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Abstract

Objective:

To investigate whether the topography of dilated perivascular spaces (DPVS) corresponds with markers of particular small-vessel diseases such as cerebral amyloid angiopathy and hypertensive vasculopathy.

Methods:

Patients were recruited from an ongoing single-center prospective longitudinal cohort study of patients evaluated in a memory clinic. All patients underwent structural, high-resolution MRI, and had a clinical assessment performed within 1 year of scan. DPVS were rated in basal ganglia (BG-DPVS) and white matter (WM-DPVS) on T1 sequences, using an established 4-point semiquantitative score. DPVS degree was classified as high (score > 2) or low (score ≤ 2). Independent risk factors for high degree of BG-DPVS and WM-DPVS were investigated.

Results:

Eighty-nine patients were included (mean age 72.7 ± 9.9 years, 57% female). High degree of WM-DPVS was more frequent than low degree in patients with presence of strictly lobar microbleeds (45.5% vs 28.4% of subjects). High BG-DPVS degree was associated with older age, hypertension, and higher white matter hyperintensity volumes. In multivariate analysis, increased lobar microbleed count was an independent predictor of high degree of WM-DPVS (odds ratio [OR] 1.53 [95% confidence interval (CI) 1.06–2.21], p = 0.02). By contrast, hypertension was an independent predictor of high degree of BG-DPVS (OR 9.4 [95% CI 1–85.2], p = 0.04).

Conclusions:

The associations of WM-DPVS with lobar microbleeds and BG-DPVS with hypertension raise the possibility that the distribution of DPVS may indicate the presence of underlying small-vessel diseases such as cerebral amyloid angiopathy and hypertensive vasculopathy in patients with cognitive impairment.

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Information & Authors

Information

Published In

Neurology®
Volume 80Number 17April 23, 2013
Pages: 1551-1556
PubMed: 23553482

Publication History

Received: August 22, 2012
Accepted: January 9, 2013
Published online: April 3, 2013
Published in print: April 23, 2013

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Disclosure

The authors report no disclosures relevant to the manuscript. Go to Neurology.org for full disclosures.

Study Funding

Supported by grant 5P50AG005134-28 from the National Institute on Aging. Dr. Martinez-Ramirez is a recipient of the research grant “Becas de Investigacion en Universidades y Centros del Extranjero” from Fundacion Alfonso Martin Escudero, Madrid (Spain). Funding entities had no involvement in study design, data collection, analysis and interpretation, writing of the manuscript, or the decision to submit for publication.

Authors

Affiliations & Disclosures

Sergi Martinez-Ramirez, MD
From the Massachusetts General Hospital Stroke Research Center (S.M.-R., O.M.P.-N., A.P.D., E.A., A.H., M.Q., M.E.G., S.M.G., A.V.), Boston; and Escola de Postgrau (S.M.-R.), Universitat Autònoma de Barcelona, Edicifi U, Campus UAB, Bellaterra (Cerdanyola del Vallès), Spain.
Disclosure
Scientific Advisory Boards:
1.
NONE
Gifts:
1.
NONE
Funding for Travel or Speaker Honoraria:
1.
NONE
Editorial Boards:
1.
NONE
Patents:
1.
NONE
Publishing Royalties:
1.
NONE
Employment, Commercial Entity:
1.
NONE
Consultancies:
1.
NONE
Speakers' Bureaus:
1.
NONE
Other Activities:
1.
NONE
Clinical Procedures or Imaging Studies:
1.
NONE
Research Support, Commercial Entities:
1.
NONE
Research Support, Government Entities:
1.
NONE
Research Support, Academic Entities:
1.
NONE
Research Support, Foundations and Societies:
1.
Dr. Martinez-Ramirez is a recipient of the research grant “Becas de Investigacion en Universidades y Centros del Extranjero” from Fundacion Alfonso Martin Escudero, Madrid (Spain).
Stock/stock Options/board of Directors Compensation:
1.
NONE
License Fee Payments, Technology or Inventions:
1.
NONE
Royalty Payments, Technology or Inventions:
1.
NONE
Stock/stock Options, Research Sponsor:
1.
NONE
Stock/stock Options, Medical Equipment & Materials:
1.
NONE
Legal Proceedings:
1.
NONE
Octavio Marques Pontes-Neto, MD, PhD
From the Massachusetts General Hospital Stroke Research Center (S.M.-R., O.M.P.-N., A.P.D., E.A., A.H., M.Q., M.E.G., S.M.G., A.V.), Boston; and Escola de Postgrau (S.M.-R.), Universitat Autònoma de Barcelona, Edicifi U, Campus UAB, Bellaterra (Cerdanyola del Vallès), Spain.
Disclosure
Scientific Advisory Boards:
1.
NONE
Gifts:
1.
NONE
Funding for Travel or Speaker Honoraria:
1.
NONE
Editorial Boards:
1.
NONE
Patents:
1.
NONE
Publishing Royalties:
1.
NONE
Employment, Commercial Entity:
1.
NONE
Consultancies:
1.
NONE
Speakers' Bureaus:
1.
NONE
Other Activities:
1.
NONE
Clinical Procedures or Imaging Studies:
1.
NONE
Research Support, Commercial Entities:
1.
NONE
Research Support, Government Entities:
1.
NONE
Research Support, Academic Entities:
1.
NONE
Research Support, Foundations and Societies:
1.
(1)Fundacao de Amparo a Pesquisa do Estado de Sao Paulo (FAPESP),(2)Conselho Nacional de Desenvolvimento Cientifico e Tecnologico (CNPq).
Stock/stock Options/board of Directors Compensation:
1.
NONE
License Fee Payments, Technology or Inventions:
1.
NONE
Royalty Payments, Technology or Inventions:
1.
NONE
Stock/stock Options, Research Sponsor:
1.
NONE
Stock/stock Options, Medical Equipment & Materials:
1.
NONE
Legal Proceedings:
1.
NONE
Andrew P. Dumas
From the Massachusetts General Hospital Stroke Research Center (S.M.-R., O.M.P.-N., A.P.D., E.A., A.H., M.Q., M.E.G., S.M.G., A.V.), Boston; and Escola de Postgrau (S.M.-R.), Universitat Autònoma de Barcelona, Edicifi U, Campus UAB, Bellaterra (Cerdanyola del Vallès), Spain.
Disclosure
Scientific Advisory Boards:
1.
NONE
Gifts:
1.
NONE
Funding for Travel or Speaker Honoraria:
1.
NONE
Editorial Boards:
1.
NONE
Patents:
1.
NONE
Publishing Royalties:
1.
NONE
Employment, Commercial Entity:
1.
1) MIT Lincoln Laboratory and Minuteman Group LLC, Biomedical Signal Processing Engineer, 2) Massachusetts General Hospital, Research Technician (6/2010 - 7/2012)
Consultancies:
1.
NONE
Speakers' Bureaus:
1.
NONE
Other Activities:
1.
NONE
Clinical Procedures or Imaging Studies:
1.
NONE
Research Support, Commercial Entities:
1.
NONE
Research Support, Government Entities:
1.
NONE
Research Support, Academic Entities:
1.
NONE
Research Support, Foundations and Societies:
1.
NONE
Stock/stock Options/board of Directors Compensation:
1.
NONE
License Fee Payments, Technology or Inventions:
1.
NONE
Royalty Payments, Technology or Inventions:
1.
NONE
Stock/stock Options, Research Sponsor:
1.
NONE
Stock/stock Options, Medical Equipment & Materials:
1.
NONE
Legal Proceedings:
1.
NONE
Eitan Auriel, MD, MSc
From the Massachusetts General Hospital Stroke Research Center (S.M.-R., O.M.P.-N., A.P.D., E.A., A.H., M.Q., M.E.G., S.M.G., A.V.), Boston; and Escola de Postgrau (S.M.-R.), Universitat Autònoma de Barcelona, Edicifi U, Campus UAB, Bellaterra (Cerdanyola del Vallès), Spain.
Disclosure
Scientific Advisory Boards:
1.
NONE
Gifts:
1.
NONE
Funding for Travel or Speaker Honoraria:
1.
NONE
Editorial Boards:
1.
NONE
Patents:
1.
NONE
Publishing Royalties:
1.
NONE
Employment, Commercial Entity:
1.
NONE
Consultancies:
1.
NONE
Speakers' Bureaus:
1.
NONE
Other Activities:
1.
NONE
Clinical Procedures or Imaging Studies:
1.
NONE
Research Support, Commercial Entities:
1.
NONE
Research Support, Government Entities:
1.
NONE
Research Support, Academic Entities:
1.
NONE
Research Support, Foundations and Societies:
1.
NONE
Stock/stock Options/board of Directors Compensation:
1.
NONE
License Fee Payments, Technology or Inventions:
1.
NONE
Royalty Payments, Technology or Inventions:
1.
NONE
Stock/stock Options, Research Sponsor:
1.
NONE
Stock/stock Options, Medical Equipment & Materials:
1.
NONE
Legal Proceedings:
1.
NONE
Amy Halpin
From the Massachusetts General Hospital Stroke Research Center (S.M.-R., O.M.P.-N., A.P.D., E.A., A.H., M.Q., M.E.G., S.M.G., A.V.), Boston; and Escola de Postgrau (S.M.-R.), Universitat Autònoma de Barcelona, Edicifi U, Campus UAB, Bellaterra (Cerdanyola del Vallès), Spain.
Disclosure
Scientific Advisory Boards:
1.
NONE
Gifts:
1.
NONE
Funding for Travel or Speaker Honoraria:
1.
NONE
Editorial Boards:
1.
NONE
Patents:
1.
NONE
Publishing Royalties:
1.
NONE
Employment, Commercial Entity:
1.
NONE
Consultancies:
1.
NONE
Speakers' Bureaus:
1.
NONE
Other Activities:
1.
NONE
Clinical Procedures or Imaging Studies:
1.
NONE
Research Support, Commercial Entities:
1.
NONE
Research Support, Government Entities:
1.
NONE
Research Support, Academic Entities:
1.
NONE
Research Support, Foundations and Societies:
1.
NONE
Stock/stock Options/board of Directors Compensation:
1.
NONE
License Fee Payments, Technology or Inventions:
1.
NONE
Royalty Payments, Technology or Inventions:
1.
NONE
Stock/stock Options, Research Sponsor:
1.
NONE
Stock/stock Options, Medical Equipment & Materials:
1.
NONE
Legal Proceedings:
1.
NONE
Megan Quimby
From the Massachusetts General Hospital Stroke Research Center (S.M.-R., O.M.P.-N., A.P.D., E.A., A.H., M.Q., M.E.G., S.M.G., A.V.), Boston; and Escola de Postgrau (S.M.-R.), Universitat Autònoma de Barcelona, Edicifi U, Campus UAB, Bellaterra (Cerdanyola del Vallès), Spain.
Disclosure
Scientific Advisory Boards:
1.
NONE
Gifts:
1.
NONE
Funding for Travel or Speaker Honoraria:
1.
NONE
Editorial Boards:
1.
NONE
Patents:
1.
NONE
Publishing Royalties:
1.
NONE
Employment, Commercial Entity:
1.
NONE
Consultancies:
1.
NONE
Speakers' Bureaus:
1.
NONE
Other Activities:
1.
NONE
Clinical Procedures or Imaging Studies:
1.
NONE
Research Support, Commercial Entities:
1.
NONE
Research Support, Government Entities:
1.
NONE
Research Support, Academic Entities:
1.
NONE
Research Support, Foundations and Societies:
1.
NONE
Stock/stock Options/board of Directors Compensation:
1.
NONE
License Fee Payments, Technology or Inventions:
1.
NONE
Royalty Payments, Technology or Inventions:
1.
NONE
Stock/stock Options, Research Sponsor:
1.
NONE
Stock/stock Options, Medical Equipment & Materials:
1.
NONE
Legal Proceedings:
1.
NONE
Mahmut Edip Gurol, MD
From the Massachusetts General Hospital Stroke Research Center (S.M.-R., O.M.P.-N., A.P.D., E.A., A.H., M.Q., M.E.G., S.M.G., A.V.), Boston; and Escola de Postgrau (S.M.-R.), Universitat Autònoma de Barcelona, Edicifi U, Campus UAB, Bellaterra (Cerdanyola del Vallès), Spain.
Disclosure
Scientific Advisory Boards:
1.
NONE
Gifts:
1.
NONE
Funding for Travel or Speaker Honoraria:
1.
NONE
Editorial Boards:
1.
NONE
Patents:
1.
NONE
Publishing Royalties:
1.
NONE
Employment, Commercial Entity:
1.
NONE
Consultancies:
1.
NONE
Speakers' Bureaus:
1.
NONE
Other Activities:
1.
NONE
Clinical Procedures or Imaging Studies:
1.
NONE
Research Support, Commercial Entities:
1.
NONE
Research Support, Government Entities:
1.
NONE
Research Support, Academic Entities:
1.
NONE
Research Support, Foundations and Societies:
1.
NONE
Stock/stock Options/board of Directors Compensation:
1.
NONE
License Fee Payments, Technology or Inventions:
1.
NONE
Royalty Payments, Technology or Inventions:
1.
NONE
Stock/stock Options, Research Sponsor:
1.
NONE
Stock/stock Options, Medical Equipment & Materials:
1.
NONE
Legal Proceedings:
1.
NONE
Steven M. Greenberg, MD, PhD
From the Massachusetts General Hospital Stroke Research Center (S.M.-R., O.M.P.-N., A.P.D., E.A., A.H., M.Q., M.E.G., S.M.G., A.V.), Boston; and Escola de Postgrau (S.M.-R.), Universitat Autònoma de Barcelona, Edicifi U, Campus UAB, Bellaterra (Cerdanyola del Vallès), Spain.
Disclosure
Scientific Advisory Boards:
1.
Hoffman-Laroche, MRI Review Committee
Gifts:
1.
NONE
Funding for Travel or Speaker Honoraria:
1.
1) VasCog 2011, travel reimbursement 2) New York Academy of Sciences 2012, travel reimbursement 3) Quebec Society of Vascular Sciences, travel reimbursement and honorarium 4) Cerebral Amyloid Angiopathy conference, travel reimbursement
Editorial Boards:
1.
Stroke, Editorial Board, 2010-present; Cerebrovascular Disease, Editorial Board, 2008-present; Neurology, Editorial Board, 2005-present; J Alzheimer's Disease and Other Dementias, Editorial Board, 2005-present
Patents:
1.
NONE
Publishing Royalties:
1.
1) UpToDate, Cerebral Amyloid Angiopathy 2) MedLink, Cerebral Amyloid Angiopathy
Employment, Commercial Entity:
1.
NONE
Consultancies:
1.
NONE
Speakers' Bureaus:
1.
NONE
Other Activities:
1.
NONE
Clinical Procedures or Imaging Studies:
1.
NONE
Research Support, Commercial Entities:
1.
NONE
Research Support, Government Entities:
1.
NIH, PI, R01AG026484, 2005-2015; NIH, PI, R01NS070834, 2010-2015; NIH, PI, U10NS077360, 2011-2018
Research Support, Academic Entities:
1.
NONE
Research Support, Foundations and Societies:
1.
NONE
Stock/stock Options/board of Directors Compensation:
1.
NONE
License Fee Payments, Technology or Inventions:
1.
NONE
Royalty Payments, Technology or Inventions:
1.
NONE
Stock/stock Options, Research Sponsor:
1.
NONE
Stock/stock Options, Medical Equipment & Materials:
1.
NONE
Legal Proceedings:
1.
NONE
Anand Viswanathan, MD, PhD
From the Massachusetts General Hospital Stroke Research Center (S.M.-R., O.M.P.-N., A.P.D., E.A., A.H., M.Q., M.E.G., S.M.G., A.V.), Boston; and Escola de Postgrau (S.M.-R.), Universitat Autònoma de Barcelona, Edicifi U, Campus UAB, Bellaterra (Cerdanyola del Vallès), Spain.
Disclosure
Scientific Advisory Boards:
1.
Has served on a Data safety monitoring board for Roche Pharmaceuticals.
Gifts:
1.
NONE
Funding for Travel or Speaker Honoraria:
1.
NONE
Editorial Boards:
1.
NONE
Patents:
1.
NONE
Publishing Royalties:
1.
NONE
Employment, Commercial Entity:
1.
NONE
Consultancies:
1.
Dr. Viswanathan has served as consultant for Athena Diagnostics.
Speakers' Bureaus:
1.
NONE
Other Activities:
1.
NONE
Clinical Procedures or Imaging Studies:
1.
NONE
Research Support, Commercial Entities:
1.
NONE
Research Support, Government Entities:
1.
(1) NIA 2P50AG005134-268382, investigator; (2) 1K23AG028726-01A2, investigator.
Research Support, Academic Entities:
1.
NONE
Research Support, Foundations and Societies:
1.
NONE
Stock/stock Options/board of Directors Compensation:
1.
NONE
License Fee Payments, Technology or Inventions:
1.
NONE
Royalty Payments, Technology or Inventions:
1.
NONE
Stock/stock Options, Research Sponsor:
1.
NONE
Stock/stock Options, Medical Equipment & Materials:
1.
NONE
Legal Proceedings:
1.
NONE

Notes

Correspondence to Dr. Martinez-Ramirez: [email protected]
Go to Neurology.org for full disclosures. Funding information and disclosures deemed relevant by the authors, if any, are provided at the end of the article.

Author Contributions

Study design: S.M.-R., A.V. Data acquisition: S.M.-R., A.P.D., A.H., M.Q., M.E.G. Data analysis: S.M.-R., O.M.P.-N., E.A., M.E.G., A.V. Study management: S.M.-R., S.M.G., A.V. Manuscript preparation: S.M.-R., O.M.P.-N., A.V. Manuscript review: S.M.-R., O.M.P.-N., E.A., M.E.G., S.M.G., A.V.

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