MRI-visible perivascular spaces in basal ganglia but not centrum semiovale or hippocampus were related to deep medullary veins changes

Zhang, Kemeng; Zhou, Ying; Zhang, Wenhua; Li, Qingqing; Sun, Jianyong; Lou, Min

doi:10.1177/0271678x211038138

Cited by 23 publications

(25 citation statements)

References 34 publications

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“…Using two different radiological PVS markers (high number of smaller-sized PVS and presence of large-sized PVS), we showed that CVR was significantly related to PVS fluid accumulation around damaged small vessels. In agreement with our findings, terminal venous disruptions were associated with decreased interstitial fluid drainage and MRI-visible PVS in the BG [ 33 , 34 ]. The enlargement of the PVS was associated with dysfunctional brain waste clearance involving the glymphatic system and intramural periarterial drainage pathway [ 31 , 35 ].…”

Section: Discussionsupporting

confidence: 92%

“…In agreement with our findings, terminal venous disruptions were associated with decreased interstitial fluid drainage and MRI-visible PVS in the BG. 33,34 The enlargement of the PVS was associated with dysfunctional brain waste clearance involving the glymphatic system and intramural periarterial drainage pathway. 31,35 Thus, our findings highlight the pathophysiological role of cerebral venous circulation in the effects of perivascular fluid drainage on SVD.…”

Section: Discussionmentioning

confidence: 99%

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Cerebral Venous Reflux and Dilated Basal Ganglia Perivascular Space in Hypertensive Intracerebral Hemorrhage

et al. 2022

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Background and Purpose Cerebral venous flow alterations potentially contribute to age-related white matter changes, but their role in small vessel disease has not been investigated.Methods This study included 297 patients with hypertensive intracerebral hemorrhages (ICH) who underwent magnetic resonance imaging. Cerebral venous reflux (CVR) was defined as the presence of abnormal signal intensity in the dural venous sinuses or internal jugular vein on time-of-flight angiography. We investigated the association between CVR, dilated perivascular spaces (PVS), and recurrent stroke risk.Results CVR was observed in 38 (12.8%) patients. Compared to patients without CVR those with CVR were more likely to have high grade (>20 in the number) dilated PVS in the basal ganglia (60.5% vs. 35.1%; adjusted odds ratio [aOR], 2.64; 95% confidence interval [CI], 1.25 to 5.60; P=0.011) and large PVS (>3 mm in diameter) (50.0% vs. 18.5%; aOR, 3.87; 95% CI, 1.85 to 8.09; P<0.001). During a median follow-up of 18 months, patients with CVR had a higher recurrent stroke rate (13.6%/year vs. 6.2%/year; aOR, 2.53; 95% CI, 1.09 to 5.84; P=0.03) than those without CVR.Conclusions CVR may contribute to the formation of enlarged PVS and increase the risk of recurrent stroke in patients with hypertensive ICH.

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Section: Discussionsupporting

confidence: 92%

Section: Discussionmentioning

confidence: 99%

Cerebral Venous Reflux and Dilated Basal Ganglia Perivascular Space in Hypertensive Intracerebral Hemorrhage

et al. 2022

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“…The assessments of DMV's visual scores were according to previous studies (Zhang et al, 2017 , 2019 ; Zhou et al, 2020 ; Zhang K. et al, 2021 ). The ESWAN raw data were reconstructed to the magnitude and phase images on a custom-built program on a separate workstation (ADW4.4, GE).…”

Section: Methodsmentioning

confidence: 99%

Different mechanisms in periventricular and deep white matter hyperintensities in old subjects

Cai

Sun

Chen

et al. 2022

Front. Aging Neurosci.

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ObjectiveAlthough multiple pieces of evidence have suggested that there are different mechanisms in periventricular white matter hyperintensities (PWMHs) and deep white matter hyperintensities (DWMHs), the exact mechanism remains uncertain.MethodsWe reviewed clinical and imaging data of old participants from a local She Ethnic group. We assessed the cerebral blood flow of white matter (WM-CBF) on arterial spin-labeling, deep medullary veins (DMVs) visual score on susceptibility-weighted imaging, and index for diffusion tensor image analysis along the perivascular space (ALPS index), indicating glymphatic function on diffusion tensor imaging. Furthermore, we investigated their relationships with volumes of PWMHs and DWMHs.ResultsA total of 152 subjects were included, with an average age of 63 ± 8 years old. We found that higher age and history of hypertension were independently related to higher volumes of both PWMHs and DWMHs (all p < 0.05). Lower ALPS index was independently associated with higher PWMHs volumes (β = 0.305, p < 0.001), and this relationship was accounted for by the indirect pathway via DMVs score (β = 0.176, p = 0.017). Both lower ALPS index and WM-CBF were independent risk factors for higher DWMHs volumes (β = −0.146, p = 0.041; β = −0.147, p = 0.036).ConclusionsOur study indicated that there were different mechanisms in PWMHs and DWMHs. PWMHs were mainly attributed to the damage of veins due to the dysfunction of the glymphatic pathway, while DWMHs could be affected by both ischemia-hypoperfusion and dysfunction of the glymphatic pathway.Advances in knowledgeThe relationship between glymphatic dysfunction and PWMHs might be accounted for by the indirect pathway via venous abnormalities, a glymphatic dysfunction, and lower CBF in white matter were independent risk factors for DWMHs.

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“…The disruption or decreased visibility of deep medullary veins (DMVs) on susceptibility-weighted imaging has been regarded as the neuroimaging marker of VC in patients with CSVD [ 100 ]. A recent study found that DMVs were associated with EPVS in basal ganglia, suggesting that the disruption of DMVs was involved in glymphatic fluid stasis in the perivascular spaces of basal ganglia [ 101 ]. No association between DMVs and EPVS in centrum semiovale was found; the potential explanation was that cortical and superficial veins and venules drained CSF/ISF in centrum semiovale where the glymphatic function was still functioning normally or in a compensatory phase [ 101 ].…”

Section: The Underlying Role Of the Glymphatic And Meningeal Lymphati...mentioning

confidence: 99%

“…A recent study found that DMVs were associated with EPVS in basal ganglia, suggesting that the disruption of DMVs was involved in glymphatic fluid stasis in the perivascular spaces of basal ganglia [ 101 ]. No association between DMVs and EPVS in centrum semiovale was found; the potential explanation was that cortical and superficial veins and venules drained CSF/ISF in centrum semiovale where the glymphatic function was still functioning normally or in a compensatory phase [ 101 ]. As perivenous space plays a key role in the glymphatic efflux, whether the deposition of collagenosis in venous affects the glymphatic system needs more direct evidence in the future.…”

Section: The Underlying Role Of the Glymphatic And Meningeal Lymphati...mentioning

confidence: 99%

The Underlying Role of the Glymphatic System and Meningeal Lymphatic Vessels in Cerebral Small Vessel Disease

et al. 2022

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There is a growing prevalence of vascular cognitive impairment (VCI) worldwide, and most research has suggested that cerebral small vessel disease (CSVD) is the main contributor to VCI. Several potential physiopathologic mechanisms have been proven to be involved in the process of CSVD, such as blood-brain barrier damage, small vessels stiffening, venous collagenosis, cerebral blood flow reduction, white matter rarefaction, chronic ischaemia, neuroinflammation, myelin damage, and subsequent neurodegeneration. However, there still is a limited overall understanding of the sequence and the relative importance of these mechanisms. The glymphatic system (GS) and meningeal lymphatic vessels (mLVs) are the analogs of the lymphatic system in the central nervous system (CNS). As such, these systems play critical roles in regulating cerebrospinal fluid (CSF) and interstitial fluid (ISF) transport, waste clearance, and, potentially, neuroinflammation. Accumulating evidence has suggested that the glymphatic and meningeal lymphatic vessels played vital roles in animal models of CSVD and patients with CSVD. Given the complexity of CSVD, it was significant to understand the underlying interaction between glymphatic and meningeal lymphatic transport with CSVD. Here, we provide a novel framework based on new advances in main four aspects, including vascular risk factors, potential mechanisms, clinical subtypes, and cognition, which aims to explain how the glymphatic system and meningeal lymphatic vessels contribute to the progression of CSVD and proposes a comprehensive insight into the novel therapeutic strategy of CSVD.

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MRI-visible perivascular spaces in basal ganglia but not centrum semiovale or hippocampus were related to deep medullary veins changes

Cited by 23 publications

References 34 publications

Cerebral Venous Reflux and Dilated Basal Ganglia Perivascular Space in Hypertensive Intracerebral Hemorrhage

Cerebral Venous Reflux and Dilated Basal Ganglia Perivascular Space in Hypertensive Intracerebral Hemorrhage

Different mechanisms in periventricular and deep white matter hyperintensities in old subjects

The Underlying Role of the Glymphatic System and Meningeal Lymphatic Vessels in Cerebral Small Vessel Disease

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