S C Kolbe1,2, L M Garcia3, N Yu3,4, F M Boonstra3, M Clough3, B Sinclair3, O White3,5, A van der Walt3,5, H Butzkueven3,5, J Fielding3, M Law3,2. 1. From the Department of Neuroscience (S.C.K., L.M.G., N.Y., F.M.B., M.C., B.S., O.W., A.v.d.W., H.B., J.F., M.L.) Monash University, Melbourne, Victoria, Australia scott.kolbe@monash.edu. 2. Departments of Radiology (S.C.K., M.L.). 3. From the Department of Neuroscience (S.C.K., L.M.G., N.Y., F.M.B., M.C., B.S., O.W., A.v.d.W., H.B., J.F., M.L.) Monash University, Melbourne, Victoria, Australia. 4. Department of Neurology (N.Y.), The Nanjing Brain Hospital Affiliated with Nanjing Medical University, Nanjing, Jiangsu, China. 5. Neurology (O.W., A.v.d.W., H.B.), Alfred Hospital, Melbourne, Victoria, Australia.
Abstract
BACKGROUND AND PURPOSE: Perivascular spaces surround the blood vessels of the brain and are involved in neuroimmune functions and clearance of metabolites via the glymphatic system of the brain. Enlarged perivascular spaces could be a marker of dysfunction in these processes and, therefore, are highly relevant to monitoring disease activity in MS. This study aimed to compare the number of enlarged perivascular spaces in people with relapsing MS with MR imaging markers of inflammation and brain atrophy. MATERIALS AND METHODS: Fifty-nine patients (18 with clinically isolated syndrome, 22 with early and 19 with late relapsing-remitting MS) were scanned longitudinally (mean follow-up duration = 19.6 [SD, 0.5] months) using T2-weighted, T1-weighted, and FLAIR MR imaging. Two expert raters identified and counted enlarged perivascular spaces on T2-weighted MR images from 3 ROIs (the centrum semiovale, basal ganglia, and midbrain). Baseline and change with time in the number of enlarged perivascular spaces were correlated with demographics and lesion and brain volumes. RESULTS: Late relapsing-remitting MS had a greater average number of enlarged perivascular spaces at baseline at the level of the basal ganglia (72.3) compared with early relapsing-remitting MS (60.5) and clinically isolated syndrome (54.7) (F = 3.4, P = .042), and this finding correlated with lesion volume (R = 0.44, P = .0004) but not brain atrophy (R = -0.16). Enlarged perivascular spaces increased in number with time in all regions, and the rate of increase did not differ among clinical groups. CONCLUSIONS: Enlarged perivascular spaces at the level of the basal ganglia are associated with greater neuroinflammatory burden, and the rate of enlargement appears constant in patients with relapsing-remitting disease phenotypes.
BACKGROUND AND PURPOSE: Perivascular spaces surround the blood vessels of the brain and are involved in neuroimmune functions and clearance of metabolites via the glymphatic system of the brain. Enlarged perivascular spaces could be a marker of dysfunction in these processes and, therefore, are highly relevant to monitoring disease activity in MS. This study aimed to compare the number of enlarged perivascular spaces in people with relapsing MS with MR imaging markers of inflammation and brain atrophy. MATERIALS AND METHODS: Fifty-nine patients (18 with clinically isolated syndrome, 22 with early and 19 with late relapsing-remitting MS) were scanned longitudinally (mean follow-up duration = 19.6 [SD, 0.5] months) using T2-weighted, T1-weighted, and FLAIR MR imaging. Two expert raters identified and counted enlarged perivascular spaces on T2-weighted MR images from 3 ROIs (the centrum semiovale, basal ganglia, and midbrain). Baseline and change with time in the number of enlarged perivascular spaces were correlated with demographics and lesion and brain volumes. RESULTS: Late relapsing-remitting MS had a greater average number of enlarged perivascular spaces at baseline at the level of the basal ganglia (72.3) compared with early relapsing-remitting MS (60.5) and clinically isolated syndrome (54.7) (F = 3.4, P = .042), and this finding correlated with lesion volume (R = 0.44, P = .0004) but not brain atrophy (R = -0.16). Enlarged perivascular spaces increased in number with time in all regions, and the rate of increase did not differ among clinical groups. CONCLUSIONS: Enlarged perivascular spaces at the level of the basal ganglia are associated with greater neuroinflammatory burden, and the rate of enlargement appears constant in patients with relapsing-remitting disease phenotypes.
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Authors: Hieab H H Adams; Saima Hilal; Petra Schwingenschuh; Katharina Wittfeld; Sven J van der Lee; Charles DeCarli; Meike W Vernooij; Petra Katschnig-Winter; Mohamad Habes; Christopher Chen; Sudha Seshadri; Cornelia M van Duijn; M Kamran Ikram; Hans J Grabe; Reinhold Schmidt; M Arfan Ikram Journal: Alzheimers Dement (Amst) Date: 2015-10-31
Authors: Alice Favaretto; Andrea Lazzarotto; Alice Riccardi; Stefano Pravato; Monica Margoni; Francesco Causin; Maria Giulia Anglani; Dario Seppi; Davide Poggiali; Paolo Gallo Journal: PLoS One Date: 2017-10-18 Impact factor: 3.240