Enlarged perivascular spaces are associated with cognitive function in healthy elderly men

Objectives: Increased white matter (WM) lesions on magnetic resonance imaging (MRI) are associated with worse cognitive function in older people. Enlarged perivascular spaces (EPVS) commonly coexist with and share some risk factors for WM lesions but are not quantified in published scales. It is not...

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Published in:Journal of neurology, neurosurgery and psychiatry Vol. 75; no. 11; pp. 1519 - 1523
Main Authors: MacLullich, A M J, Wardlaw, J M, Ferguson, K J, Starr, J M, Seckl, J R, Deary, I J
Format: Journal Article
Language:English
Published: England BMJ Publishing Group Ltd 01.11.2004
BMJ Publishing Group LTD
BMJ Group
Subjects:
Aged
ageing
Aging
Aging - physiology
Atrophy
Basal Ganglia - pathology
Brain
Brain - pathology
Cardiovascular disease
Cerebral Arteries - pathology
cognition
Cognition - physiology
Cognitive ability
Diabetes
enlarged perivascular spaces
EPVS
Hippocampus - pathology
Humans
Magnetic Resonance Imaging
Male
Medical imaging
Memory
MRI
Multivariate Analysis
NART
National Adult Reading Test
neuroimaging
Neuropsychological Tests - statistics & numerical data
NMR
Nuclear magnetic resonance
Older people
Principal Component Analysis
Psychometrics - statistics & numerical data
Reference Values
Statistics as Topic
Studies
Subarachnoid Space - pathology
white matter
white matter lesions
ISSN:0022-3050, 1468-330X
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Summary:Objectives: Increased white matter (WM) lesions on magnetic resonance imaging (MRI) are associated with worse cognitive function in older people. Enlarged perivascular spaces (EPVS) commonly coexist with and share some risk factors for WM lesions but are not quantified in published scales. It is not known whether the extent of EPVS is also associated with cognitive function. We tested the hypothesis that more EPVS would be associated with worse cognitive function. Methods: Ninety seven healthy men (65–70 years), not on medications, underwent MRI scanning and comprehensive cognitive testing. EPVS were quantified in both the basal ganglia/centrum semiovale and the hippocampus, and WM lesions were measured. Results: Scores on published WM lesion rating scales intercorrelated highly significantly and positively (ρ = 0.61 to 0.91, p<0.0001). A summary (WML) factor derived from principal components analysis of the WM scales correlated with EPVS in the basal ganglia/centrum semiovale (ρ = 0.48, p<0.0001) but not in the hippocampus. EPVS scores in the basal ganglia/centrum semiovale correlated significantly and negatively with non-verbal reasoning (ρ = −0.21, p = 0.038) and general visuospatial ability (ρ = −0.22, p = 0.032), adjusted for prior intelligence. The WML factor correlated significantly and negatively with visuospatial ability, as previously reported, and showed an unexpected positive correlation with one test of verbal memory (list-learning). Conclusions: These findings suggest that increased EPVS are correlated with worse cognitive function. Future studies examining changes in WM with ageing should consider incorporating measures of EPVS and examine the sequence of EPVS and WM lesion development over time. More work is needed to develop valid and reliable measures of EPVS.
Bibliography:Correspondence to:
 A M J MacLullich
 Geriatric Medicine Unit, The University of Edinburgh, Room SU220, The Chancellor’s Building, 49 Little France Crescent, Edinburgh, EH16 4SB; a.maclullich@ed.ac.uk
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PMID:15489380
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ISSN:0022-3050
1468-330X
DOI:10.1136/jnnp.2003.030858