Imaging perivascular space structure and function using brain MRI

Barisano, Giuseppe; Lynch, Kirsten M.; Sibilia, Francesca; Lan, Haoyou; Shih, Nien‐Chu; Sepehrband, Farshid; Choupan, Jeiran

doi:10.1016/j.neuroimage.2022.119329

Cited by 52 publications

(56 citation statements)

References 197 publications

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“…Future research on the role of Aβ and tau in the relationship between MRI-visible PVS and cognitive impairment is warranted. Third, PVS in the hippocampus are very difficult to distinguish from hippocampal sulcus remnant cysts [ 50 ]. The results of MRI-visible PVS in the hippocampus should be interpreted with caution.…”

Section: Discussionmentioning

confidence: 99%

Associations of MRI-visible perivascular spaces with longitudinal cognitive decline across the Alzheimer’s disease spectrum

et al. 2022

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Objective To investigate the characteristics and associations of MRI-visible perivascular spaces (PVS) with clinical progression and longitudinal cognitive decline across the Alzheimer’s disease spectrum. Methods We included 1429 participants (641 [44.86%] female) from the Alzheimer’s Disease Neuroimaging Initiative (ADNI) database. PVS number and grade in the centrum semiovale (CSO-PVS), basal ganglia (BG-PVS), and hippocampus (HP-PVS) were compared among the control (CN), mild cognitive impairment (MCI), and Alzheimer’s disease (AD) groups. PVS were tested as predictors of diagnostic progression (i.e., CN to MCI/AD or MCI to AD) and longitudinal changes in the 13-item Alzheimer’s Disease Assessment Scale-cognitive subscale (ADAS-Cog 13), Mini-Mental State Examination (MMSE), memory (ADNI-MEM), and executive function (ADNI-EF) using multiple linear regression, linear mixed-effects, and Cox proportional hazards modeling. Results Compared with CN subjects, MCI and AD subjects had more CSO-PVS, both in number (p < 0.001) and grade (p < 0.001). However, there was no significant difference in BG-PVS and HP-PVS across the AD spectrum (p > 0.05). Individuals with moderate and frequent/severe CSO-PVS had a higher diagnostic conversion risk than individuals with no/mild CSO-PVS (log-rank p < 0.001 for all) in the combined CN and MCI group. Further Cox regression analyses revealed that moderate and frequent/severe CSO-PVS were associated with a higher risk of diagnostic conversion (HR = 2.007, 95% CI = 1.382–2.914, p < 0.001; HR = 2.676, 95% CI = 1.830–3.911, p < 0.001, respectively). A higher CSO-PVS number was associated with baseline cognitive performance and longitudinal cognitive decline in all cognitive tests (p < 0.05 for all). Conclusions CSO-PVS were more common in MCI and AD and were associated with cognitive decline across the AD spectrum.

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Section: Discussionmentioning

confidence: 99%

Associations of MRI-visible perivascular spaces with longitudinal cognitive decline across the Alzheimer’s disease spectrum

et al. 2022

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“…A similar performance level was achieved when the same CNN was applied to T1-weighted images, suggesting that the multi-channel and multi-scale architecture is superior to a regular u-net with an autoencoder ( Kingma and Welling, 2013 ; Huang et al, 2021 ). For an in-depth discussion of each of the techniques, please refer to previous work ( Barisano et al, 2022a ; Moses et al, 2022 ).…”

Section: Automated Segmentation Of Perivascular Spacesmentioning

confidence: 99%

“…009 To improve comparability, we recommend publishing average volumes and counts alongside volume fractions and MRI parameters and the resulting SNR and CNR. For a discussion of the MRI parameters that affect PVS visibility, please refer to Zong et al (2016) and Barisano et al (2022a) .…”

Section: Automated Segmentation Of Perivascular Spacesmentioning

confidence: 99%

A critical guide to the automated quantification of perivascular spaces in magnetic resonance imaging

Pham

Lynch²,

Spitz³

et al. 2022

Front. Neurosci.

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The glymphatic system is responsible for waste clearance in the brain. It is comprised of perivascular spaces (PVS) that surround penetrating blood vessels. These spaces are filled with cerebrospinal fluid and interstitial fluid, and can be seen with magnetic resonance imaging. Various algorithms have been developed to automatically label these spaces in MRI. This has enabled volumetric and morphological analyses of PVS in healthy and disease cohorts. However, there remain inconsistencies between PVS measures reported by different methods of automated segmentation. The present review emphasizes that importance of voxel-wise evaluation of model performance, mainly with the Sørensen Dice similarity coefficient. Conventional count correlations for model validation are inadequate if the goal is to assess volumetric or morphological measures of PVS. The downside of voxel-wise evaluation is that it requires manual segmentations that require large amounts of time to produce. One possible solution is to derive these semi-automatically. Additionally, recommendations are made to facilitate rigorous development and validation of automated PVS segmentation models. In the application of automated PVS segmentation tools, publication of image quality metrics, such as the contrast-to-noise ratio, alongside descriptive statistics of PVS volumes and counts will facilitate comparability between studies. Lastly, a head-to-head comparison between two algorithms, applied to two cohorts of astronauts reveals how results can differ substantially between techniques.

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“…To further corroborate nondilated and/or dilated VRS as an imaging biomarker in MS, several open questions need to be answered: (1) Are VRS cross-sectionally or longitudinally associated with clinical or imaging outcomes in MS? (2) What is the topographical distribution of VRS, and do they coincide with MS lesions? (3) What is the longitudinal evolution of VRS in MS?…”

Section: Introductionmentioning

confidence: 99%

Dilated Virchow-Robin Spaces are a Marker for Arterial Disease in Multiple Sclerosis

Ineichen

Cananau

Plattén

et al. 2023

Preprint

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Virchow-Robin spaces (VRS) have been associated with neurodegeneration and neuroinflammation. However, it remains uncertain to what degree non-dilated or dilated VRS reflect specific features of neuroinflammatory pathology. Thus, we aimed at investigating the clinical relevance of VRS as imaging biomarker in multiple sclerosis (MS) and to correlate VRS to their histopathologic signature. In a cohort study comprising 205 MS patients (including a validation cohort) and 30 control subjects, we assessed the association of non-dilated and dilated VRS to clinical and magnetic resonance imaging (MRI) outcomes. Brain blocks from 6 MS patients and 3 non-MS controls were histopathologically processed to correlate VRS to their tissue substrate. The count of dilated centrum semiovale VRS was associated with increased T1 and T2 lesion volumes. There was no systematic spatial colocalization of dilated VRS with MS lesions. At tissue level, VRS mostly corresponded to arteries and were not associated with MS pathological hallmarks. Interestingly, dilated VRS in MS were associated with signs of small vessel disease. Contrary to prior beliefs, these observations suggest that VRS in MS do not associate with accumulation of immune cells. But instead, these findings indicate vascular pathology as a driver and/or consequence of neuroinflammatory pathology for this imaging feature.

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Imaging perivascular space structure and function using brain MRI

Cited by 52 publications

References 197 publications

Associations of MRI-visible perivascular spaces with longitudinal cognitive decline across the Alzheimer’s disease spectrum

Associations of MRI-visible perivascular spaces with longitudinal cognitive decline across the Alzheimer’s disease spectrum

A critical guide to the automated quantification of perivascular spaces in magnetic resonance imaging

Dilated Virchow-Robin Spaces are a Marker for Arterial Disease in Multiple Sclerosis

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