Abstract
The association of perivascular spaces in the centrum semiovale with amyloid accumulation among patients with Alzheimer disease-related cognitive impairment is unknown. We evaluated this association in patients with Alzheimer disease-related cognitive impairment and β-amyloid deposition, assessed with [18F] florbetaben PET/CT. MR imaging and [18F] florbetaben PET/CT images of 144 patients with Alzheimer disease-related cognitive impairment were retrospectively evaluated. MR imaging-visible perivascular spaces were rated on a 4-point visual scale: a score of ≥3 or <3 indicated a high or low degree of MR imaging-visible perivascular spaces, respectively. Amyloid deposition was evaluated using the brain β-amyloid plaque load scoring system. Compared with patients negative for β-amyloid, those positive for it were older and more likely to have lower cognitive function, a diagnosis of Alzheimer disease, white matter hyperintensity, the Apolipoprotein E ε4 allele, and a high degree of MR imaging-visible perivascular spaces in the centrum semiovale. Multivariable analysis, adjusted for age and Apolipoprotein E status, revealed that a high degree of MR imaging-visible perivascular spaces in the centrum semiovale was independently associated with β-amyloid positivity (odds ratio, 2.307; 95% CI, 1.036-5.136; P = .041). A high degree of MR imaging-visible perivascular spaces in the centrum semiovale independently predicted β-amyloid positivity in patients with Alzheimer disease-related cognitive impairment. Thus, MR imaging-visible perivascular spaces in the centrum semiovale are associated with amyloid pathology of the brain and could be an indirect imaging marker of amyloid burden in patients with Alzheimer disease-related cognitive impairment.
Highlights
BACKGROUND AND PURPOSEThe association of perivascular spaces in the centrum semiovale with amyloid accumulation among patients with Alzheimer disease–related cognitive impairment is unknown
MR imaging–visible perivascular spaces in the centrum semiovale are associated with amyloid pathology of the brain and could be an indirect imaging marker of amyloid burden in patients with Alzheimer disease–related cognitive impairment
Several clinical conditions that reduce the clearance of solutes from the brain interstitial fluid such as aging, hypertension, and inflammation can result in MR imaging–visible perivascular spaces (PVS).[5]
Summary
MR imaging and [18F] florbetaben PET/CT images of 144 patients with Alzheimer disease–related cognitive impairment were retrospectively evaluated. Amyloid deposition was evaluated using the brain b -amyloid plaque load scoring system. Data were reviewed from 153 consecutive patients with cognitive impairment and clinical indications of AD-related cognitive impairment (ADCI). 144 patients with ADCI were included in the analysis; among them, 66 patients had probable AD and 78 had mild cognitive impairment. The criteria for probable AD, proposed by the National Institutes of Neurological and Disorders and Stroke and by the Alzheimer’s Disease and Related Disorders Association[23], and the Petersen criteria,[24] were used for the clinical diagnosis of mild cognitive impairment
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