tremor-dominant　[TD],　62　postural　instability　and　gait　difficulty　[PIGD])　and　81　healthy　controls　(HC,　33　with　inflammatory　markers).　PD　exhibited　lower　DTI-ALPS　than　HC　(1.43　+/-　0.19　vs.　1.52　+/-　0.21,　p　=　0.001).　DTI-ALPS　was　negatively　correlated　with　NLR,　PLR,　and　neutrophils　in　PD　(all　p　＜　0.05)　and　with　neutrophils　in　PIGD　(beta　=　-0.043,　p　=　0.048),　and　positively　correlated　with　lymphocytes　in　TD　(beta　=　0.105,　p　=　0.034).　DTI-ALPS　mediated　the　relationship　between　peripheral　inflammation　(NLR　and　neutrophils)　and　MDS-UPDRS　III　score　in　PD.　Overall,　glymphatic　dysfunction　correlates　with　peripheral　inflammation　and　may　mediate　effects　of　inflammation　on　motor　symptoms　in　PD,　with　distinct　inflammation　profiles　between　TD　and　PIGD.