Enlarged perivascular spaces in the basal ganglia are associated with arteries not veins

Jan Oltmer, Hendrik Mattern, Julia Beck, Renat Yakupov, Steven M. Greenberg, Jaco J.M. Zwanenburg, Tine Arts, Emrah Düzel, Susanne J. van Veluw, Stefanie Schreiber, Valentina Perosa*

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

Abstract

Enlarged perivascular spaces (EPVS) are common in cerebral small vessel disease (CSVD) and have been identified as a marker of dysfunctional brain clearance. However, it remains unknown if the enlargement occurs predominantly around arteries or veins. We combined in vivo ultra-high-resolution MRI and histopathology to investigate the spatial relationship of veins and arteries with EPVS within the basal ganglia (BG). Furthermore, we assessed the relationship between the EPVS and measures of blood-flow (blood-flow velocity, pulsatility index) in the small arteries of the BG. Twenty-four healthy controls, twelve non-CAA CSVD patients, and five probable CAA patients underwent a 3 tesla [T] and 7T MRI-scan, and EPVS, arteries, and veins within the BG were manually segmented. Furthermore, the scans were co-registered. Six autopsy-cases were also assessed. In the BG, EPVS were significantly closer to and overlapped more frequently with arteries than with veins. Histological analysis showed a higher proportion of BG EPVS surrounding arteries than veins. Finally, the pulsatility index of BG arteries correlated with EPVS volume. Our results are in line with previous works and establish a pathophysiological relationship between arteries and EPVS, contributing to elucidating perivascular clearance routes in the human brain.

Original languageEnglish
Pages (from-to)1362-1377
Number of pages16
JournalJournal of Cerebral Blood Flow and Metabolism
Volume44
Issue number11
Early online date11 Jun 2024
DOIs
Publication statusPublished - Nov 2024

Keywords

  • 7T MRI
  • cerebral small vessel disease
  • histopathology
  • hypertensive arteriopathy
  • perivascular clearance

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