Evaluating the Association between Enlarged Perivascular Spaces and Disease Worsening in Multiple Sclerosis

Cavallari, Michele; Egorova, Svetlana; Healy, Brian C.; Palotai, Miklós; Prieto, Juan Carlos; Polgar‐Turcsanyi, Mariann; Tauhid, Shahamat; Anderson, Mark; Glanz, Bonnie I.; Chitnis, Tanuja

doi:10.1111/jon.12490

Cited by 24 publications

(43 citation statements)

References 16 publications

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“…Moreover, the EPVS score in the region of basal ganglia significantly correlated to the severity of tremor and the EPVS score in the region of centrum semiovale was much higher in PD patients of PIGD motor phenotype than that in patients of the non PIGD motor phenotype. Currently, clinical studies have mainly focused on investigating the association between EPVS and cognitive impairment, poor blood pressure control or disease worsening in patients with dementia (Wang et al., ), stroke (Liu et al., ), or systematic inflammation (Cavallari et al., ). The relevant studies proposed that a higher EPVS severity degree might result in impaired cerebrovascular reactivity, blood‐brain barrier dysfunction and perivascular inflammation in the diseases (Brown et al., ).…”

Section: Discussionmentioning

confidence: 99%

Exploring the association between Cerebral small‐vessel diseases and motor symptoms in Parkinson's disease

Wan

Gan

et al. 2019

Brain and Behavior

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Objectives to explore the association between cerebral small‐vessel diseases (CSVDs) and motor symptoms in Parkinson's disease (PD). Methods 137 PD patients were recruited into the study. Detailed motor symptoms, including tremor, rigidity, bradykinesia, and axial impairment, were evaluated using Unified Parkinson's disease Rating Scale (UPDRS). Non‐motor symptoms, including cognition, anxiety, and depression, were evaluated using Montreal Cognitive Assessment (MoCA), Hamilton anxiety scale (HAMA), and Hamilton depression scale (HAMD). Brain MRI was used to assess the subtypes of CSVDs, including lacunes, enlarged perivascular spaces (EPVS), and white matter hyperintensities (WMH). WMH were furtherly divided into deep WMH (DWMH) and periventricular hyperintensities (PVH). The association between CSVDs and motor symptoms was analyzed. Patients were divided into the postural instability and gait disability (PIGD) group and non‐PIGD group. Demographic, clinical and CSVDs variables were compared between the two groups. Results CSVDs subtypes were all detected in the participants with different prevalence rates and severity degrees. We found a close association between EPVS in basal ganglia and the tremor score (p = 0.032), and between DWMH in the frontal and occipital lobes and the axial motor score (p < 0.05) through the spearman and multivariate liner regression analysis. Compared with the non‐PIGD group, the PIGD group demonstrated more serious cognitive impairment and DWMH in the frontal and occipital lobes (p < 0.05). The demographic characteristics and vascular risk factors of the PIGD group were not different from those of the non‐PIGD group. Cognitive impairment and DWMH in the frontal lobe were identified to be independent risk factors of PIGD motor phenotype. Conclusions We identified a close association between the CSVDs and motor symptoms in PD and DWMH in the frontal lobe was a risk factor of PIGD motor phenotype, which supports the contribution of vascular pathology in PD.

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Section: Discussionmentioning

confidence: 99%

Exploring the association between Cerebral small‐vessel diseases and motor symptoms in Parkinson's disease

Wan

Gan

et al. 2019

Brain and Behavior

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“…Imaging the perivascular spaces (PVS), also known as Virchow-Robin space, has significant clinical value. Many recent studies have shown pathological alteration of PVS in a range of neurological disorders (Bacyinski et al, 2017;Banerjee et al, 2017;Brown et al, 2018;Cavallari et al, 2018;Feldman et al, 2018;Kalaria, 2018;Krueger and Bechmann, 2010;Laveskog et al, 2018;Park et al, 2017). It is also believed that PVS plays a major role in the clearance system, accommodating the influx of CSF to brain parenchyma through peri-arterial space, and the efflux of interstitial fluid to the lymphatic system through peri-venous space (Rasmussen et al, 2018;Tarasoff-Conway et al, 2015;Bacyinski et al, 2017;Iliff et al, 2012).…”

Section: Introductionmentioning

confidence: 99%

Image processing approaches to enhance perivascular space visibility and quantification using MRI

Sepehrband

Barisano

Sheikh‐Bahaei

et al. 2019

Preprint

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Word count: 4080 Number of figures: 8 Number of tables: 1 AbstractImaging the perivascular spaces (PVS), also known as Virchow-Robin space, has significant clinical value, but there remains a need for neuroimaging techniques to improve mapping and quantification of the PVS. Current technique for PVS evaluation is a scoring system based on visual reading of visible PVS in regions of interest, and often limited to large caliber PVS.Enhancing the visibility of the PVS could support medical diagnosis and enable novel neuroscientific investigations. Increasing the MRI resolution is one approach to enhance the visibility of PVS but is limited by acquisition time and physical constraints. Alternatively, image processing approaches can be utilized to improve the contrast ratio between PVS and surrounding tissue. Here we combine T1-and T2-weighted images to enhance PVS contrast, intensifying the visibility of PVS. The Enhanced PVS Contrast (EPC) was achieved by combining T1-and T2-weighted images that were adaptively filtered to remove non-structured highfrequency spatial noise. EPC was evaluated on healthy young adults by presenting them to two expert readers and also through automated quantification. We found that EPC improves the conspicuity of the PVS and aid resolving a larger number of PVS. We also present a highly reliable automated PVS quantification approach, which was optimized using expert readings.

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“…EPVS burden in MS was first assessed by Achiron and Faibel (2002) in a cohort of recent-onset MS patients. Most neuroimaging studies of EPVS in MS consistently showed that the number (Etemadifar et al, 2011;Conforti et al, 2014;Kilsdonk et al, 2015;Cavallari et al, 2018) and volume (Wuerfel et al, 2008) of EPVS was higher in MS patients compared to healthy controls (Table 3), with the exception of one study that failed to replicate these findings (Al-Saeed et al, 2012). The location of EPVS most consistently associated with MS was the centrum semiovale (Achiron and Faibel, 2002;Etemadifar et al, 2011;Kilsdonk et al, 2015;Cavallari et al, 2018).…”

Section: Epvs In Msmentioning

confidence: 94%

“…Studies of the association of EPVS with clinical and neuroimaging features of MS showed less consistent results (Table 3). While a few studies showed significant associations of EPVS with age (Kilsdonk et al, 2015), disease duration (Kilsdonk et al, 2015;Cavallari et al, 2018) and sex (Etemadifar et al, 2011), others failed to replicate those findings (Achiron and Faibel, 2002;Wuerfel et al, 2008). Most studies reported no association of EPVS with physical disability (Achiron and Faibel, 2002;Wuerfel et al, 2008;Kilsdonk et al, 2015) or conversion to secondary-progressive MS (Cavallari et al, 2018).…”

Section: Epvs In Msmentioning

confidence: 99%

Perivascular Unit: This Must Be the Place. The Anatomical Crossroad Between the Immune, Vascular and Nervous System

et al. 2020

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Evaluating the Association between Enlarged Perivascular Spaces and Disease Worsening in Multiple Sclerosis

Cited by 24 publications

References 16 publications

Exploring the association between Cerebral small‐vessel diseases and motor symptoms in Parkinson's disease

Exploring the association between Cerebral small‐vessel diseases and motor symptoms in Parkinson's disease

Image processing approaches to enhance perivascular space visibility and quantification using MRI

Perivascular Unit: This Must Be the Place. The Anatomical Crossroad Between the Immune, Vascular and Nervous System

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