title: Topography of dilated perivascular spaces in subjects from a memory clinic cohort.
abstract: OBJECTIVE
  To investigate whether the topography of dilated perivascular spaces (DPVS) corresponds with markers of particular small-vessel diseases such as cerebral amyloid angiopathy and hypertensive vasculopathy.
  
  
  METHODS
  Patients were recruited from an ongoing single-center prospective longitudinal cohort study of patients evaluated in a memory clinic. All patients underwent structural, high-resolution MRI, and had a clinical assessment performed within 1 year of scan. DPVS were rated in basal ganglia (BG-DPVS) and white matter (WM-DPVS) on T1 sequences, using an established 4-point semiquantitative score. DPVS degree was classified as high (score > 2) or low (score ≤ 2). Independent risk factors for high degree of BG-DPVS and WM-DPVS were investigated.
  
  
  RESULTS
  Eighty-nine patients were included (mean age 72.7 ± 9.9 years, 57% female). High degree of WM-DPVS was more frequent than low degree in patients with presence of strictly lobar microbleeds (45.5% vs 28.4% of subjects). High BG-DPVS degree was associated with older age, hypertension, and higher white matter hyperintensity volumes. In multivariate analysis, increased lobar microbleed count was an independent predictor of high degree of WM-DPVS (odds ratio [OR] 1.53 [95% confidence interval (CI) 1.06-2.21], p = 0.02). By contrast, hypertension was an independent predictor of high degree of BG-DPVS (OR 9.4 [95% CI 1-85.2], p = 0.04).
  
  
  CONCLUSIONS
  The associations of WM-DPVS with lobar microbleeds and BG-DPVS with hypertension raise the possibility that the distribution of DPVS may indicate the presence of underlying small-vessel diseases such as cerebral amyloid angiopathy and hypertensive vasculopathy in patients with cognitive impairment.
authors.affiliation: Massachusetts General Hospital Stroke Research Center, Boston, MA, USA. srmartinez@partners.org
authors.forename: Sergi
authors.initials: S
authors.lastname: Martinez-Ramirez
authors.forename: Octavio Marques
authors.initials: OM
authors.lastname: Pontes-Neto
authors.forename: Andrew P
authors.initials: AP
authors.lastname: Dumas
authors.forename: Eitan
authors.initials: E
authors.lastname: Auriel
authors.forename: Amy
authors.initials: A
authors.lastname: Halpin
authors.forename: Megan
authors.initials: M
authors.lastname: Quimby
authors.forename: Mahmut Edip
authors.initials: ME
authors.lastname: Gurol
authors.forename: Steven M
authors.initials: SM
authors.lastname: Greenberg
authors.forename: Anand
authors.initials: A
authors.lastname: Viswanathan
mesh_terms: D000368:Aged; D001921:Brain / Q000473:pathology*; D002561:Cerebrovascular Disorders / Q000473:pathology*; D015331:Cohort Studies; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008569:Memory Disorders / Q000473:pathology*
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