Enlarged perivascular spaces in multiple sclerosis on magnetic resonance imaging: a systematic review and meta-analysis

Background Perivascular spaces can become detectable on magnetic resonance imaging (MRI) upon enlargement, referred to as enlarged perivascular spaces (EPVS) or Virchow-Robin spaces. EPVS have been linked to small vessel disease. Some studies have also indicated an association of EPVS to neuroinflam...

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Bibliographic Details
Published in:Journal of neurology 2020-11, Vol.267 (11), p.3199-3212
Main Authors: Granberg, Tobias, Moridi, Thomas, Brand, Judith S., Neumann, Susanne, Hlavica, Martin, Piehl, Fredrik, Ineichen, Benjamin V.
Format: Article
Language:English
Subjects:
Atrophy
Biomarker
Cognitive ability
Enlarged perivascular spaces
Inflammation
Magnetic resonance imaging
Medicine
Medicine & Public Health
Meta-analysis
Multiple sclerosis
Neurodegeneration
Neuroimaging
Neurology
Neuroradiology
Neurosciences
Original Communication
Standardization
Systematic review
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Summary:Background Perivascular spaces can become detectable on magnetic resonance imaging (MRI) upon enlargement, referred to as enlarged perivascular spaces (EPVS) or Virchow-Robin spaces. EPVS have been linked to small vessel disease. Some studies have also indicated an association of EPVS to neuroinflammation and/or neurodegeneration. However, there is conflicting evidence with regards to their potential as a clinically relevant imaging biomarker in multiple sclerosis (MS). Methods To perform a systematic review and meta-analysis of EPVS as visualized by MRI in MS. Nine out of 299 original studies addressing EPVS in humans using MRI were eligible for the systematic review and meta-analysis including a total of 457 MS patients and 352 control subjects. Results In MS, EPVS have been associated with cognitive decline, contrast-enhancing MRI lesions, and brain atrophy. Yet, these associations were not consistent between studies. The meta-analysis revealed that MS patients have greater EPVS prevalence (odds ratio = 4.61, 95% CI = [1.84; 11.60], p  = 0.001) as well as higher EPVS counts (standardized mean difference [SMD] = 0.46, 95% CI = [0.26; 0.67], p  
ISSN:0340-5354
1432-1459
1432-1459
DOI:10.1007/s00415-020-09971-5