MRI Study Of Enlarged Perivascular Spaces In The Basal Ganglia In Cognitively Normal Elderly Peopl

Part 1The association between perivascular spaces and cerebral blood flow and brain volume in elderly individualsObjective:The impact of enlarged perivascular spaces in basal ganglia（BG-EPVS）on the structure and function in the aging brain remains poorly understood.The study carried out a cross-sectional estimation of cognitively intact older adults to determine whether gray matter volume（GMV）and cerebral blood flow（CBF）were associated with the severity of BG-EPVS.Materials and Methods:A total of 734 volunteers were recruited.MRI was performed on a 3.0T scanner with a pseudo-continuous arterial spin labeling（pCASL）sequence and a sagittal isotropic T1-weighted sequence for CBF and GMV analysis.BG-EPVS were rated using a 5-grade score scale.The severity of BG-EPVS was classified as mild（grade<3）and severe（grade≥3）.The differences in GMV/CBF between the mild and severe BGEPVS groups were analyzed using univariate linear models.Results:Severe BG-EPVS were associated with significantly smaller GMV and CBF in multiple cortical regions(P_FDR<0.05),and were associated with significantly larger volume in the bilateral caudate nucleus,pallidum,and putamen(P_FDR<0.05).Conclusion:In cognitively intact older adults,severe BG-EPVS are associated with smaller cortical GMV and CBF,and larger subcortical GMV.Part 2The association between perivascular spaces and longitudinal cognitive function in elderly individualsObjective:To evaluate the association between enlarged perivascular spaces in basal ganglia（BG-EPVS）and longitudinal cognitive function in cognitively intact older adults.Materials and Methods:Residents aged 55 years old or more in a community-based cohort from August 2013 to November 2013 were retrospectively enrolled.Seventy-eight participants completed a telephone survey regarding cognitive function 7.6 years（±0.1 years）after undergoing MRI.The survey evaluated their cognitive performance using the Subjective Cognitive Decline-Questionnaire 9 and their clinical history.BG-EPVS were rated using a 5-grade score.The severity of BG-EPVS was classified as mild（grade<3）and severe（grade≥3）.Logistic regression analysis was used to compare the longitudinal cognitive differences between mild BG-EPVS and severe BG-EPVS group.Results:Compared with participants with mild BG-EPVS,participants with severe BGEPVS were more susceptible to longitudinal cognitive decline（OR=6.11,P=0.009,corrected for age and sex）.Conclusion:In cognitively intact older adults,severe BG-EPVS is an imaging marker of long-term cognitive decline.Part 3The association between perivascular spaces and cardiovascular risk burden in elderly individualsObjective:To investigate the relationship between enlarged perivascular spaces in basal ganglia（BG-EPVS）and cardiovascular risk burden.Materials and Methods:The study recruited 254 older adults with normal cognition and complete clinical data.All the volunteers had no history of intracranial surgery,brain tumor or psychiatric disease.BG-EPVS were rated using a 5-grade score.The severity of BGPVS was classified as mild（grade<3）and severe（grade≥3）.Cardiovascular risk burden was assessed with the Framingham General Cardiovascular Risk Score（FGCRS）.Multiple cardiovascular risk factors（such as age,sex,high-density lipoprotein cholesterol,total cholesterol,systolic blood pressure,hypertension,diabetes,and smoking history）and cardiovascular risk burden were all compared between two groups using χ2 test,Student’s t-test,or Logistic regression analysis.Results:Severe BG-EPVS were associated with male sex（38.38%vs.55.36%,P=0.023）and age（69.55 years vs.77.32 years,P<0.001）.Those in the severe BG-EPVS group were more likely to have hypertension（53.53%vs.69.64%,P=0.032）,higher SBP（132.53mm Hg vs.140.91mm Hg,P=0.001）,lower total cholesterol（199.57mg/dL vs.179.29 mg/dL,P=0.001）,and higher cardiovascular risk burden（P=0.02;OR,2.06;95%CI,1.12-3.77）.Conclusion:In cognitively intact older adults,the severity of BG-EPVS is associated with various cardiovascular risk factors and cardiovascular risk burden.