MRI-Visible Perivascular Spaces in the Centrum Semiovale Are Associated with Brain Amyloid Deposition in Patients with Alzheimer Disease–Related Cognitive Impairment

Kim, H J; Cho, Hanna; Park, Mina; Kim, J W; Ahn, Sung Jun; Lyoo, Chul Hyoung; Suh, Sang Hyun; Ryu, Young Hoon

doi:10.3174/ajnr.a7155

Cited by 17 publications

(13 citation statements)

References 39 publications

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“…5 EPVS in the brain are also closely associated with cognitive impairment 6 and may serve as the pathological basis for cognitive impairment and dementia. 7,8 Hypertension and EPVS are independently associated with cognitive impairment. [9][10][11] A certain relationship may exist between these 2 factors in the pathological process by which cognitive impairment is induced, but pertinent previous research has merely focused on the separate correlations among hypertension, EPVS, and cognitive impairment.…”

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Enlarged Perivascular Spaces in Relation to Cumulative Blood Pressure Exposure and Cognitive Impairment

et al. 2023

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BACKGROUND: Hypertension and enlarged perivascular spaces (EPVS) are thought to be associated with cognitive impairment. However, the correlations among hypertension, EPVS, and cognitive impairment have not been studied yet. We aimed to investigate the relationships between cumulative blood pressure (cBP) exposure with EPVS and cognitive impairment and whether EPVS may mediate the relationship between cBP and cognitive impairment. METHODS: A total of 1507 subjects from the Kailuan prospective cohort study were enrolled. cBP was calculated from 2006 to 2022. The effects of cBP, EPVS scores, and cognitive impairment were evaluated using a logistic regression model. The relationships among cBP, EPVS score, and cognitive impairment were analyzed using a mediation model. RESULTS: An increase in cBP was positively correlated with an increase in EPVS score. For every SD increase in cBP, the odds ratios (95% CI) of increased EPVS score of the centrum semiovale were 1.67 (1.43–1.95), 1.63 (1.4–1.9), and 1.35 (1.17–1.56), respectively; the odds ratios (95% CI) of increased EPVS score of the basal ganglia were 1.83 (1.56–2.15), 2.01 (1.7–2.36), and 1.31 (1.13–1.52), respectively; and the odds ratios (95% CI) of developing cognitive impairment were 1.28 (1.06–1.53), 1.13 (0.95–1.34), and 1.28 (1.07–1.5), respectively. Basal ganglia-EPVS score accounted for 10.46% to 18.32% of the mediating effects on the relationships of cBP/SD with cognitive impairment. CONCLUSIONS: High cBP exposure was an independent risk factor for EPVS, and basal ganglia-EPVS score mediated the effects of cBP on cognitive impairment. REGISTRATION: URL: https://www.clinicaltrials.gov ; Unique identifier: ChiCTR-TNRC-11001489.

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confidence: 98%

“…5 EPVS in the brain are also closely associated with cognitive impairment 6 and may serve as the pathological basis for cognitive impairment and dementia. 7,8…”

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confidence: 99%

Enlarged Perivascular Spaces in Relation to Cumulative Blood Pressure Exposure and Cognitive Impairment

et al. 2023

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“…It is possible that ePVS in the centrum semiovale and the basal ganglia may differ in etiology or that this finding may be more related to differential functions of the centrum semiovale and basal ganglia in regards to MoCA performance. Centrum semiovale ePVS have been linked to cerebral amyloid angiopathy and β-amyloid deposition (22,(87)(88)(89). In contrast, ePVS in the basal ganglia have been more closely associated with hypertensive arteriopathy (22,87).…”

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confidence: 99%

Enlarged Perivascular Spaces Are Negatively Associated With Montreal Cognitive Assessment Scores in Older Adults

et al. 2022

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Emerging evidence suggests that enlarged perivascular spaces (ePVS) may be a clinically significant neuroimaging marker of global cognitive function related to cerebral small vessel disease (cSVD). We tested this possibility by assessing the relationship between ePVS and both a standardized measure of global cognitive function, the Montreal Cognitive Assessment (MoCA), and an established marker of cSVD, white matter hyperintensity volume (WMH) volume. One hundred and eleven community-dwelling older adults (56–86) underwent neuroimaging and MoCA testing. Quantification of region-specific ePVS burden was performed using a previously validated visual rating method and WMH volumes were computed using the standard ADNI pipeline. Separate linear regression models were run with ePVS as a predictor of MoCA scores and whole brain WMH volume. Results indicated a negative association between MoCA scores and both total ePVS counts (P ≤ 0.001) and centrum semiovale ePVS counts (P ≤ 0.001), after controlling for other relevant cSVD variables. Further, WMH volumes were positively associated with total ePVS (P = 0.010), basal ganglia ePVS (P ≤ 0.001), and centrum semiovale ePVS (P = 0.027). Our results suggest that ePVS burden, particularly in the centrum semiovale, may be a clinically significant neuroimaging marker of global cognitive dysfunction related to cSVD.

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“…In our study, we found statistically significant differences between groups in centrum semiovale PVS dilatation and did not find statistically significant differences by analyzing basal ganglia PVS and midbrain PVS. The results from other studies are ambiguous, that is, Valdes Hernandez et al proposed that the semiovale PVS is not directly associated with cognitive abilities in older age, while Kim et al found that PVS dilation is associated with Aβ positivity and thus could be an indirect imaging marker of Alzheimer’s dementia [ 55 , 56 ]. A systematic review of enlarged PVS indicates heterogeneity of assessment and that more longitudinal data with multivariate analysis is necessary to define a clear association with dementia [ 15 ].…”

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confidence: 99%

Combined Score of Perivascular Space Dilatation and White Matter Hyperintensities in Patients with Normal Cognition, Mild Cognitive Impairment, and Dementia

et al. 2022

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Background and Objectives: Cerebral perivascular spaces (PVS) are part of the cerebral microvascular structure and play a role in lymphatic drainage and the removal of waste products from the brain. White matter hyperintensities (WMH) are hyperintense lesions on magnetic resonance imaging that are associated with cognitive impairment, dementia, and cerebral vascular disease. WMH and PVS are direct and indirect imaging biomarkers of cerebral microvascular integrity and health. In our research, we evaluated WMH and PVS enlargement in patients with normal cognition (NC), mild cognitive impairment (MCI), and dementia (D). Materials and Methods: In total, 57 participants were included in the study and divided into groups based on neurological evaluation and Montreal Cognitive Assessment results (NC group 16 participants, MCI group 29 participants, D group 12 participants). All participants underwent 3T magnetic resonance imaging. PVS were evaluated in the basal ganglia, centrum semiovale, and midbrain. WMHs were evaluated based on the Fazekas scale and the division between deep white matter (DWM) and periventricular white matter (PVWM). The combined score based on PVS and WMH was evaluated and correlated with the results of the MoCA. Results: We found statistically significant differences between groups on several measures. Centrum semiovale PVS dilatation was more severe in MCI and dementia group and statistically significant differences were found between D-MCI and D-NC pairs. PVWM was more severe in patients with MCI and dementia group, and statistically significant differences were found between D-MCI and D-NC pairs. Furthermore, we found statistically significant differences between the groups by analyzing the combined score of PVS dilatation and WMH. We did not find statistically significant differences between the groups in PVS dilation of the basal ganglia and midbrain and DWM hyperintensities. Conclusions: PVS assessment could become one of neuroimaging biomarkers for patients with cognitive decline. Furthermore, the combined score of WMH and PVS dilatation could facilitate diagnostics of cognitive impairment, but more research is needed with a larger cohort to determine the use of PVS dilatation and the combined score.

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MRI-Visible Perivascular Spaces in the Centrum Semiovale Are Associated with Brain Amyloid Deposition in Patients with Alzheimer Disease–Related Cognitive Impairment

Cited by 17 publications

References 39 publications

Enlarged Perivascular Spaces in Relation to Cumulative Blood Pressure Exposure and Cognitive Impairment

Enlarged Perivascular Spaces in Relation to Cumulative Blood Pressure Exposure and Cognitive Impairment

Enlarged Perivascular Spaces Are Negatively Associated With Montreal Cognitive Assessment Scores in Older Adults

Combined Score of Perivascular Space Dilatation and White Matter Hyperintensities in Patients with Normal Cognition, Mild Cognitive Impairment, and Dementia

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