MRI Visible Perivascular Spaces and the Risk of Incident Mild Cognitive Impairment in a Community Sample
Matthew P Pase1,2,3, Adlin Pinheiro3,4, Ella Rowsthorn1
1Turner Institute for Brain and Mental Health, Monash University, Clayton, Australia.
Background:
Magnetic resonance imaging (MRI) visible perivascular spaces (PVS) are associated with the risk of incident dementia but their association with the early stages of cognitive impairment remains equivocal.
Objective:
We examined the association between MRI visible PVS and the risk of incident mild cognitive impairment (MCI) in the community-based Framingham Heart Study (FHS).
Methods:
FHS participants aged at least 50 years free of stroke, cognitive impairment, and dementia at the time of MRI were included. PVS were rated according to severity in the basal ganglia and centrum semiovale (CSO) using established criteria. Cox regression analyses were used to relate PVS to incident MCI adjusted for demographic and cardiovascular variables.
Results:
The mean age of the sample (1,314 participants) at MRI was 68 years (SD, 9; 54% women). There were 263 cases of incident MCI over a median 7.4 years follow-up (max, 19.8 years). MCI risk increased with higher PVS severity in the CSO. Relative to persons with the lowest severity rating, persons with the highest severity rating in the CSO had a higher risk of incident MCI (hazard ratio [HR] = 2.55; 95% confidence interval [CI], 1.48-4.37; p = 0.0007). In secondary analysis, this association seemed stronger in women. Risk of incident MCI was nominally higher for participants with the highest severity grade of PVS in the basal ganglia, though not statistically significant relative to the lowest grade (HR = 2.19; 95% CI, 0.78-6.14; p = 0.14).
Conclusions:
PVS burden in the CSO may be a risk marker for early cognitive impairment.
Insights
Increased perivascular spaces (PVS) in the centrum semiovale (CSO) are linked to a higher risk of developing mild cognitive impairment (MCI). This finding suggests PVS severity may indicate early-stage cognitive decline.
Area of Science:
- Neurology
- Radiology
- Gerontology
Background:
- Perivascular spaces (PVS) visible on MRI are associated with dementia risk.
- The link between PVS and early cognitive impairment, such as mild cognitive impairment (MCI), is not well-established.
Purpose of the Study:
- To investigate the association between MRI-visible PVS and the risk of incident MCI.
- To analyze PVS severity in specific brain regions (basal ganglia and centrum semiovale) in relation to MCI risk.
Main Methods:
- Utilized data from the community-based Framingham Heart Study (FHS).
- Included participants aged 50+ years, free of stroke, cognitive impairment, and dementia at baseline.
- Assessed PVS severity using established criteria in the basal ganglia and centrum semiovale (CSO).
- Employed Cox regression analyses, adjusting for demographic and cardiovascular factors.
Main Results:
- A total of 1,314 participants were analyzed, with 263 incident MCI cases over a median follow-up of 7.4 years.
- Higher PVS severity in the CSO was significantly associated with an increased risk of incident MCI (HR=2.55).
- The association between PVS severity in the CSO and MCI risk appeared stronger in women.
- A nominal, but not statistically significant, association was observed between PVS severity in the basal ganglia and MCI risk.
Conclusions:
- Perivascular space burden in the centrum semiovale (CSO) may serve as a risk marker for early cognitive impairment.
- Further research is warranted to explore the sex-specific differences in this association.
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