Enlarged perivascular spaces in the basal ganglia are independently associated with intracranial atherosclerosis in the elderly

Brutto, Oscar H. Del; Mera, Robertino M.

doi:10.1016/j.atherosclerosis.2017.10.024

Cited by 33 publications

(33 citation statements)

References 22 publications

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“…It seems unlikely that the development of BG-EPVS causes MCA atherosclerosis, but the underlying pathophysiologic mechanisms remain unclear. One possible explanation for the association of BG-EVPS and atherosclerosis might be cerebral hypoperfusion (8,29). Our findings are supported by a previous study that showed hemodynamically compromised hemispheres tend to demonstrate a higher number of EPVS (31).…”

Section: Discussionsupporting

confidence: 91%

“…To the best of our knowledge, our present study is the first to focus on the association between MCA atherosclerosis and BG-EPVS in a Chinese population. Although we cannot directly compare our data with those from others, previous studies addressing the relationship between BG-EPVS and carotid atherosclerosis (8,29,30) may provide important evidence to support our findings. It seems unlikely that the development of BG-EPVS causes MCA atherosclerosis, but the underlying pathophysiologic mechanisms remain unclear.…”

Section: Discussionsupporting

confidence: 60%

“…Comparison of number of BG-EPVS between the affected and the unaffected side in those with only unilateral MCA stenosis or occlusion are shown in Table 4. The number of BG-EPVS was higher in the affected side than the unaffected side in patients with severe MCA stenosis (12)(13)(14) vs. 8 (6)(7)(8)(9)(10)(11), p = 0.001) and occlusion (11)(12)(13)(14) vs. 8 (5)(6)(7)(8)(9)(10)(11), p = 0.028). We found no significant difference in the number of MR-visible BG-EPVS between affected and unaffected side in patients with moderate MCA stenosis (8)(9)(10)(11) vs. 8 (5)(6)(7)(8)(9)(10)(11), p = 0.173).…”

Section: Comparison Of Numbers Of Bg-epvsmentioning

confidence: 91%

“…Slice thickness was 5 mm with 1.5 mm gap between slices. Parameters for 1.5T scanner, T1WI sequence: repetition time (TR), 1,990 ms; echo time (TE), 8 2 . MRI markers of CSVD, including BG-EPVS, WMH, and lacunes were assessed blinded to clinical information by a trained neuroradiologist (JW), according to previous literature (19,20).…”

Section: Mr Imagingmentioning

confidence: 99%

“…Recently, the importance of understanding the pathophysiology of BG-EPVS in cerebrovascular disease is highlighted by their association with cerebral small vessel disease (CSVD), large artery atherosclerosis, and risk of stroke (7)(8)(9). Middle cerebral artery (MCA) is among the common locations of intracranial artery atherosclerosis, and MCA atherosclerosis is increasingly thought to be a significant precipitant of cerebral ischemic stroke, particularly in the Asian population (10)(11)(12).…”

Section: Introductionmentioning

confidence: 99%

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Association Between Steno-Occlusive Middle Cerebral Artery and Basal Ganglia Perivascular Spaces

Chen

et al. 2020

Front. Neurol.

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Objectives: Enlarged perivascular spaces in the basal ganglia (BG-EPVS) share common vascular risk factors with atherosclerosis. However, little is known about the relationship between steno-occlusive middle cerebral artery (MCA) and BG-EPVS. In this cross-sectional study, we aimed to test the hypothesis that severe MCA stenosis or occlusion is associated with increased MRI-visible BG-EPVS. Methods: We retrospectively reviewed 112 patients with a steno-occlusive MCA from Fujian Medical University Union Hospital between January 2014 and December 2018. We rated BG-EPVS, white matter hyperintensities (WMH), and lacunes as markers of cerebral small vessel disease (CSVD) on magnetic resonance image (MRI). The severity of steno-occlusive MCA was assessed by computed tomography angiography (CTA) and was classified into moderate (50-69%), severe (70-99%), and occlusion (100%). We evaluated the association of steno-occlusive MCA for >10 BG-EPVS using logistic regression model adjusted for age, gender, hypertension, MR-visible WMH, and lacunes. We also compared the number of BG-EPVS between the affected side and unaffected side in patients with only unilateral steno-occlusive MCA. Results: In multivariable logistic regression analysis, age (OR = 1.07, 95%CI: 1.03-1.13, p = 0.003), hypertension (OR = 2.77, 95%CI: 1.02-7.51, p = 0.046), severe MCA stenosis (OR = 3.65, 95%CI: 1.12-11.87, p = 0.032), or occlusion (OR = 3.67, 95%CI: 1.20-11.27, p = 0.023) were significantly associated with >10 BG-EPVS. The number of BG-EPVS in the affected side was higher than the unaffected side in patients with severe MCA stenosis (12 [9−14] vs. 8 [6−11], p = 0.001) or occlusion (11 [7−14] vs. 8 [5−11], p = 0.028). Conclusions: BG-EPVS were more prevalent in patients with severe MCA atherosclerosis. Our findings suggest a biological link between severe steno-occlusive MCA and increased BG-EPVS. These results need confirmation in prospective studies.

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Section: Discussionsupporting

confidence: 91%

Section: Discussionsupporting

confidence: 60%

Section: Comparison Of Numbers Of Bg-epvsmentioning

confidence: 91%

Section: Mr Imagingmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Association Between Steno-Occlusive Middle Cerebral Artery and Basal Ganglia Perivascular Spaces

Chen

et al. 2020

Front. Neurol.

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MRI Assessment of Brain Frailty and Clinical Outcome in Patients With Acute Posterior Perforating Artery Infarction

Duan

Lyu

Cheng

et al. 2023

Magnetic Resonance Imaging

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BackgroundGlobal brain health has gained increasing attention recently. Imaging markers of brain frailty have been related to functional outcomes in previous studies on anterior circulation; however, little data are available on imaging markers and posterior circulation.PurposeTo investigate the impact of brain frailty on functional outcomes in patients with acute perforating artery infarction (PAI) of the posterior circulation.Study TypeProspective.PopulationOne hundred patients (60.78 ± 9.51 years, 72% men) with acute posterior circulation PAI (determined by diffusion‐weighted magnetic resonance imaging (MRI)/time‐of‐flight MR angiography).Field Strength/SequenceT1‐ and T2‐weighted fast spin echo, T2‐weighted fluid‐attenuated inversion recovery, diffusion‐weighted echo planar, gradient echo (susceptibility‐weight imaging), and 3D time‐of‐flight MR angiography sequences at 3.0 T.AssessmentPeriventricular and deep white matter hyperintensities (WMH), enlarged perivascular spaces (EPVS) in the basal ganglia and centrum semiovale area, lacunes, cerebral microbleeds (CMB), and total brain frailty score by calculating the above imaging characters were rated visually by three radiologists with 9, 10, and 11 years of experience and one neuroradiologist with 12. Infarction volume was assessed using baseline diffusion‐weighted imaging (DWI) data obtained within 24 hours of symptom onset. A modified Rankin Scale (mRS) score >1 on day 90 defined an adverse functional outcome. Associations between the imaging markers of brain frailty and functional outcomes were assessed.Statistical TestsFisher's exact test, Mann–Whitney U test, and multivariable binary logistic regression. A P value <0.05 was considered statistically significant.ResultsAdverse prognoses (mRS > 1) were observed in 34 (34%) patients. Infarction volume, periventricular WMH, deep WMH, basal ganglia EPVS, CMB, and the brain frailty score were significantly associated with adverse functional outcomes. An increased brain frailty score was significantly associated with unfavorable mRS score on day 90 (odds ratio 1.773, 95% confidence interval 1.237–2.541).Data ConclusionAdvanced MRI imaging markers of brain frailty, individually or combined as a total brain frailty score, were associated with worse functional outcomes after acute posterior circulation PAI.Level of Evidence3Technical EfficacyStage 3

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Cerebral small vessel disease: neuroimaging markers and clinical implication

et al. 2018

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Enlarged perivascular spaces in the basal ganglia are independently associated with intracranial atherosclerosis in the elderly

Cited by 33 publications

References 22 publications

Association Between Steno-Occlusive Middle Cerebral Artery and Basal Ganglia Perivascular Spaces

Association Between Steno-Occlusive Middle Cerebral Artery and Basal Ganglia Perivascular Spaces

MRI Assessment of Brain Frailty and Clinical Outcome in Patients With Acute Posterior Perforating Artery Infarction

Cerebral small vessel disease: neuroimaging markers and clinical implication

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