Abstract
Background and aims: The pathophysiology of hippocampal enlarged perivascular spaces (H-EPVS) and its relationship to cognitive impairment is largely unknown. This study aimed to investigate the relationship between H-EPVS and cognition in non-dementic elderly population.Methods: A total of 109 subjects were prospectively enrolled. The eligibilities for inclusion were age from 55 to 85 years and Mini-Mental Status Examination score of ≥26. The Alzheimer's Disease Assessment Scale-Cognitive Subscale (ADAS-Cog), Montreal Cognitive Assessment, transcranial Doppler (TCD), and brain magnetic resonance imaging results were evaluated. H-EPVS was categorized in a three-degree scale: degree 0 (no), degree 1 (1,2), and degree 2 (>2). The associations between H-EPVS and TCD parameters/cognitive test profiles were analyzed.Results: The mean age was 65.2 years, and 52.3% subjects were men. H-EPVS was found to be associated with age (degree 2 vs. degree 1 vs. degree 0, 69.20 ± 6.93 vs. 65.70 ± 5.75 vs. 63.80 ± 5.43; p = 0.030) and ADAS-Cog memory score (degree 2 vs. degree 1 vs. degree 0, 14.88 ± 4.27 vs. 12.49 ± 4.56 vs. 11.4 ± 4.23; p = 0.037). However, the pulsatility index was not related to the degree of H-EPVS. Multivariate analysis revealed medial temporal atrophy (MTA) scale score was independently associated with ADAS-Cog memory score (MTA scale sum ≥4, p = 0.011) but not with the degree of H-EPVS. MTA scale score showed correlation with H-EPVS (r = 0.273, p = 0.004).Conclusions: Aging was associated with the development of H-EPVS in non-dementic elderly population. Memory function was found to be associated with MTA but not with the degree of H-EPVS.
Highlights
The majority of patients who developed dementia had a smaller baseline hippocampal volume before their clinical diagnosis than individuals who remained free from dementia [1]
After we found that ADAS-Cog memory score was related to the degree of hippocampal enlarged perivascular spaces (H-EPVS), degree 2, we divided subjects into two groups by ADAS-Cog memory to study the risk factors associated with memory cognitive function
We showed the correlation of memory cognitive function and H-EPVS count, medial temporal atrophy (MTA) scale sum score and hippocampal total volume (Figure 3)
Summary
The majority of patients who developed dementia had a smaller baseline hippocampal volume before their clinical diagnosis than individuals who remained free from dementia [1]. Various radiological terminologies have been previously used for this feature [2, 3]. It has been called an enlarged perivascular space [4,5,6]. The prevalence of hippocampal enlarged perivascular spaces (H-EPVS) seems to about more than half in healthy elderly populations [2,3,4]. The risk factors of H-EPVS, their radiological relevance, and their impact on cognitive performance remain under-investigated until now. The pathophysiology of hippocampal enlarged perivascular spaces (H-EPVS) and its relationship to cognitive impairment is largely unknown. This study aimed to investigate the relationship between H-EPVS and cognition in non-dementic elderly population
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