Objective: To evaluate the whether regional burden of enlarged perivascular space (EPVS) hold prognostic value in predicting the dementia conversion in Parkinson’s disease (PD).

Background: With accumulating experimental studies supporting that compromised perivascular clearance of α-synuclein could exacerbate abnormal α-synuclein aggregation, MRI-visible EPVS is increasingly recognized as a important imaging marker in PD. Recent evidence indicates that EPVS located in different anatomical regions may reflect diverse etiological backgrounds and have differential effects on the clinical manifestations of PD. Nevertheless, the predictive value of EPVS in specific anatomical regions for the development of PD dementia remains uncertain.

Method: In 413 drug-naive PD patients without dementia who underwent brain MRI, dopamine transporter (DAT) imaging, and neuropsychological battery at baseline, regional EPVS burden was visually rated on T2-weighted images in following locations: EPVS located in the temporal lobe (T-EPVS), centrum semiovale (CS-EPVS), and basal ganglia (BG-EPVS). Multivariate Cox regression model incorporating dichotomized regional EPVS burden in three anatomical regions, brain atrophy, DAT availability, and small vessel disease imaging markers other than EPVS was constructed to identify the potential risk factors of developing PD dementia.

Results: During the median follow-up period of 63.3 months, 74 patients (17.9%) developed PD dementia. In the multivariate Cox regression model, high-degree T-EPVS (hazard ratio [HR]: 1.866; 95% confidence interval [CI]: 1.022-3.405) was identified as a significant independent factor associated increased risk of PD dementia development, along with older age (HR: 1.050; 95% CI: 1.000-1.102), education years (HR: 0.948; 95% CI: 0.900-0.999), lower DAT availability in the caudate nucleus (HR: 0.619; 95% CI: 0.409-0.938) and smaller basal ganglia volume (HR: 0.053; 95% CI: 0.006-0.431) at baseline. Although high-degree BG-EPVS was significant associated with higher risk of PD dementia in the univariate model (HR: 2.525; 95% CI: 1.521-4.192), BG-EPVS was no longer significant in the subsequent multivariate model (HR: 0.943; 95% CI: 0.520-1.711).

Conclusion: Our findings suggest that increased burden of T-EPVS in newly diagnosed PD patient may be associated with increased risk of dementia conversion.

« Back to 2024 International Congress

MDS Abstracts - https://www.mdsabstracts.org/abstract/enlarged-perivascular-spaces-in-the-temporal-lobe-as-a-predictor-for-incident-dementia-in-parkinsons-disease/