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Perivascular space in Parkinson's disease: Association with CSF amyloid/tau and cognitive decline

Huimin Chen1, Huijuan Wan2, Meimei Zhang3

  • 1Department of Neurology, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, China; Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China; China National Clinical Research Center for Neurological Diseases (NCRC-ND), Beijing, China; Advanced Innovation Center for Human Brain Projection, Capital Medical University, Beijing, China.

Parkinsonism & Related Disorders
|January 20, 2022
PubMed
Abstract

Insights

Perivascular spaces (PVS) in the basal ganglia are linked to cognitive decline in Parkinson's disease (PD). This association may be influenced by toxic cerebrospinal fluid (CSF) proteins, suggesting a potential pathway for neurodegeneration.

Area of Science:

  • Neuroimaging
  • Neurodegenerative Diseases
  • Biomarkers

Background:

  • Perivascular spaces (PVS) visible on MRI are debated as indicators of glymphatic dysfunction and pathology in Parkinson's disease (PD).
  • Understanding the role of PVS in PD cognitive decline is crucial for identifying disease mechanisms.

Purpose of the Study:

  • To investigate the independent association between MRI-visible PVS and cognitive decline in PD patients.
  • To determine if pathological cerebrospinal fluid (CSF) proteins mediate the relationship between PVS and cognitive impairment in PD.

Main Methods:

  • Analysis of 341 PD patients from the Parkinson's Progression Marker Initiative (PPMI) cohort.
  • Semiquantitative assessment of basal ganglia PVS (BG-PVS) and centrum semiovale PVS.
  • Multivariable linear regression and mixed-effects models with path analysis to assess PVS, CSF biomarkers (Aβ42, tTau, pTau), and 3-year cognitive outcomes (MoCA scores).

Main Results:

  • BG-PVS showed a significant independent association with cognitive decline in PD patients over 3 years.
  • The interaction between BG-PVS and CSF Aβ42/tTau, Aβ42/pTau, and Aβ42 levels predicted cognitive decline.
  • Path analysis indicated that CSF Aβ42/tTau levels partially mediated the impact of BG-PVS on cognitive outcomes.

Conclusions:

  • Basal ganglia PVS are independently associated with cognitive decline in Parkinson's disease.
  • Toxic CSF proteins, particularly Aβ42/tTau, may partially explain the link between BG-PVS and cognitive impairment in PD.
Keywords:
AmyloidCognitionParkinson's diseasePerivascular spaceTau

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