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. 2023 Sep 14;13(9):1323.
doi: 10.3390/brainsci13091323.

Relation of MRI-Visible Perivascular Spaces and Other MRI Markers of Cerebral Small Vessel Disease

Frances Rodriguez Lara  1 , Arturo Ruben Toro  1 , Adlin Pinheiro  2   3 , Serkalem Demissie  2   3 , Oluchi Ekenze  3   4 , Oliver Martinez  5 , Pedram Parva  6   7 , Andreas Charidimou  8 , Saptaparni Ghosh  3   8 , Charles DeCarli  5 , Sudha Seshadri  3   8   9 , Mohamad Habes  9 , Pauline Maillard  5 , Jose Rafael Romero  3   8
Affiliations

Relation of MRI-Visible Perivascular Spaces and Other MRI Markers of Cerebral Small Vessel Disease

Frances Rodriguez Lara et al. Brain Sci. .

Abstract

Perivascular spaces (PVS) visible on brain MRI signal cerebral small vessel disease (CSVD). The coexistence of PVS with other CSVD manifestations likely increases the risk of adverse neurological outcomes. We related PVS to other CSVD manifestations and brain volumes that are markers of vascular brain injury and neurodegeneration. Framingham Heart Study (FHS) participants with CSVD ratings on brain MRI were included. PVS were rated in the basal ganglia (BG) and centrum semiovale (CSO) into grades I-IV and a category reflecting high burden in single or mixed CSO-BG regions. We related PVS to covert brain infarcts (CBI), white matter hyperintensities (WMH), cerebral microbleeds (CMB), total brain, hippocampal, and cortical gray matter volumes using adjusted multivariable regression analyses. In 2454 participants (mean age 54 ± 12 years), we observed that higher PVS burden in both BG and CSO was related to CMB in lobar and deep brain regions and increased WMH. Greater CSO PVS burden was associated with decreased total cortical gray volumes. PVS are associated with ischemic markers of CSVD and neurodegeneration markers. Further studies should elucidate the causality between PVS and other CSVD manifestations.

Keywords: MRI-visible perivascular spaces; cerebral small vessel disease; disease marker; glymphatic function.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
MRI-visible perivascular spaces (PVS) ratings by region: (A) centrum semiovale and (B) basal ganglia. PVS in each region were graded independently using counts to assign severity: grade I (<10), grade II (10–20), grade III (20–40) and grade IV (>40). The green circle represents a region enclosing PVS.
Figure 2
Figure 2
Brain MRI markers of cerebral small vessel disease: (A) Covert brain infarct (CBI). (B) White matter hyperintensities (WMH). (C). Severe WMH. (D). Single cerebral microbleed (CMB). (E). Innumerable CMB. White arrows indicate lesions of interest.
Figure 3
Figure 3
Burden and topography of MRI-visible Perivascular Spaces (PVS) with corresponding prevalence of cerebral microbleeds, covert brain infarcts and severe white matter hyperintensities. PVS were graded independently in the basal ganglia (B,E,H) and centrum semiovale (A,D,G) using counts to assign severity: grade I (<10), grade II (10–20), grade III (20–40) and grade IV (>40). Mixed group categories of high burden (C,F,I) are none, only basal ganglia, only centrum semiovale, and both regions.
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