title: Assessment of enlarged perivascular spaces and their relation to target organ damage and mild cognitive impairment in patients with hypertension.
abstract: Enlarged perivascular spaces (EPVS) have been recently considered a feature of cerebral small vessel disease. They have been related to aging, hypertension and dementia but their relationship with hypertension related variables (i.e. target organ damage, treatment compliance) and mild cognitive impairment (MCI) is not fully elucidated. Our aims were to investigate the relation between basal ganglia (BG) and centrum semiovale (CSO) EPVS with vascular risk factors, hypertension related variables and MCI.
  
  
  
  In all, 733 hypertensive individuals free of stroke and dementia from the Investigating Silent Strokes in Hypertensives, a magnetic resonance imaging Study (ISSYS) underwent brain magnetic resonance imaging and cognitive testing to diagnose MCI or normal cognitive aging.
  
  
  
  The numbers of participants presenting high grade (>10) EPVS at the BG and CSO were 23.3% and 40.0%, respectively. After controlling for vascular risk factors, high grade BG EPVS were associated with age (odds ratio 1.68; 95% confidence interval 1.37, 2.06), poor antihypertensive compliance (1.49; 1.03, 2.14) and the presence of microalbuminuria (1.95; 1.16, 3.28), whereas in the CSO only age (1.38; 1.18, 1.63) and male sex were associated with EPVS (1.73; 1. 24, 2.42). MCI was diagnosed in 9.3% of the participants and it was predicted by EPVS in the BG (1.87; 1.03, 3.39) but not in the CSO. This last association was greatly attenuated after correction for lacunes and white matter hyperintensities.
  
  
  
  Basal ganglia EPVS are associated with the presence of microalbuminuria and poor adherence to antihypertensive drugs. The BG EPVS relation with MCI is not independent of the presence of other cerebral small vessel disease markers.
authors.affiliation: Neurovascular Research Laboratory, Vall Hebron Research Institute, Universitat Autònoma de Barcelona, Barcelona, Spain.
authors.forename: I
authors.initials: I
authors.lastname: Riba-Llena
authors.affiliation: Neurovascular Research Laboratory, Vall Hebron Research Institute, Universitat Autònoma de Barcelona, Barcelona, Spain.
authors.forename: C
authors.initials: C
authors.lastname: Nafría
authors.affiliation: Barcelona City Research Support Unit - IDIAP Jordi Gol, Universitat Autònoma de Barcelona, Barcelona, Spain.
authors.forename: X
authors.initials: X
authors.lastname: Mundet
authors.affiliation: Neurovascular Research Laboratory, Vall Hebron Research Institute, Universitat Autònoma de Barcelona, Barcelona, Spain.
authors.forename: A
authors.initials: A
authors.lastname: López-Rueda
authors.affiliation: Neurovascular Research Laboratory, Vall Hebron Research Institute, Universitat Autònoma de Barcelona, Barcelona, Spain.
authors.forename: I
authors.initials: I
authors.lastname: Fernández-Cortiñas
authors.affiliation: Barcelona City Research Support Unit - IDIAP Jordi Gol, Universitat Autònoma de Barcelona, Barcelona, Spain.
authors.forename: C I
authors.initials: CI
authors.lastname: Jarca
authors.affiliation: Neurovascular Research Laboratory, Vall Hebron Research Institute, Universitat Autònoma de Barcelona, Barcelona, Spain.
authors.forename: J
authors.initials: J
authors.lastname: Jiménez-Balado
authors.affiliation: Barcelona City Research Support Unit - IDIAP Jordi Gol, Universitat Autònoma de Barcelona, Barcelona, Spain.
authors.forename: M
authors.initials: M
authors.lastname: Domingo
authors.affiliation: Nephrology Service, Vall Hebron University Hospital, Barcelona, Spain.
authors.forename: J L
authors.initials: JL
authors.lastname: Tovar
authors.affiliation: Barcelona City Research Support Unit - IDIAP Jordi Gol, Universitat Autònoma de Barcelona, Barcelona, Spain.
authors.forename: F
authors.initials: F
authors.lastname: Orfila
authors.affiliation: Dementia Unit, Neurology Department, Vall Hebron University Hospital, Universitat Autònoma de Barcelona, Barcelona, Spain.
authors.forename: F
authors.initials: F
authors.lastname: Pujadas
authors.affiliation: Stroke Unit, Neurology Department, Vall Hebron University Hospital, Universitat Autònoma de Barcelona, Barcelona, Spain.
authors.forename: J
authors.initials: J
authors.lastname: Álvarez-Sabín
authors.affiliation: Stroke Unit, Neurology Department, Vall Hebron University Hospital, Universitat Autònoma de Barcelona, Barcelona, Spain.
authors.forename: O
authors.initials: O
authors.lastname: Maisterra
authors.affiliation: Neurovascular Research Laboratory, Vall Hebron Research Institute, Universitat Autònoma de Barcelona, Barcelona, Spain.|Stroke Unit, Neurology Department, Vall Hebron University Hospital, Universitat Autònoma de Barcelona, Barcelona, Spain.
authors.forename: J
authors.initials: J
authors.lastname: Montaner
authors.affiliation: Neurovascular Research Laboratory, Vall Hebron Research Institute, Universitat Autònoma de Barcelona, Barcelona, Spain.
authors.forename: P
authors.initials: P
authors.lastname: Delgado
mesh_terms: D000368:Aged; D000375:Aging; D001479:Basal Ganglia / Q000000981:diagnostic imaging* / Q000473:pathology; D015415:Biomarkers; D059345:Cerebral Small Vessel Diseases / Q000150:complications / Q000000981:diagnostic imaging* / Q000473:pathology; D060825:Cognitive Dysfunction / Q000150:complications / Q000000981:diagnostic imaging* / Q000473:pathology; D005260:Female; D006801:Humans; D006973:Hypertension / Q000150:complications / Q000000981:diagnostic imaging* / Q000473:pathology; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D012307:Risk Factors
chemical_list: D015415:Biomarkers
keywords: cerebral small vessel disease; cognitive impairment; enlarged perivascular spaces; hypertension