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2017 ; 38
(5
): 862-867
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Brain Perivascular Spaces as Biomarkers of Vascular Risk: Results from the
Northern Manhattan Study
#MMPMID28341719
Gutierrez J
; Elkind MSV
; Dong C
; Di Tullio M
; Rundek T
; Sacco RL
; Wright CB
AJNR Am J Neuroradiol
2017[May]; 38
(5
): 862-867
PMID28341719
show ga
BACKGROUND AND PURPOSE: Dilated perivascular spaces in the brain are associated
with greater arterial pulsatility. We hypothesized that perivascular spaces
identify individuals at higher risk for systemic and cerebral vascular events.
MATERIALS AND METHODS: Stroke-free participants in the population-based Northern
Manhattan Study had brain MR imaging performed and were followed for myocardial
infarction, any stroke, and death. Imaging analyses distinguished perivascular
spaces from lesions presumably ischemic. Perivascular spaces were further
subdivided into lesions with diameters of ?3 mm (small perivascular spaces) and
>3 mm (large perivascular spaces). We calculated relative rates of events with
Poisson models and hazard ratios with Cox proportional models. RESULTS: The
Northern Manhattan Study participants who had MR imaging data available for
review (n = 1228; 59% women, 65% Hispanic; mean age, 71 ± 9 years) were followed
for an average of 9 ± 2 years. Participants in the highest tertile of the small
perivascular space score had a higher relative rate of all deaths (relative rate,
1.38; 95% CI, 1.01-1.91), vascular death (relative rate, 1.87; 95% CI,
1.12-3.14), myocardial infarction (relative rate, 2.08; 95% CI, 1.01-4.31), any
stroke (relative rate, 1.79; 95% CI, 1.03-3.11), and any vascular event (relative
rate, 1.74; 95% CI, 1.18-2.56). After we adjusted for confounders, there was a
higher risk of vascular death (hazard ratio, 1.06; 95% CI, 1.01-1.11), myocardial
infarction (hazard ratio, 2.22; 95% CI, 1.12-4.42), and any vascular event
(hazard ratio, 1.04; 95% CI, 1.01-1.08) with higher small perivascular space
scores. CONCLUSIONS: In this multiethnic, population-based study, participants
with a high burden of small perivascular spaces had increased risk of vascular
events. By gaining pathophysiologic insight into the mechanism of perivascular
space dilation, we may be able to propose novel therapies to better prevent
vascular disorders in the population.
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