Large Perivascular Spaces Visible on Magnetic Resonance Imaging, Cerebral Small Vessel Disease Progression, and Risk of Dementia

Ding, Jie; Sigurðsson, Sigurður; Jónsson, Pálmi V.; Eiríksdóttir, Guðný; Charidimou, Andreas; López, Oscar L.; Buchem, Mark A. van; Guðnason, Vilmundur; Launer, Lenore J.

doi:10.1001/jamaneurol.2017.1397

Cited by 163 publications

(150 citation statements)

References 39 publications

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“…58,76,77,83,88,90,91,[97][98][99] Of note, for 7 studies, association results of CMB with recurrent stroke or ICH risk were obtained from 3 previously published meta-analyses. 78,100,101 Regarding PVS, 5 studies were included: 3 for stroke, 18,102,103 2 for dementia, 104,105 and 2 for death. 102,103 White Matter Hyperintensity Burden…”

Section: Resultsmentioning

confidence: 99%

“…As well as integrating information on multiple MRI markers of VBI, our review adds numerous new studies. 14,16,[18][19][20][21][24][25][26]28,29,32,33,35,36,41,46,[49][50][51]57,58,64,72,75,84,88,95,96,99,[102][103][104][105] We also present, to our knowledge, the first metaanalyses on the association of BI with stroke subtypes, dementia, and mortality and the first systematic review on the association of PVS with stroke, dementia, and mortality.…”

Section: Discussionmentioning

confidence: 99%

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Clinical Significance of Magnetic Resonance Imaging Markers of Vascular Brain Injury

et al. 2019

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IMPORTANCE Covert vascular brain injury (VBI) is highly prevalent in community-dwelling older persons, but its clinical and therapeutic implications are debated. OBJECTIVE To better understand the clinical significance of VBI to optimize prevention strategies for the most common age-related neurological diseases, stroke and dementia. DATA SOURCE We searched for articles in PubMed between 1966 and December 22, 2017, studying the association of 4 magnetic resonance imaging (MRI) markers of covert VBI (white matter hyperintensities [WMHs] of presumed vascular origin, MRI-defined covert brain infarcts [BIs], cerebral microbleeds [CMBs], and perivascular spaces [PVSs]) with incident stroke, dementia, or death. STUDY SELECTION Data were taken from prospective, longitudinal cohort studies including 50 or more adults. DATA EXTRACTION AND SYNTHESIS We performed inverse variance-weighted meta-analyses with random effects and z score-based meta-analyses for WMH burden. The significance threshold was P < .003 (17 independent tests). We complied with the Meta-analyses of Observational Studies in Epidemiology guidelines. MAIN OUTCOMES AND MEASURES Stroke (hemorrhagic and ischemic), dementia (all and Alzheimer disease), and death. RESULTS Of 2846 articles identified, 94 studies were eligible, with up to 14 529 participants for WMH, 16 012 participants for BI, 15 693 participants for CMB, and 4587 participants for PVS. Extensive WMH burden was associated with higher risk of incident stroke (hazard ratio [

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Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Clinical Significance of Magnetic Resonance Imaging Markers of Vascular Brain Injury

et al. 2019

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“…Thirteen articles met the aforementioned criteria ( Fig. 1) [16][17][18][19][20][21][22][23][24][25][26][27][28]. Three studies analyzed longitudinal data [16,17,19] and ten were cross-sectional studies [18,[20][21][22][23][24][25][26][27][28].…”

Section: Resultsmentioning

confidence: 99%

Enlarged Perivascular Spaces and Dementia: A Systematic Review

Smeijer

Ikram

Hilal

2019

JAD

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Perivascular compartments surrounding the penetrating arteries in the brain are part of a physiologic system, which facilitates fluids exchange and clearance of solutes from the brain. The perivascular compartments become visible on MRI when enlarged and are commonly referred to as perivascular spaces (ePVS). Previous studies on the association between ePVS and dementia have been inconsistent due to varying methods of measuring ePVS. As a frame of reference for future MRI studies on ePVS, we systematically review the literature on ePVS as a marker of vascular brain injury related to dementia from population-based as well as hospital-based settings. We identified three longitudinal and ten cross-sectional studies involving 7,581 persons. Potential outcomes were all-cause dementia, Alzheimer's disease, and vascular dementia. There was considerable heterogeneity in ePVS assessment: with studies using either visual inspection or segmentation, examining different brain locations and implementing different grading scales. Moreover, out of the total of 13 studies, all five studies on vascular dementia reported an association with presence of basal ganglia ePVS after adjustment for age, gender, and white matter hyperintensities. For seven studies on Alzheimer's disease and all-cause dementia, the results were ambiguous. This review did not identify an independent association of ePVS with prevalent or incident dementia. Harmonized methods for ePVS assessment, tested across different populations, may benefit future MRI studies on ePVS and dementia.

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“…Many studies determined a strong correlation between increased perivascular clearance and cognitive impairment. Based on clinical study results, Ding et al [59] reported that 3-mm EPVS was associated with cognitive decline and vascular dementia. Maclullich et al [60] showed that EPVS may lead to nerve fiber destruction in the basal ganglia associated with cognitive functions, resulting in the reduction of nonverbal reasoning and visuospatial ability.…”

Section: Enlarged Perivascular Spacesmentioning

confidence: 99%

Cerebral small vessel disease and cognitive impairment

Meng¹,

Zhao²,

Li³

2019

Journal of Neurorestoratology

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Cerebral small vessel disease (CSVD) is a pathophysiological process involving small arteries such as cerebellar arteries, arterioles, capillaries, and veinlets. Imaging features vary; they are mainly composed of recent subcortical infarcts, lacunes of presumed vascular origin, white matter hyperintensities (WMHs) of presumed vascular origin, cerebral microbleeds, enlarged perivascular spaces, and global and regional brain atrophy. CSVD is a common cause of vascular cognitive dysfunction, and in its end stage, dementia often develops. CSVD has been a major research hotspot; however, its causes are poorly understood. Neuroimaging markers of CSVD can be used as the basis for etiological analysis. This review highlights the relevance of neuroimaging markers and cognitive impairment, providing a new direction for the early recognition, treatment, and prevention of cognitive dysfunction in small cerebral angiopathy.

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Large Perivascular Spaces Visible on Magnetic Resonance Imaging, Cerebral Small Vessel Disease Progression, and Risk of Dementia

Cited by 163 publications

References 39 publications

Clinical Significance of Magnetic Resonance Imaging Markers of Vascular Brain Injury

Clinical Significance of Magnetic Resonance Imaging Markers of Vascular Brain Injury

Enlarged Perivascular Spaces and Dementia: A Systematic Review

Cerebral small vessel disease and cognitive impairment

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