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Published on: February 19, 2021
Circulating inflammatory markers are associated with magnetic resonance imaging-visible perivascular spaces but not
Benjamin S Aribisala1, Stewart Wiseman, Zoe Morris
1From Brain Research Imaging Centre (B.S.A., S.W., Z.M., M.C.V.-H., N.A.R., S.M.M., M.E.B., J.M.W.), Centre for Cognitive Ageing and Cognitive Epidemiology (B.S.A., M.C.V.-H., N.A.R., S.M.M., A.J.G., M.E.B., J.S., I.J.D., J.M.W.), Department of Psychology (J.C., I.J.D.), and Geriatric Medicine Unit (J.S.), University of Edinburgh, Edinburgh, United Kingdom; Scottish Imaging Network: A Platform for Scientific Excellence (SINAPSE), Edinburgh, United Kingdom (B.S.A., M.C.V.-H., N.A.R., S.M.M., M.E.B., J.M.W.); Department of Computer Science, Lagos State University, Nigeria (B.S.A.); and Department of Psychology, Heriot-Watt University, United Kingdom (A.J.G.).
Background And Purpose:
White matter hyperintensities (WMH) and perivascular spaces (PVS) are features of small vessel disease, found jointly on MRI of older people. Inflammation is a prominent pathological feature of small vessel disease. We examined the association between inflammation, PVS, and WMH in the Lothian Birth Cohort 1936 (N=634).
Methods:
We measured plasma fibrinogen, C-reactive protein, and interleukin-6 and rated PVS in 3 brain regions. We measured WMH volumetrically and visually using the Fazekas scale. We derived latent variables for PVS, WMH, and Inflammation from measured PVS, WMH, and inflammation markers and modelled associations using structural equation modelling.
Results:
After accounting for age, sex, stroke, and vascular risk factors, PVS were significantly associated with WMH (β=0.47; P<0.0001); Inflammation was weakly but significantly associated with PVS (β=0.12; P=0.048), but not with WMH (β=0.02; P=NS).
Conclusions:
Circulating inflammatory markers are weakly associated with MR-visible PVS, but not directly with WMH. Longitudinal studies should examine whether visible PVS predate WMH progression and whether inflammation modulators can prevent small vessel disease.
Insights
Inflammation is weakly linked to perivascular spaces (PVS) but not directly to white matter hyperintensities (WMH) in older adults. Further research is needed to explore PVS progression and inflammation
Area of Science:
- Neurology
- Vascular Biology
- Inflammation Research
Background:
- White matter hyperintensities (WMH) and perivascular spaces (PVS) are MRI-visible markers of small vessel disease.
- Inflammation is a key pathological feature implicated in small vessel disease progression.
Purpose of the Study:
- To investigate the relationship between inflammation, PVS, and WMH.
- To analyze these associations in the Lothian Birth Cohort 1936.
Main Methods:
- Measured plasma inflammatory markers (fibrinogen, C-reactive protein, interleukin-6).
- Assessed PVS in three brain regions and WMH volumetrically and visually (Fazekas scale).
- Employed structural equation modeling with latent variables for inflammation, PVS, and WMH.
Main Results:
- Perivascular spaces (PVS) showed a significant association with white matter hyperintensities (WMH) (β=0.47; P<0.0001).
- Inflammation was weakly but significantly associated with PVS (β=0.12; P=0.048).
- No significant direct association was found between inflammation and WMH (β=0.02; P=NS).
Conclusions:
- Circulating inflammatory markers are weakly associated with MR-visible PVS, but not directly with WMH.
- Longitudinal studies are warranted to determine if PVS precede WMH progression.
- Investigating inflammation modulators could offer strategies for preventing small vessel disease.
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