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Change in Enlarged Perivascular Spaces over Time and Associations with Outcomes After Traumatic Brain Injury

Alexa E Walter1, Krupa Savalia2, Jason Yoon3

  • 1Department of Neurology, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA.

Neurotrauma Reports
|August 15, 2024
PubMed

Insights

Enlarged perivascular spaces (EPVs) after traumatic brain injury (TBI) did not change significantly over six months. Higher EPV counts at two weeks correlated with poorer functional recovery in TBI patients.

Area of Science:

  • Neurology
  • Radiology
  • Neuroimaging

Background:

  • Enlarged perivascular spaces (EPVs) are observable on MRI in neurological conditions, including traumatic brain injury (TBI).
  • While EPVs are linked to cognitive and sleep issues, their clinical importance post-TBI is not fully understood.
  • Understanding EPV dynamics and their association with outcomes is crucial for TBI management.

Purpose of the Study:

  • To quantify the burden of EPVs over time using MRI following TBI.
  • To investigate the relationship between EPV burden and post-TBI outcomes, including functional recovery and sleep disturbances.
  • To explore EPVs as potential imaging biomarkers in TBI.

Main Methods:

  • Thirty-two TBI participants underwent MRI and blood collection at 2 weeks and 6 months post-injury.
  • EPV burden was assessed on T1 and FLAIR MRI sequences.
  • Serum neurofilament light (NfL) and glial fibrillary acidic protein (GFAP) levels were measured; sleep and functional outcomes were evaluated.

Main Results:

  • The total count of EPVs remained stable between 2 weeks and 6 months post-TBI.
  • No significant association was found between EPV count and self-reported insomnia or sleep quality.
  • A higher number of EPVs at 2 weeks post-TBI was significantly associated with incomplete functional recovery at 6 months.

Conclusions:

  • EPV burden shows minimal change in the six months following TBI, suggesting they may represent stable structural findings.
  • EPV count at two weeks post-TBI may serve as an early indicator of long-term functional recovery.
  • Further research is needed to clarify the role of EPVs in TBI pathophysiology and their potential as prognostic imaging biomarkers.
Keywords:
enlarged perivascular spacesmagnetic resonance imagingperivascular spacestraumatic brain injury

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