The Study On The Distribution Characteristics Of Enlarged Perivascular Spaces In Alzheimer’s Disease And Parkinson’s Disease

Objective: To explore the distribution characteristics of the enlarged perivascular spaces(EPVS)in the patients with Alzheimer’s disease(AD),Parkinson’s disease(PD)and high blood pressure(HBP),to discuss its clinical significances,and to deepen the understanding of the this common clinical cerebrovascular disease imaging.Methods: 100 patients with AD,PD,respectively,as well as 100 healthy people and 100 HBP patients whose age and gender are matching and without above diseases were recruited,from January 2012 to December 2018,in the neurology department of Shengjing Hospital Affiliated to China Medical University.All the subjects underwent3.0T head MRI.By observing the T2 WI and FLAIR images of the Centrum semiovale(CSO),basal ganglia(BG)and hippocampus(HC),we analyzed the number and distribution characteristics of EPVS in the four groups and analyzed the relationship between the EPVS number and age,as well as the relationship between MMSE score and EPVS number in AD group.Results: The average age of AD,HBP,PD and normal control group were 66.7,66.3,66.9 and 65.8 years old respectively,and the male proportion was 39%,38%,39% and38% respectively,without significant difference.The anatomical distributions of the CSO-EPVS and BG-EPVS in the four groups were different(P < 0.001).The number of EPVS in AD,HBP and PD groups was significantly higher than that in normal control group(P<0.001).The number of EPVS in AD group was significantly higher than that in other three groups(the means are:AD=11.23,HBP=8.97,PD=7.88,N=3.00,successively),suggesting that EPVS in CSO was more common in AD group.The number of EPVS in HBP group was significantly higher than that in other three groups(the means are:HBP=7.21,PD=5.85,AD=4.87,N=2.95,successively),suggesting that EPVS in BG was more common in HBP group.In hippocampus,the number of EPVS in AD,HBP and PD groups was higher than that in the normal control group,but there was no significant difference between three groups.The percentage of CSO-EPVS in AD group was significantly higher than that in the other three groups(the mean of percentage are:AD=69.41%,HBP=54.75%,PD=57.49%,N=46.35%,successively),the difference between AD and HBP group is statistically significant.Combined with the above data,the distribution of EPVS in AD group was mainly in CSO,with more significant difference.In AD,HBP and PD groups,the number of CSO-EPVS and BG-EPVS as well as the sum of EPVS in the two regions were positively correlated with age(P < 0.01).While there was no correlation in normal control group.In AD group,the number of CSO-EPVS and MMSE scores show a weak negative correlation(rs=-0.251,P<0.05),while there was no correlation between them in BG.So it was speculated that EPVS extent in CSO might be more closely associated to the cognitive function.Conclusion:1.The distribution characteristics of the EPVS caused by different pathological basis are different in distinct parts of the brain: the distribution of EPVS in AD group is mainly in CSO,that in HBP group is mainly in basal ganglia,and in PD group it did not show the difference of brain interval distribution.2.The number of EPVS in AD,HBP and PD group increased with age,but there is no correlation in the normal control group.3.In AD group,the more EPVS in CSO,the lower MMSE score,i.e.the more serious the cognitive decline,while there is on correlation between EPVS number and the degree of cognitive decline in BG.