| Title: |
Enlarged perivascular spaces are associated with brain microangiopathy and aging in multiple sclerosis. |
| Authors: |
Borrelli, S.; Guisset, F.; Vanden Bulcke, C.; Stölting, A.; Bugli, C.; Lolli, V.; Du Pasquier, R.; van Pesch, V.; Absinta, M.; Pasi, M.; Maggi, P. |
| Publication Year: |
2024 |
| Collection: |
Université de Lausanne (UNIL): Serval - Serveur académique lausannois |
| Subject Terms: |
Humans; Male; Female; Middle Aged; Adult; Magnetic Resonance Imaging; Glymphatic System/pathology; Glymphatic System/diagnostic imaging; Multiple Sclerosis/pathology; Multiple Sclerosis/diagnostic imaging; Aging/pathology; Cross-Sectional Studies; Brain/pathology; Brain/diagnostic imaging; Enlarged perivascular spaces; brain-predicted age; cerebral small vessel disease; multiple sclerosis; vascular risk factors |
| Description: |
Growing evidence links brain-MRI enlarged perivascular spaces (EPVS) and multiple sclerosis (MS), but their role remains unclear. This study aimed to investigate the cross-sectional associations of EPVS with several neuroinflammatory and neurodegenerative features in a large multicentric-MS cohort. In total, 207 patients underwent 3T axial-T2-weighted brain-MRI for EPVS assessment (EPVS dichotomized into high/low according to ⩾ 2/< 2 rating categories). MRI biomarkers included brain-predicted age and brain-predicted age difference (brain-PAD), central vein sign (CVS)-positive lesion percentage (CVS%), paramagnetic rim and cortical lesions, T2-lesion load, and brain volumetry. The variable relative importance for EPVS-category prediction was explored using a classification random forest approach. High EPVS patients were older (49 vs 44 years, p = 0.003), had ⩾ 1 vascular risk factors (VRFs; p = 0.005), lower CVS% (67% vs 78%, p < 0.001), reduced brain volumes (whole brain: 0.63 vs 0.73, p = 0.01; gray matter: 0.36 vs 0.40; p = 0.002), and older brain-predicted age (58 vs 50 years, p < 0.001). No differences were found for neuroinflammatory markers. After adjusting for age and VFRs (multivariate analyses), the high EPVS category correlated with lower CVS% (odds ratio (OR) = 0.98, 95% confidence interval (CI) = 0.96-0.99; p = 0.02), lower whole brain (OR = 0.01, 95% CI = 0.0003-0.5; p = 0.02), gray matter (OR = 0.0004, 95% CI = 0.0000004-0.4; p = 0.03) volumes, and higher brain-PAD (OR = 1.05, 95% CI = 1.01-1.09; p = 0.02). Random forest identified brain-PAD as the most important predictor of high EPVS. EPVS in MS likely reflect microangiopathic disease rather than neuroinflammation, potentially contributing to accelerated neurodegeneration. |
| Document Type: |
article in journal/newspaper |
| Language: |
English |
| ISSN: |
1477-0970 |
| Relation: |
Multiple Sclerosis Journal; https://iris.unil.ch/handle/iris/155945; serval:BIB_6B85AAD6FF7E; 001243145000001 |
| DOI: |
10.1177/13524585241256881 |
| Availability: |
https://iris.unil.ch/handle/iris/155945; https://doi.org/10.1177/13524585241256881 |
| Accession Number: |
edsbas.E7CF9316 |
| Database: |
BASE |