Brain deep medullary veins on 3-T MRI in a population-based cohort

Abstract

Our aim is to investigate whether vascular risk factors are associated with cerebral deep medullary veins (DMVs) and whether DMVs are associated with MRI markers of cerebral small vessel disease (CSVD) or risk of stroke. In a community-based cohort of 1056 participants (mean age 55.7 years), DMVs were identified on susceptibility-weighted imaging (SWI) and counted in periventricular regions. Neuroimaging markers including lacunes, whiter matter hyperintensity (WMH), microbleeds, enlarged perivascular space, and brain atrophy were evaluated. The number of DMVs decreased with age (p = 0.007). After adjusting for age and sex, the number of DMVs was not associated with traditional vascular risk factors. Fewer DMVs was associated with increase of WMH and lacunes, but the association vanished after adjustment for vascular risk factors. However, fewer DMVs were independently associated with brain atrophy (p < 0.001). DMVs were not associated with three-year risk of stroke. Our results suggest that DMV is significantly different from other MRI markers of CSVD regarding risk factors, association with other CSVD markers, and risk of stroke. Nonetheless, the significant association between DMV and brain atrophy suggested the potential role of venules in age-related neurodegenerative process, which deserves further investigation.

Inflammatory biomarkers and cerebral small vessel disease: a community-based cohort study

“…Owing to the difficulties in human pathological studies, the discontinuity or decreased number of DMVs visualised on SWI could be considered to be an imaging feature of venous collagenosis to assess the pathological changes in CSVD 2 31. Previous studies have suggested that a decreased number of DMVs was positively associated with age, whereas little is known about the potential mechanisms related to the cerebral small veins disease, or whether the number of DMVs is associated with inflammatory processes 1. Our results showed that high levels of systemic biomarkers, especially hsCRP, were negatively correlated with the number of DMVs, suggesting that an underlying mechanism mediated by inflammation was involved in the development of cerebral venule disease.…”

“…DMVs were visually counted in the periventricular WM of each hemisphere on reconstructed SWI. Details of the method are reported elsewhere 1. Briefly, a region of interest (ROI), 60×10 mm in size, was delineated in the periventricular WM between the frontal and occipital horn in each cerebral hemisphere.…”

“…Deep medullary veins (DMVs), which are small parenchymal veins located in the periventricular white matter, can be visualised on susceptibility-weighted imaging (SWI). As those veins range in diameter from tens to hundreds of microns, they are also in the scope of small vessels 1 2…”

“…Associations between MRI markers and inflammatory biomarkersThe number of missing values for model1 and model 2 is 98 and 121 for WMH volume, 0 and 23 for lacunes, 0 and 23 for CMBs, 0 and 23 for PVS and 117 and 140 for DMVs. Model 1 is adjusted for age and sex; and model 2 is adjusted for age, sex, current smoking, hypertension, diabetes mellitus and hyperlipidaemia.…”

Deep medullary veins are associated with widespread brain structural abnormalities

“…8 However, our previous study in a population-based cohort discovered that having fewer DMVs is not associated with conventional CSVD changes on MRI, such as lacunes, white matter hyperintensities (WMH), or cerebral microbleeds, but is strongly related to brain atrophy as indicated by the brain parenchymal fraction (BPF). 9 Thus, further research is in need on white matter (WM) microstructural alternation related to DMV. Meanwhile, changes in cerebral venules are possibly involved in different pathogenic mechanisms compared to those of other CSVD markers, and the potential role of neurodegenerative processes deserves more research attention.…”