Enlarged Perivascular Spaces in Patients with Lacunar Infarctions

Area of Science:

• Neurology
• Radiology
• Cerebrovascular Disease

Background:

• Lacunar infarction (LI) and enlarged perivascular spaces (EPVS) are key MRI findings in cerebral small vessel disease.
• The underlying causes of LI and EPVS share similarities, prompting investigation into their relationship.

Purpose of the Study:

• To examine the association between lacunar infarction (LI) and enlarged perivascular spaces (EPVS).

Main Methods:

• Investigated 210 controls and 67 LI patients using multivariate analyses.
• Assessed EPVS severity in centrum semiovale (CSO) and basal ganglia (BG), white matter lesions (WML), and cerebral microbleeds (CMBs).

Main Results:

• LI was significantly associated with age >73, diabetes mellitus (DM), deep/mixed CMBs, and BG-EPVS ≥ grade 2.
• BG-EPVS ≥ grade 2 was associated with age ≥73, hypertension, DM, symptomatic LIs, and CSO-EPVS ≥ grade 3.
• WML showed no association with LI, BG-EPVS, or CSO-EPVS.

Conclusions:

• A strong association exists between LI and BG-EPVS, but not CSO-EPVS.
• BG-EPVS was linked to CSO-EPVS, indicating varied interrelationships among cerebral small vessel disease markers.
• While risk factors overlap, MRI findings like LI and EPVS are not always directly associated.