The correlation between enlarged perivascular spaces and cognitive impairment in Parkinson’s disease and vascular parkinsonism

Abstract

Introduction The widespread use of brain magnetic resonance imaging (MRI) has revealed the correlation between enlarged perivascular spaces (EPVS) and cognitive impairment (CI). However, few studies have examined the correlation between MRI-visible EPVS and CI in patients with Parkinson’s disease (PD) and vascular parkinsonism (VaP). This study explored how the number and main location of EPVS in PD and VaP are correlated with the occurrence of CI in these diseases to provide radiology markers and other evidence for early clinical diagnosis in a Chinese cohort. Methods Clinical data were prospectively collected from 77 patients: 26 patients clinically diagnosed with PD or probable PD, 19 patients clinically diagnosed with VaP, and 32 control subjects with normal cognitive function and no stroke or parkinsonism. The patients with PD and VaP were divided into a CI group and a no CI (NCI) group according to the Montreal Cognitive Assessment Beijing version (MoCA-BJ). The relevant clinical data were statistically analysed. Results The centrum semiovale (CSO)-EPVS, lacunes, Fazekas scores, global cortical atrophy scale (GCA) scores, Koedam posterior atrophy visual scale (KS) scores, and medial temporal atrophy (MTA) scores were higher in the PD-CI and VaP-CI groups than in the control group (adjusted P < 0.017). The number of basal ganglia (BG)-EPVS in the VaP group was higher than that in the PD and control groups (adjusted P < 0.017). BG-EPVS, Fazekas scores, GCA scores, KS scores, and MTA scores were higher in the VaP-CI group than in the PD-CI group (adjusted P < 0.017). Multivariate logistic regression analysis showed that the differences in BG-EPVS and Fazekas scores were not significant between PD-CI and VaP-CI patients (P > 0.05). Conclusion VaP-CI results from multiple factors and is significantly associated with BG-EPVS, lacunes, white matter hyperintensities and brain atrophy. BG-EPVS can be used as an imaging marker to distinguish VaP-CI from PD-CI.

Imaging the neurovascular unit in health and neurodegeneration: a scoping review of interdependencies between MRI measures

“…Specifically, while BG ePVS tended to have associations with other MRI measures (perfusion, BBB permeability) in both healthy samples and in those with vascular-related conditions such as CSVD or stroke, CSO ePVS associations with other MRI measures (free water) were only evident in those with probable cerebral amyloid angiopathy. Although literature investigating CSO ePVS was limited in the studies included in this review, this finding is consistent with other research suggesting that BG ePVS are more prevalent in diseases with a vascular component or origin, such as atherosclerosis [ 142 ] or vascular parkinsonism [ 143 ]. Conversely, CSO ePVS are associated with the progression of diseases with increased amyloid deposition, including Alzheimer’s disease [ 144 ] and cerebral amyloid angiopathy [ 91 , 142 ].…”