Abstract WP226: Topography of Dilated Perivascular Spaces in Patients with Markers of Cerebral Amyloid Angiopathy and Hypertensive Vasculopathy

Abstract

Objectives: To investigate whether the topography of dilated perivascular spaces (DPVS) corresponds with markers of particular small vessel diseases such as cerebral amyloid angiopathy (CAA) and hypertensive vasculopathy. Methods: Patients were recruited from an ongoing single-center prospective longitudinal cohort study of patients evaluated in a memory clinic. All patients underwent structural, high-resolution MRI, and had a clinical assessment performed within 1 year of scan. DPVS were rated in basal ganglia (BG-DPVS) and white matter (WM-DPVS) on T1 sequences, using an established 4-point semi-quantitative score. DPVS degree was classified as high (score >2) or low (score ≤ 2). Independent risk factors for high degree of BG-DPVS and WM-DPVS were investigated. Results: Eighty-nine patients were included (mean age 72.7 ± 9.9 years, 57% female). High degree of WM-DPVS was more frequent than low degree in patients with presence of strictly lobar MB (45.5% versus 28.4% of subjects). High BG-DPVS degree was associated with older age, hypertension, and higher WMH volumes. In multivariate analysis increased lobar MB count was an independent predictor of high degree of WM-DPVS [OR 1.53 (95% CI 1.06-2.21), p=0.02]. By contrast, hypertension was an independent predictor of high degree of BG-DPVS [OR 9.4 (95% (CI 1-85.2), p=0.04]. Conclusions: The associations of WM-DPVS with lobar MB and BG-DPVS with hypertension raise the possibility that the distribution of DPVS may indicate the presence of underlying small vessel diseases such as CAA and HV, in patients with cognitive impairment.