Joel Ramirez1, Courtney Berezuk1, Alicia A McNeely1, Christopher J M Scott1, Fuqiang Gao1, Sandra E Black2. 1. LC Campbell Cognitive Neurology Research Unit, Brain Sciences Research Program, Sunnybrook Research Institute, Toronto, Canada Heart & Stroke Foundation Canadian Partnership for Stroke Recovery, Sunnybrook Health Sciences Centre, Toronto, Canada. 2. LC Campbell Cognitive Neurology Research Unit, Brain Sciences Research Program, Sunnybrook Research Institute, Toronto, Canada Heart & Stroke Foundation Canadian Partnership for Stroke Recovery, Sunnybrook Health Sciences Centre, Toronto, Canada Institute of Medical Science, University of Toronto, Toronto, Canada Department of Medicine, Neurology, Sunnybrook Health Sciences Centre, Toronto, Canada.
Abstract
BACKGROUND: Visible Virchow-Robin spaces (VRS) are commonly used markers for small vessel disease in aging and dementia. OBJECTIVE: However, as previous reports were based on subjective visual ratings, the goal of this project was to validate and apply an MRI-based quantitative measure of VRS as a potential neuroimaging biomarker. METHODS: A modified version of Lesion Explorer was applied to MRIs from Alzheimer's disease patients (AD: n = 203) and normal elderly controls (NC: n = 94). Inter-rater reliability, technique validity, group/gender differences, and correlations with other small vessel disease markers were examined (lacunes and white matter hyperintensities, WMH). RESULTS: Inter-rater reliability and spatial congruence was excellent (ICC = 0.99, SI = 0.96), and VRS volumes were highly correlated with established rating scales (CS: ρ = 0.84, p < 0.001; BG: ρ = 0.75, p < 0.001). Compared to NC, AD had significantly greater volumes of WMH (p < 0.01), lacunes (p < 0.001), and VRS in the white matter (p < 0.01), but not in the basal ganglia (n.s.). Compared to women, demented and non-demented men had greater VRS in the white matter (p < 0.001), but not in the basal ganglia (n.s.). Additionally, VRS were correlated with lacunes and WMH, but only in AD (r = 0.3, p < 0.01). CONCLUSION: Compared to women, men may be more susceptible to greater volumes of VRS, particularly in the white matter. RESULTS support the hypothesis that VRS in the white matter may be more related to AD-related vascular pathology compared to VRS found in the basal ganglia. Future work using this novel VRS segmentation tool will examine its potential utility as an imaging biomarker of vascular rather than parenchymal amyloid.
BACKGROUND: Visible Virchow-Robin spaces (VRS) are commonly used markers for small vessel disease in aging and dementia. OBJECTIVE: However, as previous reports were based on subjective visual ratings, the goal of this project was to validate and apply an MRI-based quantitative measure of VRS as a potential neuroimaging biomarker. METHODS: A modified version of Lesion Explorer was applied to MRIs from Alzheimer's diseasepatients (AD: n = 203) and normal elderly controls (NC: n = 94). Inter-rater reliability, technique validity, group/gender differences, and correlations with other small vessel disease markers were examined (lacunes and white matter hyperintensities, WMH). RESULTS: Inter-rater reliability and spatial congruence was excellent (ICC = 0.99, SI = 0.96), and VRS volumes were highly correlated with established rating scales (CS: ρ = 0.84, p < 0.001; BG: ρ = 0.75, p < 0.001). Compared to NC, AD had significantly greater volumes of WMH (p < 0.01), lacunes (p < 0.001), and VRS in the white matter (p < 0.01), but not in the basal ganglia (n.s.). Compared to women, demented and non-demented men had greater VRS in the white matter (p < 0.001), but not in the basal ganglia (n.s.). Additionally, VRS were correlated with lacunes and WMH, but only in AD (r = 0.3, p < 0.01). CONCLUSION: Compared to women, men may be more susceptible to greater volumes of VRS, particularly in the white matter. RESULTS support the hypothesis that VRS in the white matter may be more related to AD-related vascular pathology compared to VRS found in the basal ganglia. Future work using this novel VRS segmentation tool will examine its potential utility as an imaging biomarker of vascular rather than parenchymal amyloid.
Entities:
Keywords:
Alzheimer's disease; Virchow-Robin; lacunes; perivascular spaces; small vessel disease; white matter hyperintensities
Authors: Jie Ding; Sigurður Sigurðsson; Pálmi V Jónsson; Gudny Eiriksdottir; Andreas Charidimou; Oscar L Lopez; Mark A van Buchem; Vilmundur Guðnason; Lenore J Launer Journal: JAMA Neurol Date: 2017-09-01 Impact factor: 18.302
Authors: Ryan A Opel; Alison Christy; Erin L Boespflug; Kristianna B Weymann; Brendan Case; Jeffery M Pollock; Lisa C Silbert; Miranda M Lim Journal: J Cereb Blood Flow Metab Date: 2018-08-10 Impact factor: 6.200
Authors: Adam M Staffaroni; Fanny M Elahi; Dana McDermott; Kacey Marton; Elissaios Karageorgiou; Simone Sacco; Matteo Paoletti; Eduardo Caverzasi; Christopher P Hess; Howard J Rosen; Michael D Geschwind Journal: Semin Neurol Date: 2017-12-05 Impact factor: 3.420
Authors: J Piantino; E L Boespflug; D L Schwartz; M Luther; A M Morales; A Lin; R V Fossen; L Silbert; B J Nagel Journal: AJNR Am J Neuroradiol Date: 2020-10-08 Impact factor: 3.825
Authors: Rosalind Brown; Helene Benveniste; Sandra E Black; Serge Charpak; Martin Dichgans; Anne Joutel; Maiken Nedergaard; Kenneth J Smith; Berislav V Zlokovic; Joanna M Wardlaw Journal: Cardiovasc Res Date: 2018-09-01 Impact factor: 10.787
Authors: Erin L Boespflug; Daniel L Schwartz; David Lahna; Jeffrey Pollock; Jeffrey J Iliff; Jeffrey A Kaye; William Rooney; Lisa C Silbert Journal: Radiology Date: 2017-08-29 Impact factor: 11.105