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Assessing Cortical Cerebral Microinfarcts on High Resolution MR Images
Published on: November 20, 2015
High dilated perivascular space burden: a new MRI marker for risk of intracerebral hemorrhage
Marie-Gabrielle Duperron1, Christophe Tzourio2, Sabrina Schilling1
1Univ. Bordeaux, Inserm U1219, Bordeaux Population Health Research Center, Bordeaux, France.
Abstract:
Commonly observed in older community persons, dilated perivascular spaces (dPVSs) are thought to represent an emerging MRI marker of cerebral small vessel disease, but their clinical significance is uncertain. We examined the longitudinal relationship of dPVS burden with risk of incident stroke, ischemic stroke, and intracerebral hemorrhage (ICH) in the 3C-Dijon population-based study (N = 1678 participants, mean age 72.7 ± 4.1 years) using Cox regression. dPVS burden was studied as a global score and according to dPVS location (basal ganglia, white matter, hippocampus, brainstem) at the baseline. During a mean follow-up of 9.1 ± 2.6 years, 66 participants suffered an incident stroke. Increasing global dPVS burden was associated with a higher risk of any incident stroke (hazard ratio [HR], 1.24; 95% CI, [1.06-1.45]) and of incident ICH (HR, 3.12 [1.78-5.47]), adjusting for sex and intracranial volume. Association with ICH remained significant after additionally adjusting for vascular risk factors and for other cerebral small vessel disease MRI markers. High dPVS burden in basal ganglia and hippocampus, but not in white matter or brainstem, were associated with higher risk of any stroke and ICH.
Insights
Increased dilated perivascular spaces (dPVSs), a marker of small vessel disease, are linked to a higher risk of stroke, particularly intracerebral hemorrhage (ICH). This association was strongest for dPVSs in the basal ganglia and hippocampus.
Area of Science:
- Neurology
- Radiology
- Epidemiology
Background:
- Dilated perivascular spaces (dPVSs) are common in older adults and considered a potential MRI marker for cerebral small vessel disease.
- The clinical significance and prognostic value of dPVS burden, especially concerning stroke risk, remain uncertain.
Purpose of the Study:
- To investigate the longitudinal association between dPVS burden and the risk of incident stroke, ischemic stroke, and intracerebral hemorrhage (ICH).
- To explore the impact of dPVS location on stroke risk.
Main Methods:
- Utilized data from the 3C-Dijon population-based study (N=1678, mean age 72.7 years).
- Employed Cox regression analysis to assess the relationship between global and location-specific dPVS burden (basal ganglia, white matter, hippocampus, brainstem) and incident stroke over a mean follow-up of 9.1 years.
- Adjusted for covariates including sex, intracranial volume, vascular risk factors, and other cerebral small vessel disease MRI markers.
Main Results:
- A total of 66 incident strokes occurred during follow-up.
- Increasing global dPVS burden was significantly associated with a higher risk of any incident stroke (HR 1.24) and incident ICH (HR 3.12).
- High dPVS burden in the basal ganglia and hippocampus, but not white matter or brainstem, correlated with increased risk of stroke and ICH.
Conclusions:
- Global dPVS burden is an independent predictor of incident stroke and ICH in older adults.
- Specific locations of dPVSs, namely basal ganglia and hippocampus, are particularly associated with elevated stroke and ICH risk.
- dPVSs represent a valuable MRI marker for assessing cerebrovascular disease risk.
