Enlarged perivascular space burden predicts declines in cognitive and functional performance

Abstract

Introduction: We evaluated the relationship between baseline enlarged perivascular space (ePVS) burden and later cognitive decline.

Methods: 83 community-dwelling, older adults (aged 56-86) completed three annual cognitive assessments that included the Clinical Dementia Rating (CDR®) Dementia Staging Instrument Sum of Boxes (CDR-SB) and composite measures of executive function and episodic memory. An MRI scan at baseline was used to count ePVS in the basal ganglia and centrum semiovale. Mixed effects models were run with ePVS as the predictor variable and cognitive measures as the dependent variable. Covariates included age, sex, education, cerebral small vessel disease (cSVD) risk factors, and cSVD neuroimaging biomarkers.

Results: At baseline, high basal ganglia ePVS counts were associated with lower executive function scores and episodic memory scores. Moreover, baseline basal ganglia ePVS predicted worse longitudinal CDR-SB scores over the study period.

Discussion: Basal ganglia ePVS burden is a promising biomarker for cSVD-related cognitive and functional decline.

Keywords: Cerebral small vessel disease; Clinical dementia rating (CDR®) dementia staging instrument; Enlarged perivascular spaces; Magnetic resonance imaging; Neuroimaging biomarkers.