Perivascular Space Disease May Increase Dementia Risk

According to a new study published in Neurology, enlarged perivascular spaces in the brain may be associated with a higher likelihood of develop cognitive problems and dementia over time. 

During the study, participants with the largest number of enlarged perivascular spaces in basal ganglia (BG) and centrum semiovale (CSO) of the brain were nearly 3 times more likely to develop dementia than participants with fewer or no enlarged spaces. The results persisted after adjustments for age, high blood pressure, and diabetes. During the study, a total of 97 of 414 participants (24%) were diagnosed with dementia. Of the 31 participants with severe perivascular disease in the BG and CSO, 12 participants (39%) were diagnosed with dementia. These participants were also more likely to have greater cognitive decline 4 years later. 
      
“Severe perivascular space disease may be a marker for an increased risk of cognitive decline and dementia,” said study author Matthew Paradise, MBChB, MSc, of the University of New South Wales in Sydney, Australia. “More research is needed to understand how these enlarged spaces develop, as they could be an important potential biomarker to help with early diagnosis of dementia.” 

Participants were assessed for dementia at the beginning of the study and every 2 years for 8 years, and had brain MRI to check for enlarged perivascular with the same frequency. The top quarter of the people with the largest number of enlarged perivascular spaces, designated as severe cases, were compared to those with fewer or no enlarged spaces. 
      
“These results suggest that there is an independent mechanism for the perivascular spaces as a biomarker of cognitive impairment and dementia apart from being a general marker of disease in the small vessels,” Paradise said. “For example, enlarged perivascular spaces may be a biomarker of impaired waste clearance in the brain.”