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Aging | Aging, Prevalence and Risk Factors of MRI-visible Enlarged Perivascular Spaces

09-22-2022

“Severe ePVS prevalence increased with age in men and women [...]”

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BUFFALO, NY- September 22, 2022 – A new research paper was published in Aging (listed as "Aging (Albany NY)" by Medline/PubMed and "Aging-US" by Web of Science) Volume 14, Issue 17, entitled, “Aging, prevalence and risk factors of MRI-visible enlarged perivascular spaces.”

Cerebral small vessel disease (CSVD) increases with age and is associated with stroke and cognitive decline. Enlarged Perivascular Spaces (ePVS) is an emerging marker of CSVD, but its prevalence over the life span remains unclear. 

In a new study, researchers Frances Rodriguez Lara, Ashlea Lynn Scruton, Adlin Pinheiro, Serkalem Demissie, Pedram Parva, Andreas Charidimou, Michael Francis, Jayandra J. Himali, Charles DeCarli, Alexa Beiser, Sudha Seshadri, and Jose R. Romero from Boston University School of Medicine, Boston University School of Public Health, NHLBI’s Framingham Heart Study, Veterans Affairs Boston Health System, University of Texas Health Sciences Center, and University of California at Davis characterized the age and sex-specific prevalence of ePVS and its relation to age-specific risk factors in a large community-based sample.

“In this report we aim to describe 1) the age and sex specific prevalence of ePVS in a large sample of asymptomatic, community dwelling individuals, and contrast ePVS prevalence with the prevalence of vascular risk factors in the same age groups, and 2) study the association of vascular risk factors with burden of ePVS by brain region. This knowledge will help support the increasing number of studies of ePVS as a biomarker of aging and age related adverse neurological outcomes.”

The researchers included 3,710 Framingham Heart Study participants with available brain MRI data (average age 61.4±14.6, 46% men). ePVS burden was rated in the centrum semiovale (CSO) and basal ganglia (BG) regions. Individual vascular risk factors were related to ePVS burden in the CSO, BG and mixed CSO-BG regions using multivariable adjusted ordinal logistic regression analysis. 

Severe ePVS prevalence increased with age in men and women, and paralleled increases in vascular risk factors and prevention treatment use. Older age, hypertension (and resulting higher treatment use), higher systolic and diastolic blood pressure, and smoking were associated with higher burden of ePVS in the CSO, BG and mixed regions. Their observations reinforce the hypothesis that ePVS may be a marker of aging-driven brain vascular pathologies, and its association with vascular risk factors support their role as a CSVD imaging biomarker.

“Our findings suggest that ePVS may also be considered a subclinical marker of aging and bring attention to their close relation and interplay with vascular risk factors, whose prevalence also rises with age in parallel to ePVS burden. The associations of high ePVS burden (and presumed glymphatic dysfunction) with increased blood pressure in particular, may begin earlier than previously thought, in pre-hypertension stages. Clinical trials would be needed to assess whether early treatment may prevent adverse cognitive consequences and stroke in individuals with high ePVS burden.”

DOI: https://doi.org/10.18632/aging.204181 

Corresponding Author: Jose R. Romero - Email: joromero@bu.edu 

Keywords: neurological markers, aging, disease marker, perivascular spaces

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About Aging-US:

The mission of the journal is to understand the mechanisms surrounding aging and age-related diseases, including cancer as the main cause of death in the modern aged population.

The journal aims to promote 1) treatment of age-related diseases by slowing down aging, 2) validation of anti-aging drugs by treating age-related diseases, and 3) prevention of cancer by inhibiting aging. (Cancer and COVID-19 are age-related diseases.)

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