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Enlarged Perivascular Spaces on MRI Are a Feature of Cerebral Small Vessel Disease
Enlarged perivascular spaces in the brain are common but generally overlooked and of uncertain pathophysiology. They may reflect underlying cerebral small vessel disease. We determined whether enlarged perivascular spaces were associated with lacunar stroke subtype and white matter hyperintensities,...
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| Published in: | Stroke (1970) 2010-03, Vol.41 (3), p.450-454 |
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| cites | cdi_FETCH-LOGICAL-c499t-174e2bb26f8b0ea5ffa7f6747ce75003e65dd00026716f28151f47cf984ed4873 |
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| container_title | Stroke (1970) |
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| creator | DOUBAL, Fergus N MACLULLICH, Alasdair M. J FERGUSON, Karen J DENNIS, Martin S WARDLAW, Joanna M |
| description | Enlarged perivascular spaces in the brain are common but generally overlooked and of uncertain pathophysiology. They may reflect underlying cerebral small vessel disease. We determined whether enlarged perivascular spaces were associated with lacunar stroke subtype and white matter hyperintensities, markers of established small vessel disease.
We prospectively recruited patients with acute ischemic lacunar or cortical stroke. Age-matched nonstroke control subjects were also recruited. We rated basal ganglia and centrum semiovale enlarged perivascular spaces 0 to 4 (0=none, 4=>40) on T2-weighted MRI and white matter hyperintensities. We compared enlarged perivascular spaces between stroke subtypes and control subjects and assessed associations with vascular risk factors and white matter hyperintensities.
We recruited 350 patients; 129 lacunar, 124 cortical stroke, and 97 age-matched control subjects. Adjusting for vascular risk factors and white matter hyperintensities, total enlarged perivascular spaces were associated with lacunar stroke subtype (P=0.04) in the acute stroke group (n=253); basal ganglia enlarged perivascular spaces were associated with lacunar stroke subtype (P=0.003), deep (P=0.02) and periventricular white matter hyperintensities (P=0.01); in all 350 subjects, total enlarged perivascular spaces were associated with deep (P |
| doi_str_mv | 10.1161/strokeaha.109.564914 |
| format | article |
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We prospectively recruited patients with acute ischemic lacunar or cortical stroke. Age-matched nonstroke control subjects were also recruited. We rated basal ganglia and centrum semiovale enlarged perivascular spaces 0 to 4 (0=none, 4=>40) on T2-weighted MRI and white matter hyperintensities. We compared enlarged perivascular spaces between stroke subtypes and control subjects and assessed associations with vascular risk factors and white matter hyperintensities.
We recruited 350 patients; 129 lacunar, 124 cortical stroke, and 97 age-matched control subjects. Adjusting for vascular risk factors and white matter hyperintensities, total enlarged perivascular spaces were associated with lacunar stroke subtype (P=0.04) in the acute stroke group (n=253); basal ganglia enlarged perivascular spaces were associated with lacunar stroke subtype (P=0.003), deep (P=0.02) and periventricular white matter hyperintensities (P=0.01); in all 350 subjects, total enlarged perivascular spaces were associated with deep (P<0.001) and periventricular (P<0.001) white matter hyperintensities.
Although prevalent in patients with vascular risk factors and stroke, enlarged perivascular spaces are specifically associated with lacunar ischemic stroke and white matter hyperintensities. Further studies should determine the mechanism of this association while including adequate controls to account for stroke and vascular risk factors. Enlarged perivascular spaces should not be overlooked in studies of small vessel disease.</description><identifier>ISSN: 0039-2499</identifier><identifier>EISSN: 1524-4628</identifier><identifier>DOI: 10.1161/strokeaha.109.564914</identifier><identifier>PMID: 20056930</identifier><identifier>CODEN: SJCCA7</identifier><language>eng</language><publisher>Hagerstown, MD: Lippincott Williams & Wilkins</publisher><subject>Adult ; Aged ; Aged, 80 and over ; Arterioles - pathology ; Arterioles - physiopathology ; Biological and medical sciences ; Brain Infarction - pathology ; Brain Infarction - physiopathology ; Cerebral Ventricles - blood supply ; Cerebral Ventricles - pathology ; Cerebrovascular Disorders - pathology ; Cerebrovascular Disorders - physiopathology ; Female ; Headache. Facial pains. Syncopes. Epilepsia. Intracranial hypertension. Brain oedema. Cerebral palsy ; Humans ; Magnetic Resonance Imaging ; Male ; Medical sciences ; Middle Aged ; Nervous system (semeiology, syndromes) ; Neurology ; Prospective Studies ; Vascular diseases and vascular malformations of the nervous system</subject><ispartof>Stroke (1970), 2010-03, Vol.41 (3), p.450-454</ispartof><rights>2015 INIST-CNRS</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c499t-174e2bb26f8b0ea5ffa7f6747ce75003e65dd00026716f28151f47cf984ed4873</citedby><cites>FETCH-LOGICAL-c499t-174e2bb26f8b0ea5ffa7f6747ce75003e65dd00026716f28151f47cf984ed4873</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=22509820$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/20056930$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>DOUBAL, Fergus N</creatorcontrib><creatorcontrib>MACLULLICH, Alasdair M. J</creatorcontrib><creatorcontrib>FERGUSON, Karen J</creatorcontrib><creatorcontrib>DENNIS, Martin S</creatorcontrib><creatorcontrib>WARDLAW, Joanna M</creatorcontrib><title>Enlarged Perivascular Spaces on MRI Are a Feature of Cerebral Small Vessel Disease</title><title>Stroke (1970)</title><addtitle>Stroke</addtitle><description>Enlarged perivascular spaces in the brain are common but generally overlooked and of uncertain pathophysiology. They may reflect underlying cerebral small vessel disease. We determined whether enlarged perivascular spaces were associated with lacunar stroke subtype and white matter hyperintensities, markers of established small vessel disease.
We prospectively recruited patients with acute ischemic lacunar or cortical stroke. Age-matched nonstroke control subjects were also recruited. We rated basal ganglia and centrum semiovale enlarged perivascular spaces 0 to 4 (0=none, 4=>40) on T2-weighted MRI and white matter hyperintensities. We compared enlarged perivascular spaces between stroke subtypes and control subjects and assessed associations with vascular risk factors and white matter hyperintensities.
We recruited 350 patients; 129 lacunar, 124 cortical stroke, and 97 age-matched control subjects. Adjusting for vascular risk factors and white matter hyperintensities, total enlarged perivascular spaces were associated with lacunar stroke subtype (P=0.04) in the acute stroke group (n=253); basal ganglia enlarged perivascular spaces were associated with lacunar stroke subtype (P=0.003), deep (P=0.02) and periventricular white matter hyperintensities (P=0.01); in all 350 subjects, total enlarged perivascular spaces were associated with deep (P<0.001) and periventricular (P<0.001) white matter hyperintensities.
Although prevalent in patients with vascular risk factors and stroke, enlarged perivascular spaces are specifically associated with lacunar ischemic stroke and white matter hyperintensities. Further studies should determine the mechanism of this association while including adequate controls to account for stroke and vascular risk factors. Enlarged perivascular spaces should not be overlooked in studies of small vessel disease.</description><subject>Adult</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Arterioles - pathology</subject><subject>Arterioles - physiopathology</subject><subject>Biological and medical sciences</subject><subject>Brain Infarction - pathology</subject><subject>Brain Infarction - physiopathology</subject><subject>Cerebral Ventricles - blood supply</subject><subject>Cerebral Ventricles - pathology</subject><subject>Cerebrovascular Disorders - pathology</subject><subject>Cerebrovascular Disorders - physiopathology</subject><subject>Female</subject><subject>Headache. Facial pains. Syncopes. Epilepsia. Intracranial hypertension. Brain oedema. Cerebral palsy</subject><subject>Humans</subject><subject>Magnetic Resonance Imaging</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Nervous system (semeiology, syndromes)</subject><subject>Neurology</subject><subject>Prospective Studies</subject><subject>Vascular diseases and vascular malformations of the nervous system</subject><issn>0039-2499</issn><issn>1524-4628</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2010</creationdate><recordtype>article</recordtype><recordid>eNpFkMtOwzAQRS0EgvL4A4S8QaxSbMd24mVVWkCAitrCNpokYwi4TbEbJP4eoxZYzevMzNUl5JSzPueaX4a1b98RXqHPmekrLQ2XO6THlZCJ1CLfJT3GUpMIacwBOQzhjTEm0lztkwPBmNImZT0yHS0d-Bes6SP65hNC1cWazlZQYaDtkj5Mb-nAIwU6Rlh3MWstHaLH0oOjswU4R58xBHT0qgkIAY_JngUX8GQbj8jTeDQf3iT3k-vb4eA-qaKidcIziaIshbZ5yRCUtZBZncmswkxF5ahVXf9I1hnXVuRccRuH1uQSa5ln6RG52Nxd-fajw7AuFk2o0DlYYtuFIktTrQwzLJJyQ1a-DcGjLVa-WYD_KjgrfswsZvPp5G40uBnEjik2Zsa1s-2Drlxg_bf0614EzrdA9A2c9bCsmvDPCcVMLlj6DXXTfPE</recordid><startdate>20100301</startdate><enddate>20100301</enddate><creator>DOUBAL, Fergus N</creator><creator>MACLULLICH, Alasdair M. J</creator><creator>FERGUSON, Karen J</creator><creator>DENNIS, Martin S</creator><creator>WARDLAW, Joanna M</creator><general>Lippincott Williams & Wilkins</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20100301</creationdate><title>Enlarged Perivascular Spaces on MRI Are a Feature of Cerebral Small Vessel Disease</title><author>DOUBAL, Fergus N ; MACLULLICH, Alasdair M. J ; FERGUSON, Karen J ; DENNIS, Martin S ; WARDLAW, Joanna M</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c499t-174e2bb26f8b0ea5ffa7f6747ce75003e65dd00026716f28151f47cf984ed4873</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2010</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Arterioles - pathology</topic><topic>Arterioles - physiopathology</topic><topic>Biological and medical sciences</topic><topic>Brain Infarction - pathology</topic><topic>Brain Infarction - physiopathology</topic><topic>Cerebral Ventricles - blood supply</topic><topic>Cerebral Ventricles - pathology</topic><topic>Cerebrovascular Disorders - pathology</topic><topic>Cerebrovascular Disorders - physiopathology</topic><topic>Female</topic><topic>Headache. Facial pains. Syncopes. Epilepsia. Intracranial hypertension. Brain oedema. Cerebral palsy</topic><topic>Humans</topic><topic>Magnetic Resonance Imaging</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Nervous system (semeiology, syndromes)</topic><topic>Neurology</topic><topic>Prospective Studies</topic><topic>Vascular diseases and vascular malformations of the nervous system</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>DOUBAL, Fergus N</creatorcontrib><creatorcontrib>MACLULLICH, Alasdair M. J</creatorcontrib><creatorcontrib>FERGUSON, Karen J</creatorcontrib><creatorcontrib>DENNIS, Martin S</creatorcontrib><creatorcontrib>WARDLAW, Joanna M</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Stroke (1970)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>DOUBAL, Fergus N</au><au>MACLULLICH, Alasdair M. J</au><au>FERGUSON, Karen J</au><au>DENNIS, Martin S</au><au>WARDLAW, Joanna M</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Enlarged Perivascular Spaces on MRI Are a Feature of Cerebral Small Vessel Disease</atitle><jtitle>Stroke (1970)</jtitle><addtitle>Stroke</addtitle><date>2010-03-01</date><risdate>2010</risdate><volume>41</volume><issue>3</issue><spage>450</spage><epage>454</epage><pages>450-454</pages><issn>0039-2499</issn><eissn>1524-4628</eissn><coden>SJCCA7</coden><abstract>Enlarged perivascular spaces in the brain are common but generally overlooked and of uncertain pathophysiology. They may reflect underlying cerebral small vessel disease. We determined whether enlarged perivascular spaces were associated with lacunar stroke subtype and white matter hyperintensities, markers of established small vessel disease.
We prospectively recruited patients with acute ischemic lacunar or cortical stroke. Age-matched nonstroke control subjects were also recruited. We rated basal ganglia and centrum semiovale enlarged perivascular spaces 0 to 4 (0=none, 4=>40) on T2-weighted MRI and white matter hyperintensities. We compared enlarged perivascular spaces between stroke subtypes and control subjects and assessed associations with vascular risk factors and white matter hyperintensities.
We recruited 350 patients; 129 lacunar, 124 cortical stroke, and 97 age-matched control subjects. Adjusting for vascular risk factors and white matter hyperintensities, total enlarged perivascular spaces were associated with lacunar stroke subtype (P=0.04) in the acute stroke group (n=253); basal ganglia enlarged perivascular spaces were associated with lacunar stroke subtype (P=0.003), deep (P=0.02) and periventricular white matter hyperintensities (P=0.01); in all 350 subjects, total enlarged perivascular spaces were associated with deep (P<0.001) and periventricular (P<0.001) white matter hyperintensities.
Although prevalent in patients with vascular risk factors and stroke, enlarged perivascular spaces are specifically associated with lacunar ischemic stroke and white matter hyperintensities. Further studies should determine the mechanism of this association while including adequate controls to account for stroke and vascular risk factors. Enlarged perivascular spaces should not be overlooked in studies of small vessel disease.</abstract><cop>Hagerstown, MD</cop><pub>Lippincott Williams & Wilkins</pub><pmid>20056930</pmid><doi>10.1161/strokeaha.109.564914</doi><tpages>5</tpages><oa>free_for_read</oa></addata></record> |
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| ispartof | Stroke (1970), 2010-03, Vol.41 (3), p.450-454 |
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| subjects | Adult Aged Aged, 80 and over Arterioles - pathology Arterioles - physiopathology Biological and medical sciences Brain Infarction - pathology Brain Infarction - physiopathology Cerebral Ventricles - blood supply Cerebral Ventricles - pathology Cerebrovascular Disorders - pathology Cerebrovascular Disorders - physiopathology Female Headache. Facial pains. Syncopes. Epilepsia. Intracranial hypertension. Brain oedema. Cerebral palsy Humans Magnetic Resonance Imaging Male Medical sciences Middle Aged Nervous system (semeiology, syndromes) Neurology Prospective Studies Vascular diseases and vascular malformations of the nervous system |
| title | Enlarged Perivascular Spaces on MRI Are a Feature of Cerebral Small Vessel Disease |
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