Factors associated with the location of perivascular space enlargement in middle-aged individuals undergoing brain screening in Japan

Tomohiro Yamasaki; Fusao Ikawa; Nao Ichihara; Toshikazu Hidaka; Shingo Matsuda; Iori Ozono; Masaaki Chiku; Naoyuki Kitamura; Tomoaki Hamano; Nobutaka Horie; Yasuhiko Akiyama; Shuhei Yamaguchi; Hidekazu Tomimoto; Michiyasu Suzuki

doi:10.1016/j.clineuro.2022.107497

Factors associated with the location of perivascular space enlargement in middle-aged individuals undergoing brain screening in Japan

Clin Neurol Neurosurg. 2022 Dec:223:107497. doi: 10.1016/j.clineuro.2022.107497. Epub 2022 Nov 2.

Authors

Affiliations

¹ Department of Neurosurgery, Shimane University Faculty of Medicine, Shimane, Japan. Electronic address: ty597@med.shimane-u.ac.jp.
² Department of Neurosurgery, Shimane Prefectural Central Hospital, Shimane, Japan; Department of Neurosurgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan. Electronic address: fikawa-nsu@umin.ac.jp.
³ Department of Healthcare Quality Assessment, University of Tokyo, Tokyo, Japan. Electronic address: nao-i@keio.jp.
⁴ Department of Neurosurgery, Shimane Prefectural Central Hospital, Shimane, Japan. Electronic address: hidaka@spch.izumo.shimane.jp.
⁵ Department of Neurosurgery, Shimane Prefectural Central Hospital, Shimane, Japan. Electronic address: 1108shingo@gmail.com.
⁶ Department of Neurosurgery, Shimane Prefectural Central Hospital, Shimane, Japan. Electronic address: i.ozono0517@gmail.com.
⁷ Department of Cardiovascular medicine, Medical Check Studio Tokyo Ginza Clinic, Tokyo, Japan. Electronic address: chiku@medicalcheckstudio.jp.
⁸ Department of Diagnostic Radiology, Kasumi Clinic, Hiroshima, Japan. Electronic address: kitamura@mnes.org.
⁹ SmartScan, Inc, Japan. Electronic address: tomoaki.hamano@smartscan.co.jp.
¹⁰ Department of Neurosurgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan. Electronic address: nobstanford@gmail.com.
¹¹ Department of Neurosurgery, Shimane University Faculty of Medicine, Shimane, Japan. Electronic address: yakiyama@med.shimane-u.ac.jp.
¹² Hospital Bureau of Shimane Prefectural Central Hospital, Shimane, Japan. Electronic address: yamagu3n@med.shimane-u.ac.jp.
¹³ Department of Neurology, Mie University Graduate School of Medicine Faculty of Medicine, Mie, Japan. Electronic address: tomimoto@clin.medic.mie-u.ac.jp.
¹⁴ Department of Advanced ThermoNeuroBiology, Yamaguchi University School of Medicine, Yamaguchi, Japan. Electronic address: michi@yamaguchi-u.ac.jp.

PMID: 36356441
DOI: 10.1016/j.clineuro.2022.107497

Abstract

Objective: In elderly populations, the enlargement of the perivascular space is related to small vessel disease and the glymphatic system. Enlarged perivascular spaces (EPVS) in the basal ganglia (EPVS-BG) and EPVS in the centrum semiovale (EPVS-CSO) are associated with different pathophysiological processes. However, the prevalence of EPVS and the factors associated with EPVS location in healthy middle-aged individuals are still unclear. We aimed to determine the prevalence of EPVS and the factors associated with EPVS location among healthy individuals in their 40 s METHODS: This study included 5000 consecutive healthy individuals who underwent screening for brain diseases in Japan from August to December 2018. Of them, the data of individuals in their 40 s were extracted and analyzed. The associations of age, sex, body mass index, smoking and drinking history, and medical history with EPVS location were investigated. Similar analyses were performed for the other age groups. A literature review on the factors associated with EPVS location was also performed.

Results: A total of 1720 individuals in their 40 s were finally included. The prevalence of EPVS-BG and EPVS-CSO was 7.7% and 9.2%, respectively. Age (years), smoking history, and hypertension were associated with EPVS-BG; none of the studied factors were found to be associated with EPVS-CSO. In the elderly, the factors previously reported to be associated with EPVS-BG included atherosclerosis change, while the factors associated with EPVS-CSO were cerebral amyloid angiopathy-related formation.

Conclusion: Both EPVS-BG and EPVS-CSO occurred among healthy individuals in their 40 s, but they did so rarely, and less prevalently than in older age groups. EPVS-BG and EPVS-CSO may represent early imaging signs of the atherosclerotic and cerebral amyloid angiopathy processes, respectively.

Data availability: The anonymized data for this study will be shared upon any qualified investigator's request to the corresponding author. Primary data from this study will be made available upon reasonable request in accordance with the review board of the research institute.

Keywords: Cognitive disorders; Epidemiology risk factors; Magnetic resonance imaging; Perivascular space enlargement; Prevalence studies.

Publication types

Review

MeSH terms

Aged
Basal Ganglia
Cerebral Amyloid Angiopathy* / complications
Cerebral Small Vessel Diseases* / complications
Cerebral Small Vessel Diseases* / diagnostic imaging
Cerebral Small Vessel Diseases* / epidemiology
Glymphatic System* / diagnostic imaging
Humans
Japan / epidemiology
Magnetic Resonance Imaging
Middle Aged