Neurology: Gaps around blood vessels are an independent risk factor for dementia

The gap around blood vessels (PVS) is the fluid space that surrounds small blood vessels in the brain.
growing evidence that MRI visible dilation of PVS is associated with small vascular disease (SVD) and neurodegenerative lesions.
very few longitudinal studies have examined the relationship between PVS and new dementia, and a review has reported results associated with Alzheimer's disease (AD) or all-cause dementia, but they are ambiguous.
have different studies on the association between PVS and cognitive impairment; there is stronger evidence of a link between PVS and longitudinal cognitive impairment.
PVS is commonly found in substrate sections (BGs) and half-egg circles (CSOs).
this may represent at least some different pathophysiology, BG PVS is associated with more hypertension-related pathology, CSO PVS is associated with amyloid pathology, and ultimately, the incidence of AD is higher.
these areas may also be associated with damage in different cognitive areas, caused by damage to specific cognitive networks and/or due to underlying pathology.
Matthew Paradise of the University of New South Wales, Australia, et al., based on data from a forward-looking cohort study, looked at whether severe VASCULAR space (PVS) expansion was associated with longitudinal cognitive decline and dementia events over a four- and eight-year period, respectively, and baselined 414 community residents aged 72-92 and conducted an eight-year assessment every two years, including cognitive assessment, consensus dementia diagnosis and 3T MRI imaging.
the number of PVS in two representative slices of the substrate section (BG) and half ovary (CSO) and define severe PVS pathology as the first quarter.
and studied the effects of severe PVS pathology in either region of i), ii) two regions, and iii) severe BG PVS and iv) severe CSO PVS effects.
, the volume of high whiteness signal lesions, the number of micro-bleeding in the brain and the number of fissures were finally counted.
results showed that participants with severe PVS pathology, who had severe PVS pathology in two regions or only CSO, had a significant decline in global cognitive ability over a four-year period, even after adjusting for neuroimaging markers of other small vascular diseases.
the presence of severe PVS pathology in both regions is an independent predictive factor for dementia within 8 years (OR 2.91,95% CI 1.43-5.95, p=0.003).
addition, the presence of severe PVS pathology in all subject groups was associated with a greater risk of dementia in the fourth or sixth year.
importance of this study is the discovery that severe PVS pathology is a serious risk of dementia.
severe PVS pathology is a sign of cognitive decline and an increased risk of dementia, independent of other small vascular disease markers.
cognitive changes caused by BG and CSO PVS may represent potential pathological differences.
originals; The Association of Dilate Perivascular Spaces with Cognitive Decline and Dementia; Matthew Paradise, John D Crawford, et al. Neurology Jan 2021, 10.1212/WNL.0000000000011537; DOI: 10.1212/WNL.0000000000011537 Freeman Source: MedSci Original Copyright Notice: All noted on this website "Source: Met Medical" or "Source: MedSci Original" text, images and audio and video materials, copyrights are owned by Metz Medical, without authorization, no media, website or individual may reproduce, authorized to reproduce with the words "Source: Mets Medicine".
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