MRI-visible perivascular space location is associated with Alzheimer's disease independently of amyloid burden

Abstract

MRI-visible perivascular spaces are a neuroimaging marker of cerebral small vessel disease.Their location may relate to the type of underlying small vessel pathology: those in the white matter centrum semi-ovale have been associated with cerebral amyloid angiopathy, whilst those in the basal ganglia have been associated with deep perforating artery arteriolosclerosis.Since cerebral amyloid angiopathy is an almost invariable pathological finding in Alzheimer's disease, we hypothesized that MRI-visible perivascular spaces in the centrum semi-ovale would be associated with a clinical diagnosis of Alzheimer's disease, whereas those in the basal ganglia would be associated with subcortical vascular cognitive impairment. We also hypothesised that MRI-visible perivascular spaces in the centrum semiovale would be associated with brain amyloid burden, as detected by amyloid-PET using subcortical vascular cognitive impairment n=116) with standardised MRI and PiB-PET imaging were included. MRI-visible perivascular spaces were rated using a validated 4-point visual rating scale, and then categorised by severity ("none/mild", "moderate" or "frequent/severe").

Enlarged perivascular spaces are associated with health‐related quality of life in patients with acute ischemic stroke

“…who was blinded to the clinical data and psychological assessments assessed EPVS on axial‐T2‐weighted sequences using a scale invented by Wardlaw et al . EPVS were defined as fluid‐filled spaces with signal intensities similar to that of cerebrospinal fluid on all sequences, that followed the courses of penetrating vessels and were linear, round or ovoid in shape, and with diameters generally smaller than 3 mm . The severity of EPVS in the basal ganglia and the centrum semiovale was rated according to the number of spaces in a unilateral slice containing the maximum EPVS: 0 = none; 1 = 1‐10; 2 = 11‐20; 3 = 21‐40; 4 ≥ 40 .…”

“…Basal ganglia and centrum semiovale are the two locations for easy observations for EPVS . EPVS are associated with a variety of neuropsychiatric disorders, including multiple sclerosis, dementia, depression, and sleep disorder . EPVS also commonly occur in stroke .…”

Down syndrome, Alzheimer disease, and cerebral amyloid angiopathy: The complex triangle of brain amyloidosis

“…The presence and severity of WMH lesions strongly correlate with CAA and are typically more severe in CAA patients than in patients with AD (Chen et al, ). Dilated perivascular spaces: Their presence in centrum semiovale is associated with the number of lobar microbleeds and cSS (Martinez‐Ramirez et al, ). Its severity is strongly associated with cognitive impairment and cortical amyloid burden in positron emission tomography (PET) in probable CAA and elderly controls (Banerjee et al, ). Their presence in CAA could reflect the failure of protein elimination implicated in disease pathogenesis, suggesting that interstitial fluid drainage impairment within perivascular spaces is caused by cumulative leptomeningeal and superficial cortical vascular Aß deposition (Martinez‐Ramirez et al, ). Cerebral microbleeds: Pathologically, they correspond to clusters of hemosiderin‐laden macrophages within the perivascular space due to blood extravasation without disruption of the surrounding tissue.…”

“…• Dilated perivascular spaces: Their presence in centrum semiovale is associated with the number of lobar microbleeds and cSS (Martinez-Ramirez et al, 2013). Its severity is strongly associated with cognitive impairment and cortical amyloid burden in positron emission tomography (PET) in probable CAA and elderly controls (Banerjee et al, 2017). Their presence in CAA could reflect the failure of protein elimination implicated in disease pathogenesis, suggesting that interstitial fluid drainage impairment within perivascular spaces is caused by cumulative leptomeningeal and superficial cortical vascular Aß deposition (Martinez-Ramirez et al, 2013).…”

The fine anatomy of the perivascular compartment in the human brain: relevance to dilated perivascular spaces in cerebral amyloid angiopathy

“…Dilated perivascular spaces (PVS) are of particular interest for the study of interstitial fluid (ISF) dynamics because they are related to the intramural periarterial drainage (IPAD) of ISF and solutes along arterial basement membranes and can potentially be detected by MRI. MRI‐visible dilated PVS have been described in the white matter of patients with AD or cerebral amyloid angiopathy (CAA) . There are no detectable PVS around arteries in the cerebral cortex, even in pathological conditions, whereas PVS can dilate in the white matter and may indicate failure of drainage of ISF and solutes .…”