Association of MRI-Visible Perivascular Spaces With Longitudinal Cognitive Decline Over a Decade

Area of Science:

• Neurology
• Radiology
• Gerontology

Background:

• Cerebral small vessel disease (SVD) is a primary cause of vascular dementia.
• Perivascular spaces (PVS) visualized by MRI are an emerging SVD marker.
• Previous research indicated PVS's cross-sectional association with cognitive decline.

Purpose of the Study:

• To investigate the role of PVS as a unique marker of longitudinal cognitive decline.
• To assess the independent contribution of PVS to cognitive changes over time.
• To characterize the clinical relevance of PVS in aging.

Main Methods:

• Longitudinal observational study (Vanderbilt Memory and Aging Project) with 750 participants.
• 3T MRI at baseline to quantify SVD markers including PVS volume fraction.
• Deep learning algorithm used for PVS segmentation.
• Serial neuropsychological testing over an 11-year follow-up.
• Linear mixed-effects models used for statistical analysis, adjusting for covariates.

Main Results:

• Higher basal ganglia PVS burden was associated with worse longitudinal performance in multiple cognitive domains.
• Independent associations were observed for executive function and visuospatial skills (Hooper Visual Organization Test).
• PVS remained a significant predictor even when compared head-to-head with other SVD markers.

Conclusions:

• Basal ganglia PVS burden independently predicts longitudinal decline in executive function and visuospatial skills.
• PVS emerges as a significant marker for domain-specific cognitive decline in aging.
• Findings support PVS's role in vascular contributions to cognitive impairment over time.