Perivascular Spaces in Old Age: Assessment, Distribution, and Correlation with White Matter Hyperintensities

Laveskog, Anna; Wang, Rui; Bronge, Lena; Wahlund, Lars‐Olof; Qiu, Chengxuan

doi:10.3174/ajnr.a5455

Cited by 51 publications

(55 citation statements)

References 31 publications

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“…We used a visual rating scale to evaluate PVS, as fully reported elsewhere. 18 Briefly, we used T1 and T2 images to assess PVS in different brain areas (e.g., frontal lobe, parieto-occipital lobe, basal ganglia, thalami, and cerebellum) in each brain hemisphere. In each region, the number of visible PVS was measured on a 0–3 point scale: 0, no visible PVS; 1, 1–5 PVS; 2, 6–10 PVS; or 3, >10 PVS.…”

Section: Methodsmentioning

confidence: 99%

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MRI load of cerebral microvascular lesions and neurodegeneration, cognitive decline, and dementia

et al. 2018

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ObjectiveTo explore the differential associations of neurodegeneration and microvascular lesion load with cognitive decline and dementia in older people and the modifying effect of the APOE genotype on these associations.MethodsA sample of 436 participants (age ≥ 60 years) was derived from the population-based Swedish National study on Aging and Care in Kungsholmen, Stockholm, and clinically examined at baseline (2001–2003) and 3 occasions during the 9-year follow-up. At baseline, we assessed microvascular lesion load using a summary score for MRI markers of lacunes, white matter hyperintensities (WMHs), and perivascular spaces and neurodegeneration load for markers of enlarged ventricles, smaller hippocampus, and smaller gray matter. We assessed cognitive function using the Mini-Mental State Examination (MMSE) test and diagnosed dementia following the Diagnostic and Statistical Manual of Mental Disorders, 4th edition criteria. We analyzed data using linear mixed-effects, mediation, and random-effects Cox models.ResultsDuring the follow-up, 46 participants were diagnosed with dementia. Per 1-point increase in microvascular lesion and neurodegeneration score (range 0–3) was associated with multiple adjusted β-coefficients of −0.35 (95% confidence interval, −0.51 to −0.20) and −0.44 (−0.56 to −0.32), respectively, for the MMSE score and multiple adjusted hazard ratios of 1.68 (1.12–2.51) and 2.35 (1.58–3.52), respectively, for dementia; carrying APOE ε4 reinforced the associations with MMSE decline. WMH volume changes during the follow-up mediated 66.9% and 12.7% of the total association of MMSE decline with the baseline microvascular score and neurodegeneration score, respectively.ConclusionsBoth cerebral microvascular lesion and neurodegeneration loads are strongly associated with cognitive decline and dementia. The cognitive decline due to microvascular lesions is exacerbated by APOE ε4 and is largely attributed to progression and development of microvascular lesions.

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Section: Methodsmentioning

confidence: 99%

“…The visual rating scale for PVS had the weighted κ statistic of 0.77 for both intrarater and inter-rater reliability. 18 …”

Section: Methodsmentioning

confidence: 99%

MRI load of cerebral microvascular lesions and neurodegeneration, cognitive decline, and dementia

et al. 2018

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“…Imaging the perivascular spaces (PVS), also known as Virchow-Robin space, has significant clinical value. Many recent studies have shown pathological alteration of PVS in a range of neurological disorders (Bacyinski et al, 2017;Banerjee et al, 2017;Brown et al, 2018;Cavallari et al, 2018;Feldman et al, 2018;Kalaria, 2018;Krueger and Bechmann, 2010;Laveskog et al, 2018;Park et al, 2017). It is also believed that PVS plays a major role in the clearance system, accommodating the influx of CSF to brain parenchyma through peri-arterial space, and the efflux of interstitial fluid to the lymphatic system through peri-venous space (Rasmussen et al, 2018;Tarasoff-Conway et al, 2015;Bacyinski et al, 2017;Iliff et al, 2012).…”

Section: Introductionmentioning

confidence: 99%

Image processing approaches to enhance perivascular space visibility and quantification using MRI

Sepehrband

Barisano

Sheikh‐Bahaei

et al. 2019

Preprint

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Word count: 4080 Number of figures: 8 Number of tables: 1 AbstractImaging the perivascular spaces (PVS), also known as Virchow-Robin space, has significant clinical value, but there remains a need for neuroimaging techniques to improve mapping and quantification of the PVS. Current technique for PVS evaluation is a scoring system based on visual reading of visible PVS in regions of interest, and often limited to large caliber PVS.Enhancing the visibility of the PVS could support medical diagnosis and enable novel neuroscientific investigations. Increasing the MRI resolution is one approach to enhance the visibility of PVS but is limited by acquisition time and physical constraints. Alternatively, image processing approaches can be utilized to improve the contrast ratio between PVS and surrounding tissue. Here we combine T1-and T2-weighted images to enhance PVS contrast, intensifying the visibility of PVS. The Enhanced PVS Contrast (EPC) was achieved by combining T1-and T2-weighted images that were adaptively filtered to remove non-structured highfrequency spatial noise. EPC was evaluated on healthy young adults by presenting them to two expert readers and also through automated quantification. We found that EPC improves the conspicuity of the PVS and aid resolving a larger number of PVS. We also present a highly reliable automated PVS quantification approach, which was optimized using expert readings.

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“…Multiple sclerosis may also increase the relative size of the PVS due WM atrophy 23 , and PVS size is also known to increase with age 24 . Moreover, CBF and CBV were generally found to be reduced in the normal appearing white matter in MS 25 .…”

Section: Discussionmentioning

confidence: 99%

The role of diffusion and perivascular spaces in dynamic susceptibility contrast MRI

Doucette

Kames

Hernández‐Torres

et al. 2019

Preprint

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We investigated the effects of brain tissue orientation, diffusion, and perivascular spaces on dynamic susceptibility contrast MRI. A 3D numerical model of a white matter voxel was created that consists of an isotropic capillary bed and anisotropic vessels that run in parallel with white matter tracts and are surrounded by perivascular spaces. The signal within the voxel was simulated by solving the Bloch-Torrey equation.

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Perivascular Spaces in Old Age: Assessment, Distribution, and Correlation with White Matter Hyperintensities

Abstract: BACKGROUND AND PURPOSE:The visual rating scales for perivascular spaces vary considerably. We sought to develop a new scale for visual assessment of perivascular spaces and to further describe their distribution and association with white matter hyperintensities in old age.

Cited by 51 publications

References 31 publications

MRI load of cerebral microvascular lesions and neurodegeneration, cognitive decline, and dementia

MRI load of cerebral microvascular lesions and neurodegeneration, cognitive decline, and dementia

Image processing approaches to enhance perivascular space visibility and quantification using MRI

The role of diffusion and perivascular spaces in dynamic susceptibility contrast MRI

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