Abstract
Background and Purpose: To compare the risk factors and risk of stroke between lacune and large perivascular spaces (PVSs) in a community-based sample. Methods: Large PVSs were assessed using 3.0T MRI in a population-based cohort consisting of 1,204 participants. The relationship between cardiovascular risk factors, neuroimaging changes, and incidental stroke risk and the presence of lacune or large PVSs was assessed with univariate and multivariable ordinal logistic regression analysis. Results: Of the 1,204 study participants (55.7 ± 9.3 years, 37.0% men), a total of 347 large PVSs were detected in 235 (19.5%) subjects, while a total of 219 lacunes were detected in 183 subjects (15.2%). The presence of lacunes was found to be significantly associated with age, male gender, hypertension, and diabetes, whereas only age (p < 0.01) and ApoEε4 carrier status (p < 0.01) were related to the presence of large PVSs. Those who had lacunes detected on MRI at baseline had a significant increased risk of stroke (hazard ratio [HR] 4.68; 95% confidence interval [CI], 1.15–19.07) during the 3-year follow-up independent of age, gender, and other vascular risk factors. However, there was no significant relationship between the presence of large PVSs and incident stroke (HR 3.84; 95% CI, 0.82–18.04). Conclusions: The lack of association between large PVSs and cardiovascular risk factors or risk of stroke indicated a nonvascular pathogenic mechanism underlying large PVSs, suggesting the importance of distinguishing large PVSs from lacunes in clinical practice.
Journal Section:
Clinical Research in Stroke
References
1.
Zhu
YC
, Tzourio
C
, Soumaré
A
, Mazoyer
B
, Dufouil
C
, Chabriat
H
. Severity of dilated Virchow-Robin spaces is associated with age, blood pressure, and MRI markers of small vessel disease: a population-based study
. Stroke
. 2010 Nov
;41
(11
):2483
–90
.2.
Takao
M
, Koto
A
, Tanahashi
N
, Fukuuchi
Y
, Takagi
M
, Morinaga
S
. Pathologic findings of silent, small hyperintense foci in the basal ganglia and thalamus on MRI
. Neurology
. 1999 Feb
;52
(3
):666
–8
..3.
Zhu
YC
, Dufouil
C
, Mazoyer
B
, Soumaré
A
, Ricolfi
F
, Tzourio
C
, et al. Frequency and location of dilated Virchow-Robin spaces in elderly people: a population-based 3D MR imaging study
. AJNR Am J Neuroradiol
. 2011 Apr
;32
(4
):709
–13
.4.
Wardlaw
JM
, Smith
EE
, Biessels
GJ
, Cordonnier
C
, Fazekas
F
, Frayne
R
, et al. Neuroimaging standards for research into small vessel disease and its contribution to ageing and neurodegeneration
. Lancet Neurol
. 2013 Aug
;12
(8
):822
–38
.5.
Ding
J
, Sigurðsson
S
, Jónsson
PV
, Eiriksdottir
G
, Charidimou
A
, Lopez
OL
, et al. Large perivascular spaces visible on magnetic resonance imaging, cerebral small vessel disease progression, and risk of dementia: the age, gene/environment susceptibility-Reykjavik study
. JAMA Neurol
. 2017 Sep 1
;74
(9
):1105
–12
.6.
McMurtray
AM
, Liao
A
, Haider
J
, Licht
E
, Mendez
MF
. Cognitive performance after lacunar stroke correlates with leukoaraiosis severity
. Cerebrovasc Dis
. 2007
;24
(2–3
):271
–6
.7.
Vermeer
SE
, Longstreth
WT
Jr, Koudstaal
PJ
. Silent brain infarcts: a systematic review
. Lancet Neurol
. 2007 Jul
;6
(7
):611
–9
.8.
Thong
JY
, Hilal
S
, Wang
Y
, Soon
HW
, Dong
Y
, Collinson
SL
, et al. Association of silent lacunar infarct with brain atrophy and cognitive impairment
. J Neurol Neurosurg Psychiatry
. 2013 Nov
;84
(11
):1219
–25
.9.
Su
N
, Zhai
FF
, Zhou
LX
, Ni
J
, Yao
M
, Li
ML
, et al. Cerebral small vessel disease burden is associated with motor performance of lower and upper extremities in community-dwelling populations
. Front Aging Neurosci
. 2017
;9
:313
.10.
Gutierrez
J
, Rundek
T
, Ekind
MS
, Sacco
RL
, Wright
CB
. Perivascular spaces are associated with atherosclerosis: an insight from the Northern Manhattan study
. AJNR Am J Neuroradiol
. 2013 Sep
;34
(9
):1711
–6
.11.
Yao
M
, Hervé
D
, Jouvent
E
, Duering
M
, Reyes
S
, Godin
O
, et al. Dilated perivascular spaces in small-vessel disease: a study in CADASIL
. Cerebrovasc Dis
. 2014
;37
(3
):155
–63
.12.
Bouvy
WH
, Zwanenburg
JJ
, Reinink
R
, Wisse
LE
, Luijten
PR
, Kappelle
LJ
, et al. Perivascular spaces on 7 Tesla brain MRI are related to markers of small vessel disease but not to age or cardiovascular risk factors
. J Cereb Blood Flow Metab
. 2016 Oct
;36
(10
):1708
–17
.13.
Amarenco
P
, Bogousslavsky
J
, Caplan
LR
, Donnan
GA
, Hennerici
MG
. Classification of stroke subtypes
. Cerebrovasc Dis
. 2009
;27
(5
):493
–501
.14.
Gutierrez
J
, Elkind
MSV
, Dong
C
, Di Tullio
M
, Rundek
T
, Sacco
RL
, et al. Brain perivascular spaces as biomarkers of vascular risk: results from the Northern Manhattan study
. AJNR Am J Neuroradiol
. 2017 May
;38
(5
):862
–7
.15.
Zhai
FF
, Yan
S
, Li
ML
, Han
F
, Wang
Q
, Zhou
LX
, et al. Intracranial arterial dolichoectasia and stenosis: risk factors and relation to cerebral small vessel disease
. Stroke
. 2018 May
;49
(5
):1135
–40
.16.
Samuels
OB
, Joseph
GJ
, Lynn
MJ
, Smith
HA
, Chimowitz
MI
. A standardized method for measuring intracranial arterial stenosis
. AJNR Am J Neuroradiol
. 2000 Apr
;21
(4
):643
–6
..17.
Bokura
H
, Kobayashi
S
, Yamaguchi
S
. Distinguishing silent lacunar infarction from enlarged Virchow-Robin spaces: a magnetic resonance imaging and pathological study
. J Neurol
. 1998 Feb
;245
(2
):116
–22
.18.
Banerjee
G
, Kim
HJ
, Fox
Z
, Jäger
HR
, Wilson
D
, Charidimou
A
, et al. MRI-visible perivascular space location is associated with Alzheimer’s disease independently of amyloid burden
. Brain
. 2017 Apr 1
;140
(4
):1107
–16
.19.
Laveskog
A
, Wang
R
, Bronge
L
, Wahlund
LO
, Qiu
C
. Perivascular spaces in old age: assessment, distribution, and correlation with white matter hyperintensities
. AJNR Am J Neuroradiol
. 2018 Jan
;39
(1
):70
–6
.20.
van Swieten
JC
, van den Hout
JH
, van Ketel
BA
, Hijdra
A
, Wokke
JH
, van Gijn
J
. Periventricular lesions in the white matter on magnetic resonance imaging in the elderly. A morphometric correlation with arteriolosclerosis and dilated perivascular spaces
. Brain
. 1991 Apr
;114
(Pt 2
):761
–74
.21.
Homeyer
P
, Cornu
P
, Lacomblez
L
, Chiras
J
, Derouesné
C
. A special form of cerebral lacunae: expanding lacunae
. J Neurol Neurosurg Psychiatry
. 1996 Aug
;61
(2
):200
–2
.22.
Chen
X
, Wen
W
, Anstey
KJ
, Sachdev
PS
. Prevalence, incidence, and risk factors of lacunar infarcts in a community sample
. Neurology
. 2009 Jul 28
;73
(4
):266
–72
.23.
Debette
S
, Beiser
A
, DeCarli
C
, Au
R
, Himali
JJ
, Kelly-Hayes
M
, et al. Association of MRI markers of vascular brain injury with incident stroke, mild cognitive impairment, dementia, and mortality: the Framingham offspring study
. Stroke
. 2010 Apr
;41
(4
):600
–6
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