Young Min Choe1, Hyewon Baek1, Hyo Jung Choi1, Min Soo Byun1, Dahyun Yi1, Bo Kyung Sohn1, Chul-Ho Sohn1, Dong Young Lee2. 1. From the Department of Neuropsychiatry (Y.M.C.), Hallym University Dongtan Sacred Heart Hospital, Hwaseong; Department of Neuropsychiatry (H.B.), Gyeonggi Provincial Hospital for the Elderly, Yongin; Department of Neuropsychiatry (H.J.C., M.S.B., D.Y.L.), Seoul National University Hospital; Department of Psychiatry (M.S.B., D.Y.L.), Seoul National University College of Medicine; Institute of Human Behavioral Medicine (D.Y., D.Y.L.), Seoul National University Medical Research Center; Department of Psychiatry (B.K.S.), Inje University Sanggye Paik Hospital, Seoul; and Department of Radiology (C.H.S.), Seoul National University Hospital, South Korea. 2. From the Department of Neuropsychiatry (Y.M.C.), Hallym University Dongtan Sacred Heart Hospital, Hwaseong; Department of Neuropsychiatry (H.B.), Gyeonggi Provincial Hospital for the Elderly, Yongin; Department of Neuropsychiatry (H.J.C., M.S.B., D.Y.L.), Seoul National University Hospital; Department of Psychiatry (M.S.B., D.Y.L.), Seoul National University College of Medicine; Institute of Human Behavioral Medicine (D.Y., D.Y.L.), Seoul National University Medical Research Center; Department of Psychiatry (B.K.S.), Inje University Sanggye Paik Hospital, Seoul; and Department of Radiology (C.H.S.), Seoul National University Hospital, South Korea. selfpsy@snu.ac.kr.
Abstract
BACKGROUND AND OBJECTIVES: Although enlarged perivascular spaces (EPVS) have been suggested as an emerging measure of small vessel disease (SVD) in the brain, their association with cognitive impairment is not yet clearly understood. We aimed to examine the relationship between each EPVS in the basal ganglia (BG-EPVS) and centrum semiovale (CSO-EPVS) with cognition in a memory clinic population. METHODS: Participants with a diverse cognitive spectrum were recruited from a university hospital memory clinic. They underwent comprehensive clinical and neuropsychological assessments and brain MRI. BG-EPVS and CSO-EPVS were measured on T2-weighted MRI and then dichotomized into low and high degrees for further analyses. Other SVD markers were assessed using validated rating scales. RESULTS: A total of 910 participants were included in this study. A high degree of BG-EPVS was significantly associated with poorer scores on the executive function domain, but not with other cognitive domains, when age, sex, education, MRI scanner type, and cognitive diagnosis were controlled as covariates. However, the association between BG-EPVS and executive function was no longer significant after controlling for other markers of SVD, such as lacunar infarcts and periventricular white matter hyperintensities, as additional covariates. CSO-EPVS did not have a significant relationship with any cognitive scores, regardless of the covariates. DISCUSSION: Our findings from a large memory clinic population suggest that EPVS, regardless of the topographical location, may not be used as a specific SVD marker for cognitive impairment, although an apparent association was observed between a high degree of BG-EPVS and executive dysfunction before controlling other SVD markers that share a common pathophysiologic process with BG-EPVS.
BACKGROUND AND OBJECTIVES: Although enlarged perivascular spaces (EPVS) have been suggested as an emerging measure of small vessel disease (SVD) in the brain, their association with cognitive impairment is not yet clearly understood. We aimed to examine the relationship between each EPVS in the basal ganglia (BG-EPVS) and centrum semiovale (CSO-EPVS) with cognition in a memory clinic population. METHODS: Participants with a diverse cognitive spectrum were recruited from a university hospital memory clinic. They underwent comprehensive clinical and neuropsychological assessments and brain MRI. BG-EPVS and CSO-EPVS were measured on T2-weighted MRI and then dichotomized into low and high degrees for further analyses. Other SVD markers were assessed using validated rating scales. RESULTS: A total of 910 participants were included in this study. A high degree of BG-EPVS was significantly associated with poorer scores on the executive function domain, but not with other cognitive domains, when age, sex, education, MRI scanner type, and cognitive diagnosis were controlled as covariates. However, the association between BG-EPVS and executive function was no longer significant after controlling for other markers of SVD, such as lacunar infarcts and periventricular white matter hyperintensities, as additional covariates. CSO-EPVS did not have a significant relationship with any cognitive scores, regardless of the covariates. DISCUSSION: Our findings from a large memory clinic population suggest that EPVS, regardless of the topographical location, may not be used as a specific SVD marker for cognitive impairment, although an apparent association was observed between a high degree of BG-EPVS and executive dysfunction before controlling other SVD markers that share a common pathophysiologic process with BG-EPVS.
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