title: Dilated perivascular spaces and fatigue: is there a link? Magnetic resonance retrospective 3Tesla study.
abstract: BACKGROUND
  Fatigue (F) is a common, inexplicable, and disabling symptom in multiple sclerosis (MS) patients. The purpose of this study was to evaluate a possible correlation between fatigue and morpho-volumetric features and site of dilated perivascular spaces (dPS), visible on 3T magnetic resonance (MR) in fatigued multiple sclerosis patients (FMS).
  
  
  METHODS
  We studied 82 relapsing remitting (RR) FMS patients and 43 HC, matched for age, sex, and education. F was assessed by the Fatigue Severity Scale (FSS). To evaluate a possible correlation between degree of F and characteristics of dPS, patients were divided in two groups: more (mFMS) (FSS ≥ 5; n = 30) and less fatigued (lFMS) (FSS ≥ 4; n = 52), compared to a matched healthy control (HC) subject group. The MR study was performed with 3T scanner by SpinEcho T1, Fast-SpinEcho DP-T2, FLAIR, and 3D FSPGR T1 sequences. dPS volumes were measured with Medical Image Processing Analysis and Visualization (MIPAV); Global Cerebral Atrophy (GCA), expressed as Brain Parenchymal Fraction (BPF), was assessed by FSL SIENAX.
  
  
  RESULTS
  The t test showed significantly increased dPS number (p = 0.021) in FMS patients (mFMS p = 0.0024 and lFMS p = 0.033) compared to HC. Pearson correlation revealed a significant correlation between dPS number and FSS (r = 0.208 p = 0.051). Furthermore, the chi-squared test confirms the intragroup (HC, mFMS, lFMS) differences about dPS location (p = 0.01) and size (p = 0.0001).
  
  
  CONCLUSIONS
  Our study confirms that PS in MS patients presents with different volumetric and site characteristics as compared to HC; moreover, F severity significantly correlates with dPS number, site, and size.
authors.affiliation: Neuroradiology Service, Department of Radiology, Second University of Naples, C/o CTO Viale dei Colli Aminei 21, Naples, Italy.
authors.forename: Renata
authors.initials: R
authors.lastname: Conforti
authors.affiliation: Neuroradiology Service, Department of Radiology, Second University of Naples, C/o CTO Viale dei Colli Aminei 21, Naples, Italy.
authors.forename: Mario
authors.initials: M
authors.lastname: Cirillo
authors.affiliation: Neuroradiology Service, Department of Radiology, Second University of Naples, C/o CTO Viale dei Colli Aminei 21, Naples, Italy. sardaroangela@libero.it.
authors.forename: Angela
authors.initials: A
authors.lastname: Sardaro
authors.affiliation: MRI Research Center SUN-FISM, Second University of Naples, Naples, Italy.
authors.forename: Giuseppina
authors.initials: G
authors.lastname: Caiazzo
authors.affiliation: Neuroradiology Service, Department of Radiology, Second University of Naples, C/o CTO Viale dei Colli Aminei 21, Naples, Italy.
authors.forename: Alberto
authors.initials: A
authors.lastname: Negro
authors.affiliation: MRI Research Center SUN-FISM, Second University of Naples, Naples, Italy.
authors.forename: Antonella
authors.initials: A
authors.lastname: Paccone
authors.affiliation: Department of Neurology, Second University of Naples, Naples, Italy.
authors.forename: Rosaria
authors.initials: R
authors.lastname: Sacco
authors.affiliation: Department of Neurology, Second University of Naples, Naples, Italy.
authors.forename: Maddalena
authors.initials: M
authors.lastname: Sparaco
authors.affiliation: Department of Neurology, Second University of Naples, Naples, Italy.
authors.forename: Antonio
authors.initials: A
authors.lastname: Gallo
authors.affiliation: Department of Neurology, Second University of Naples, Naples, Italy.
authors.forename: Luigi
authors.initials: L
authors.lastname: Lavorgna
authors.affiliation: Department of Neurology, Second University of Naples, Naples, Italy.
authors.forename: Gioacchino
authors.initials: G
authors.lastname: Tedeschi
authors.affiliation: Neuroradiology Service, Department of Radiology, Second University of Naples, C/o CTO Viale dei Colli Aminei 21, Naples, Italy.
authors.forename: Sossio
authors.initials: S
authors.lastname: Cirillo
mesh_terms: D000328:Adult; D001927:Brain Diseases / Q000175:diagnosis / Q000453:epidemiology* / Q000473:pathology*; D015984:Causality; D015897:Comorbidity; D004108:Dilatation, Pathologic / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000473:pathology; D004311:Double-Blind Method; D005221:Fatigue / Q000175:diagnosis / Q000453:epidemiology*; D005260:Female; D006801:Humans; D007558:Italy / Q000453:epidemiology; D008279:Magnetic Resonance Imaging / Q000379:methods* / Q000706:statistics & numerical data; D008297:Male; D009103:Multiple Sclerosis / Q000000981:diagnostic imaging / Q000453:epidemiology* / Q000473:pathology*; D010841:Pia Mater / Q000000981:diagnostic imaging / Q000473:pathology*; D015995:Prevalence; D015203:Reproducibility of Results; D012307:Risk Factors; D012680:Sensitivity and Specificity; D013223:Statistics as Topic
keywords: Dilated Virchow-Robin spaces (dVRS); Dilated perivascular spaces (dPS); Fatigue (F); Multiple sclerosis (MS)