Dilated Perivascular Spaces in the Centrum Semiovale Begin to Develop in Middle Age

Article type: Research Article

Authors: Ishikawa, Masatsune^{a; b; *} | Yamada, Shigeki^{b; c} | Yamamoto, Kazuo^c

Affiliations: [a] Rakuwa Villa Ilios, Nakagyo-ku, Kyoto, Kyoto, Japan | [b] Normal Pressure Hydrocephalus Center, Otowa Hospital, Otowa, Yamashina-ku, Kyoto, Kyoto, Japan | [c] Department of Neurosurgery, Otowa Hospital, Otowa, Yamashina-ku, Kyoto, Kyoto, Japan

Correspondence: [*] Correspondence to: Masatsune Ishikawa, MD, PhD, Rakuwa Villa Ilios, 186 Jyurakumawari-Nishimachi, Nakagyo-ku, Kyoto, Kyoto 604-8402, Japan. Tel.: +81 75 801 0377; Fax: +81 75 801 0352; E-mail: rakuwadr1001@rakuwadr.com.

Abstract: Background:Dilated perivascular spaces in the centrum semiovale (CSO-PVS) are closely related to small vessel disease. However, recent studies have revealed that cerebral amyloid angiopathy can cause dilation of the CSO-PVS and obstruction of interstitial fluid flow along the intramural periarterial drainage. Objective:To examine the severity and age-related prevalence of CSO-PVS through magnetic resonance imaging (MRI) and investigate their clinically relevant factors. Methods:This study included 1,060 subjects who participated in our brain program. The subjects ranged from 23 to 83 years in age and were active in society. The frequencies of the MRI abnormalities of small vessel diseases, including CSO-PVS, were examined. The CSO-PVS severity was classified into three grades: G0, G1, G2, according to the visual rating. The subjects were divided into five age groups and their age-related frequencies were also studied. Using the clinico-laboratory data of 712 subjects, the clinically relevant factors of CSO-PVS were investigated using logistic regression analysis. Results:The frequencies of all G0 (“normal”) MRI abnormalities significantly decreased with age. A high prevalence of G2 CSO-PVS was observed (24%) in the youngest group aged≤39 years, whereas other MRI abnormalities in this group were not or rarely observed. In multivariable logistic regression analyses, G2 CSO-PVS was found to be closely associated with age, hypertension, and the estimated glomerular filtration ratio. Conclusions:This study reveals that CSO-PVS begin to develop in subjects aged less than 39 years. Age-related changes are involved. Further studies are necessary to elucidate the pathophysiological role of the CSO-PVS.

Keywords: Aging, cerebral amyloid angiopathy, dementia, interstitial fluid, magnetic resonance imaging, small vessel disease, white matter

DOI: 10.3233/JAD-170755

Journal: Journal of Alzheimer's Disease, vol. 61, no. 4, pp. 1619-1626, 2018