Enlarged Perivascular Spaces Are Independently Associated with High Pulse Wave Velocity: A Cross-Sectional Study
Article type: Research Article
Authors: Kinjo, Yoshinoa; b; 1 | Saji, Naokib; 1; * | Murotani, Kentac; d | Sakima, Hirokunia | Takeda, Akinorib | Sakurai, Takashib; e; f | Ohya, Yusukea | Kusunose, Kenyaa
Affiliations: [a] Department of Cardiovascular Medicine, Nephrology and Neurology, University of the Ryukyus Graduate School of Medicine, Nishihara-cho, Okinawa, Japan | [b] Center for Comprehensive Care and Research on Memory Disorders, Hospital, National Center for Geriatrics and Gerontology, Obu, Aichi, Japan | [c] School of Medical Technology, Kurume University, Kurume, Fukuoka, Japan | [d] Biostatistics Center, Graduate School of Medicine, Kurume University, Kurume, Fukuoka, Japan | [e] Department of Prevention and Care Science, Research Institute, National Center for Geriatrics and Gerontology, Obu, Aichi, Japan | [f] Department of Cognition and Behavioral Science, Nagoya University Graduate School of Medicine, Showa-ku, Nagoya, Aichi, Japan
Correspondence: [*] Correspondence to: Naoki Saji, MD, PhD, Center for Comprehensive Care and Research on Memory Disorders, National Center for Geriatrics and Gerontology, 7-430 Morioka, Obu, Aichi 474-8511, Japan. Tel.: +81 562 46 2311; Fax: +81 562 48 2373; E-mail: sajink@nifty.com.
Note: [1] These authors contributed equally to this work.
Abstract: Background:Recent studies have demonstrated an association between pulse wave velocity (PWV), cerebral small vessel disease (SVD), and cognitive impairment such as Alzheimer’s disease. However, the association between brachial-ankle PWV and enlarged perivascular spaces (EPVS), one component of cerebral SVD remains controversial. Objective:To investigate the relationship between brachial-ankle PWV and EPVS severity in participants without dementia. Methods:We performed a cross-sectional study of data of 74 participants from sub-analysis of ongoing research. We assessed cognitive function, brachial-ankle PWV, and brain magnetic resonance imaging (MRI) features. Using brain MRI, EPVS were separately assessed as basal ganglia (BG)-EPVS or centrum semiovale (CSO)-EPVS on the basis of their location. The relationship between EPVS severity and brachial-ankle PWV was evaluated using multivariable ordinal logistic regression analyses. Results:We analyzed 74 participants (women: 47%, mean age: 73 years, mild cognitive impairment [MCI]: 74%). Compared with participants with normal cognition, those with MCI were more likely to have both severe BG-EPVS and severe CSO-EPVS. In multivariable analyses, high brachial-ankle PWV and age were independently associated with BG-EPVS severity (odds ratio [95% confidence interval]: 1.19 [1.02–1.38], 1.09 [1.01–1.17], respectively), whereas only age was independently associated with CSO-EPVS severity. A causal mediation analysis under a counterfactual approach revealed a significant pure natural indirect effect of brachial-ankle PWV on MCI that was mediated by BG-EPVS (estimate: 1.04, 95% CI: 1.01–1.12, p = 0.006). Conclusions:Brachial-ankle PWV was associated with BG-EPVS severity. High PWV may cause cerebrovascular pulsatility, which accelerates BG-EPVS and may worsen cognitive impairment.
Keywords: Alzheimer’s disease, cerebral small vessel disease, cognitive decline, enlarged perivascular spaces, pulsatility, pulse wave velocity
DOI: 10.3233/JAD-240589
Journal: Journal of Alzheimer's Disease, vol. 101, no. 2, pp. 627-636, 2024