Associations Between Vascular Risk Factors and Perivascular Spaces in Adults with Intact Cognition, Mild Cognitive Impairment, and Dementia

Article type: Research Article

Authors: Rundek, Tatjana^{a; b} | Del Brutto, Victor J.^b | Goryawala, Mohammed^{a; c} | Dong, Chuanhui^{a; b} | Agudelo, Christian^{a; b; *} | Saporta, Anita Seixas^{a; b} | Merritt, Stacy^{a; b} | Camargo, Christian^{a; b} | Ariko, Taylor^a | Loewenstein, David A.^{a; d; e} | Duara, Ranjan^f | Haq, Ihtsham^{a; b}

Affiliations: [a] The Evelyn F. McKnight Brain Institute, University of Miami Miller School of Medicine, Miami, FL, USA | [b] Department of Neurology, University of Miami Miller School of Medicine, Miami, FL, USA | [c] Department of Radiology, University of Miami Miller School of Medicine, Miami, FL, USA | [d] The Center for Neurocognitive Sciences and Aging, University of Miami Miller School of Medicine, Miami, FL, USA | [e] Department of Psychiatry, University of Miami Miller School of Medicine, Miami, FL, USA | [f] Wien Center for Alzheimer’s Disease and Memory Disorders, Mount Sinai Medical Center, Miami Beach, FL, USA

Correspondence: [*] Correspondence to: Christian Agudelo, MD, Evelyn F. McKnight Brain Institute, University of Miller School of Medicine, Department of Neurology, Clinical Research Building, 1120 NW 14th Street, Miami, FL 33136, USA. Tel.: +1 305 243 1664; E-mail: [email protected].

Abstract: Background:Perivascular spaces (PVS) are fluid-filled compartments surrounding small intracerebral vessels that transport fluid and clear waste. Objective:We examined associations between PVS count, vascular and neurodegenerative risk factors, and cognitive status among the predominantly Hispanic participants of the FL-VIP Study of Alzheimer’s Disease Risk. Methods:Using brain MRI (n = 228), we counted PVS in single axial image through the basal ganglia (BG) and centrum semiovale (CSO). PVS per region were scored as 0 (none), 1 (<10), 2 (11–20), 3 (21–40), and 4 (>40). Generalized linear models examined PVS associations with vascular risk factors and a composite vascular comorbidity risk (VASCom) score. Results:Our sample (mean age 72±8 years, 61% women, 60% Hispanic, mean education 15±4 years, 33% APOE4 carriers) was 59% hypertensive, 21% diabetic, 66% hypercholesteremic, and 30% obese. Mean VASCom score was 2.3±1.6. PVS scores ranged from 0–4 in the BG (mean 1.3±0.7) and CSO (mean 1.2±0.9), and 0–7 combined (mean 2.5±1.4). In multivariable regression models, BG PVS was associated with age (β= 0.03/year, p < 0.0001), Hispanic ethnicity (β= 0.29, p = 0.01), education (β= 0.04/year, p = 0.04), and coronary bypass surgery (β= 0.93, p = 0.02). CSO PVS only associated with age (β= 0.03/year, p < 0.01). APOE4 and amyloid-β were not associated with PVS. Conclusion:BG PVS may be a marker of subclinical cerebrovascular disease. Further research is needed to validate associations and identify mechanisms linking BG PVS and cerebrovascular disease markers. PVS may be a marker of neurodegeneration despite our negative preliminary findings and more research is warranted. The association between BG PVS and Hispanic ethnicity also requires further investigation.

Keywords: Basal ganglia, brain MRI, centrum semiovale, perivascular spaces, vascular risk factors

DOI: 10.3233/JAD-215585

Journal: Journal of Alzheimer's Disease, vol. 89, no. 2, pp. 437-448, 2022