Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2025 Jan;67(1):57-64.
doi: 10.1007/s00234-024-03532-7. Epub 2024 Dec 23.

Increased burden of enlarged perivascular spaces in patients with patent foramen ovale

Yangyingqiu Liu  1 , Yuxuan Li  1   2 , Qun Shang  1 , Jinfeng Cao  1 , Wei Zhao  3 , Jiaxiang Xin  4 , Xin Luo  5   6
Affiliations

Increased burden of enlarged perivascular spaces in patients with patent foramen ovale

Yangyingqiu Liu et al. Neuroradiology. 2025 Jan.

Abstract

Introduction: Patent foramen ovale (PFO) patients may experience states of hypoxia and hypoperfusion, which may increase the burden of enlarged perivascular spaces (EPVS). However, to our knowledge, no data are available regarding EPVS in PFO patients. This study sought to investigate if patients with PFO exhibit a heightened burden of EPVS and to identify the mediating factors between PFO and EPVS.

Methods: A total of 108 consecutive PFO patients (PFO group) and 110 healthy controls (HC group) from January 2022 to February 2024 were enrolled. The differences in centrum semiovale EPVS (CSO-EPVS) and basal ganglia EPVS (BG-EPVS) scores between PFO and HC groups were compared. The correlations among PFO diameters, laboratory indexes, and EPVS burdens were analyzed. The relationships among them were obtained using mediation analysis.

Results: Mean age of PFO and HC group was 47.68 ± 14.47 and 48.14 ± 12.84 years. The CSO-EPVS and BG-EPVS scores were higher in PFO group than HC group (P < 0.001). The CSO-EPVS and BG-EPVS scores for PFO group were concentrated in the ranges 1-3 and 1-2 points, while for HC group were concentrated in the range 0-1 points. A positive correlation among PFO diameters and CSO-EPVS score (r = 0.62, P < 0.001), BG-EPVS score (r = 0.63, P < 0.001), and homocysteine (HCY)(r = 0.21, P = 0.03) was observed. Mediation analysis indicated that higher HCY significantly mediated the relationship between PFO diameter and BG-EPVS burden in PFO patients (P < 0.05).

Conclusion: These findings revealed the presence of glymphatic dysfunction in patients with PFO. HCY may mediate the impact of PFO diameter on glymphatic function.

Keywords: Cerebral small vessel disease; Enlarged perivascular spaces; Homocysteine; Patent foramen ovale.

PubMed Disclaimer

Conflict of interest statement

Declarations. Ethical approval: This retrospective study was approved by the Institutional Review Board of Zibo Central Hospital(No. 2024103). The informed consent of participants was waived due to the retrospective design of the study. All experiments were performed in accordance with the Declaration of Helsinki and all relevant guidelines and regulations. Conflict of interest: We declare that we have no conflict of interest.

Similar articles

See all similar articles

References

    1. Kishve P, Motwani R (2021) Morphometric study of fossa ovale in human cadaveric hearts: embryological and clinical relevance. ANAT CELL BIOL 54:42–50. https://doi.org/10.5115/acb.20.286 - DOI - PubMed - PMC
    1. Calvert PA, Rana BS, Kydd AC et al (2011) Patent foramen ovale: anatomy, outcomes, and closure. NAT REV CARDIOL 8:148–160. https://doi.org/10.1038/nrcardio.2010.224 - DOI - PubMed
    1. Shi F, Sha L, Li H et al (2023) Recent progress in patent foramen ovale and related neurological diseases: a narrative review. Front Neurol 14:1129062. https://doi.org/10.3389/fneur.2023.1129062 - DOI - PubMed - PMC
    1. Lovering AT, Kelly TS, DiMarco KG et al (2022) Implications of a patent foramen ovale for environmental physiology and pathophysiology: do we know the ‘hole’ story? J PHYSIOL-LONDON 600:1541–1553. https://doi.org/10.1113/JP281108 - DOI - PubMed
    1. Yang Z, Huang C, Wen X et al (2021) Circular RNA circ-FoxO3 attenuates blood-brain barrier damage by inducing autophagy during ischemia/reperfusion. MOL THER 30:1275–1287. https://doi.org/10.1016/j.ymthe.2021.11.004 - DOI - PubMed - PMC

LinkOut - more resources