title: Topography and associations of perivascular spaces in healthy adults: the Kashima scan study.
abstract: OBJECTIVE
  We investigated whether the topography of MRI-visible perivascular spaces (PVS) is associated with markers of specific underlying small vessel disease, including cerebral microbleed (CMB) distribution, in neurologically healthy adults.
  
  
  METHODS
  We analyzed baseline data of an ongoing Japanese population-based cohort study. PVS were rated in the basal ganglia (BG-PVS) and centrum semiovale (CSO-PVS) on axial T2-weighted MRI using a validated rating scale (score 0-4). BG-PVS degree was classified as low (score <2) or high (score ≥2). CSO-PVS degree was classified as low (score <3) or high (score ≥3). Independent demographic, clinical, and imaging factors for high degree of BG-PVS and CSO-PVS were investigated.
  
  
  RESULTS
  A total of 1,575 neurologically healthy adults were included (mean age 57.1 years, SD 9.7; 47% male). In multivariable analyses, high degree of BG-PVS (n = 212, 14%) was associated with deep or infratentorial CMBs (odds ratio [OR] 2.77, 95% confidence interval [CI] 1.62-4.74), a marker of hypertensive arteriopathy; by contrast, high degree of CSO-PVS (n = 357, 23%) was associated with strictly lobar CMBs (OR 2.49, 95% CI 1.35-4.61), which share risk factors with cerebral amyloid angiopathy. Both high degree of BG-PVS and CSO-PVS were associated with hypertension (OR 2.03, 95% CI 1.46-2.82 and OR 1.39, 95% CI 1.07-1.81, respectively), lacunes (OR 3.35, 95% CI 1.92-5.86; OR 1.83 95% CI 1.08-3.08), and severe white matter hyperintensities (OR 2.17, 95% CI 1.42-3.31; OR 1.35, 95% CI 0.93-1.96), but these associations were stronger for high degree of BG-PVS.
  
  
  CONCLUSIONS
  In a neurologically healthy cohort, the associations of PVS differ according to their topography. PVS distribution may be useful for the early detection and classification of small vessel disease.
authors.affiliation: From the Division of Neurology, Department of Internal Medicine (Y.Y., M.E., Y.N., H.H.), and Departments of Preventive Medicine (M.H.) and Radiology (T.N., M. Nishihara), Saga University Faculty of Medicine; Yuai-Kai Oda Hospital (M. Nishiyama), Kashima, Saga, Japan; and Stroke Research Group (Y.Y., A.C., D.J.W.), Department of Brain Repair & Rehabilitation, UCL Institute of Neurology and The National Hospital for Neurology and Neurosurgery, Queen Square, London, UK. yakushij@cc.saga-u.ac.jp.
authors.forename: Yusuke
authors.initials: Y
authors.lastname: Yakushiji
authors.affiliation: From the Division of Neurology, Department of Internal Medicine (Y.Y., M.E., Y.N., H.H.), and Departments of Preventive Medicine (M.H.) and Radiology (T.N., M. Nishihara), Saga University Faculty of Medicine; Yuai-Kai Oda Hospital (M. Nishiyama), Kashima, Saga, Japan; and Stroke Research Group (Y.Y., A.C., D.J.W.), Department of Brain Repair & Rehabilitation, UCL Institute of Neurology and The National Hospital for Neurology and Neurosurgery, Queen Square, London, UK.
authors.forename: Andreas
authors.initials: A
authors.lastname: Charidimou
authors.affiliation: From the Division of Neurology, Department of Internal Medicine (Y.Y., M.E., Y.N., H.H.), and Departments of Preventive Medicine (M.H.) and Radiology (T.N., M. Nishihara), Saga University Faculty of Medicine; Yuai-Kai Oda Hospital (M. Nishiyama), Kashima, Saga, Japan; and Stroke Research Group (Y.Y., A.C., D.J.W.), Department of Brain Repair & Rehabilitation, UCL Institute of Neurology and The National Hospital for Neurology and Neurosurgery, Queen Square, London, UK.
authors.forename: Megumi
authors.initials: M
authors.lastname: Hara
authors.affiliation: From the Division of Neurology, Department of Internal Medicine (Y.Y., M.E., Y.N., H.H.), and Departments of Preventive Medicine (M.H.) and Radiology (T.N., M. Nishihara), Saga University Faculty of Medicine; Yuai-Kai Oda Hospital (M. Nishiyama), Kashima, Saga, Japan; and Stroke Research Group (Y.Y., A.C., D.J.W.), Department of Brain Repair & Rehabilitation, UCL Institute of Neurology and The National Hospital for Neurology and Neurosurgery, Queen Square, London, UK.
authors.forename: Tomoyuki
authors.initials: T
authors.lastname: Noguchi
authors.affiliation: From the Division of Neurology, Department of Internal Medicine (Y.Y., M.E., Y.N., H.H.), and Departments of Preventive Medicine (M.H.) and Radiology (T.N., M. Nishihara), Saga University Faculty of Medicine; Yuai-Kai Oda Hospital (M. Nishiyama), Kashima, Saga, Japan; and Stroke Research Group (Y.Y., A.C., D.J.W.), Department of Brain Repair & Rehabilitation, UCL Institute of Neurology and The National Hospital for Neurology and Neurosurgery, Queen Square, London, UK.
authors.forename: Masashi
authors.initials: M
authors.lastname: Nishihara
authors.affiliation: From the Division of Neurology, Department of Internal Medicine (Y.Y., M.E., Y.N., H.H.), and Departments of Preventive Medicine (M.H.) and Radiology (T.N., M. Nishihara), Saga University Faculty of Medicine; Yuai-Kai Oda Hospital (M. Nishiyama), Kashima, Saga, Japan; and Stroke Research Group (Y.Y., A.C., D.J.W.), Department of Brain Repair & Rehabilitation, UCL Institute of Neurology and The National Hospital for Neurology and Neurosurgery, Queen Square, London, UK.
authors.forename: Makoto
authors.initials: M
authors.lastname: Eriguchi
authors.affiliation: From the Division of Neurology, Department of Internal Medicine (Y.Y., M.E., Y.N., H.H.), and Departments of Preventive Medicine (M.H.) and Radiology (T.N., M. Nishihara), Saga University Faculty of Medicine; Yuai-Kai Oda Hospital (M. Nishiyama), Kashima, Saga, Japan; and Stroke Research Group (Y.Y., A.C., D.J.W.), Department of Brain Repair & Rehabilitation, UCL Institute of Neurology and The National Hospital for Neurology and Neurosurgery, Queen Square, London, UK.
authors.forename: Yusuke
authors.initials: Y
authors.lastname: Nanri
authors.affiliation: From the Division of Neurology, Department of Internal Medicine (Y.Y., M.E., Y.N., H.H.), and Departments of Preventive Medicine (M.H.) and Radiology (T.N., M. Nishihara), Saga University Faculty of Medicine; Yuai-Kai Oda Hospital (M. Nishiyama), Kashima, Saga, Japan; and Stroke Research Group (Y.Y., A.C., D.J.W.), Department of Brain Repair & Rehabilitation, UCL Institute of Neurology and The National Hospital for Neurology and Neurosurgery, Queen Square, London, UK.
authors.forename: Masanori
authors.initials: M
authors.lastname: Nishiyama
authors.affiliation: From the Division of Neurology, Department of Internal Medicine (Y.Y., M.E., Y.N., H.H.), and Departments of Preventive Medicine (M.H.) and Radiology (T.N., M. Nishihara), Saga University Faculty of Medicine; Yuai-Kai Oda Hospital (M. Nishiyama), Kashima, Saga, Japan; and Stroke Research Group (Y.Y., A.C., D.J.W.), Department of Brain Repair & Rehabilitation, UCL Institute of Neurology and The National Hospital for Neurology and Neurosurgery, Queen Square, London, UK.
authors.forename: David J
authors.initials: DJ
authors.lastname: Werring
authors.affiliation: From the Division of Neurology, Department of Internal Medicine (Y.Y., M.E., Y.N., H.H.), and Departments of Preventive Medicine (M.H.) and Radiology (T.N., M. Nishihara), Saga University Faculty of Medicine; Yuai-Kai Oda Hospital (M. Nishiyama), Kashima, Saga, Japan; and Stroke Research Group (Y.Y., A.C., D.J.W.), Department of Brain Repair & Rehabilitation, UCL Institute of Neurology and The National Hospital for Neurology and Neurosurgery, Queen Square, London, UK.
authors.forename: Hideo
authors.initials: H
authors.lastname: Hara
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D044466:Asian People; D015415:Biomarkers; D001921:Brain / Q000098:blood supply*; D016657:Cerebral Amyloid Angiopathy / Q000175:diagnosis; D015331:Cohort Studies; D005260:Female; D006801:Humans; D006973:Hypertension; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D019371:Topography, Medical
chemical_list: D015415:Biomarkers