Association between Perivascular Spaces and Progression of White Matter Hyperintensities in Lacunar Stroke Patients

Loos, Caroline; Klarenbeek, Pim; Oostenbrugge, Robert J. van; Staals, Julie

doi:10.1371/journal.pone.0137323

Cited by 37 publications

(37 citation statements)

References 33 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Finally, the SVD score includes perivascular spaces in the basal ganglia, but not in the white matter. This can, however, be justified because PVS in the basal ganglia, not those in the white matter, are associated with SVD in terms of lacunar stroke (Doubal et al, 2010; Potter et al, 2015), WMH (Doubal et al, 2010), progression of WMH (Loos et al, 2015), blood pressure (Klarenbeek et al, 2013a), and cognition (Huijts et al, 2014). PVS in the white matter seem to be related to amyloid angiopathy (Charidimou et al, 2015).…”

Section: Discussionmentioning

confidence: 99%

Total Cerebral Small Vessel Disease MRI Score Is Associated with Cognitive Decline in Executive Function in Patients with Hypertension

Uiterwijk

Oostenbrugge

Huijts

et al. 2016

Front. Aging Neurosci.

Self Cite

View full text Add to dashboard Cite

Objectives: Hypertension is a major risk factor for white matter hyperintensities (WMH), lacunes, cerebral microbleeds, and perivascular spaces, which are MRI markers of cerebral small vessel disease (SVD). Studies have shown associations between these individual MRI markers and cognitive functioning and decline. Recently, a “total SVD score” was proposed in which the different MRI markers were combined into one measure of SVD, to capture total SVD-related brain damage. We investigated if this SVD score was associated with cognitive decline over 4 years in patients with hypertension.Methods: In this longitudinal cohort study, 130 hypertensive patients (91 patients with uncomplicated hypertension and 39 hypertensive patients with a lacunar stroke) were included. They underwent a neuropsychological assessment at baseline and after 4 years. The presence of WMH, lacunes, cerebral microbleeds, and perivascular spaces were rated on baseline MRI. Presence of each individual marker was added to calculate the total SVD score (range 0–4) in each patient.Results: Uncorrected linear regression analyses showed associations between SVD score and decline in overall cognition (p = 0.017), executive functioning (p < 0.001) and information processing speed (p = 0.037), but not with memory (p = 0.911). The association between SVD score and decline in overall cognition and executive function remained significant after adjustment for age, sex, education, anxiety and depression score, potential vascular risk factors, patient group, and baseline cognitive performance.Conclusion: Our study shows that a total SVD score can predict cognitive decline, specifically in executive function, over 4 years in hypertensive patients. This emphasizes the importance of considering total brain damage due to SVD.

show abstract

Section: Discussionmentioning

confidence: 99%

Total Cerebral Small Vessel Disease MRI Score Is Associated with Cognitive Decline in Executive Function in Patients with Hypertension

Uiterwijk

Oostenbrugge

Huijts

et al. 2016

Front. Aging Neurosci.

Self Cite

View full text Add to dashboard Cite

show abstract

“…EPVS are considered one of the earliest and most consistent neuroimaging findings in SVD(3, 4, 39–41). They are spaces, less than 3 mm in diameter, filled with CSF-like fluid, which follow penetrating vessels.…”

Section: Glymphatic Systemmentioning

confidence: 99%

“…Basal ganglia and centrum semiovale EPVS are routinely seen together, implying a common cause(3). In addition, EPVS are independently associated with SVD risk factors including hypertension and advanced age(41, 47, 48). White matter lesions, comprised of myelin loss, scattered small infarcts, and astrogliosis, are an important contributor to the clinical picture of SVD(50–52).…”

Section: Glymphatic Systemmentioning

confidence: 99%

“…These features suggest that EPVS may be a sign of glymphatic fluid stasis. Since current evidence indicates that EPVS play a role in the pathogenesis of SVD –as opposed to being the result of the disease– glymphatic dysfunction is likely to be an important contributor to SVD pathology(3, 4, 39–41). Whether perivascular fluid accumulation results in white matter edema, giving rise to WML remains to be addressed, and represents an interesting avenue of research.…”

Section: Glymphatic Systemmentioning

confidence: 99%

See 1 more Smart Citation

Perivascular spaces, glymphatic dysfunction, and small vessel disease

2017

View full text Add to dashboard Cite

Cerebral small vessel diseases (SVD) range broadly in etiology but share a remarkably overlapping pathology. Features of SVD including enlarged perivascular spaces and formation of abluminal protein deposits cannot be completely explained by the putative pathophysiology. The recently discovered glymphatic system provides a new perspective to potentially address these gaps. This work provides a comprehensive review of the known factors that regulate glymphatic function and the disease mechanisms underlying glymphatic impairment emphasizing the role that aquaporin-4 (AQP4)-lined perivascular spaces, cerebrovascular pulsatility, and metabolite clearance play in normal CNS physiology. This review also discusses the implications that glymphatic impairment may have on SVD inception and progression with the aim of exploring novel therapeutic targets and highlighting the key questions that remain to be answered.

show abstract

“…That being said, thickening of vein vessel walls and perivenous collagenosis have also been described . Key imaging‐pathology features SVD are leukoaraiosis , defined as WMH on FLAIR/T2 brain MRI images without prominent hypointensity on the T1 images, lacunes , microbleeds and enlarged perivascular spaces as summarized in Table . Leukoaraiosis occurs in 5‐10% of patients aged 20–40 years and in up to one‐third of people aged 65–84 years .…”

Section: Differentiating Ms From Svdmentioning

confidence: 99%

Age‐related small vessel disease: a potential contributor to neurodegeneration in multiple sclerosis

et al. 2017

View full text Add to dashboard Cite

Multiple sclerosis (MS) is a chronic inflammatory demyelinating disorder of the central nervous system wherein, after an initial phase of transient neurological defects, slow neurological deterioration due to progressive neuronal loss ensues. Age is a major determinant of MS progression onset and disability. Over the past years, several mechanisms have been proposed to explain the key drivers of neurodegeneration and disability accumulation in MS. However, the effect of commonly encountered age-related cerebral vessel disease, namely small vessel disease (SVD), has been largely neglected and constitutes the aim of this review. SVD shares some features with MS, that is, white matter demyelination and brain atrophy, and has been shown to contribute to the neuronal damage seen in vascular cognitive impairment. Several lines of evidence suggest that an interaction between MS and SVD may influence MS-related neurodegeneration. SVD may contribute to hypoperfusion, reduced vascular reactivity and tissue hypoxia, features seen in MS. Venule and endothelium abnormalities have been documented in MS but the role of arterioles and of other neurovascular unit structures, such as the pericyte, has not been explored. Vascular risk factors (VRF) have recently been associated with faster progression in MS, though the mechanisms are unclear since very few studies have addressed the impact of VRF and SVD on MS imaging and pathology outcomes. Therapeutic agents targeting the microvasculature and the neurovascular unit may impact both SVD and MS and may benefit patients with dual pathology.

show abstract

Association between Perivascular Spaces and Progression of White Matter Hyperintensities in Lacunar Stroke Patients

Cited by 37 publications

References 33 publications

Total Cerebral Small Vessel Disease MRI Score Is Associated with Cognitive Decline in Executive Function in Patients with Hypertension

Total Cerebral Small Vessel Disease MRI Score Is Associated with Cognitive Decline in Executive Function in Patients with Hypertension

Perivascular spaces, glymphatic dysfunction, and small vessel disease

Age‐related small vessel disease: a potential contributor to neurodegeneration in multiple sclerosis

Contact Info

Product

Resources

About