Severity of Dilated Virchow-Robin Spaces Is Associated With Age, Blood Pressure, and MRI Markers of Small Vessel Disease A Population-Based Study

• Published in: Stroke (1970) Vol. 41; no. 11; pp. 2483 - 2490
• Main Authors: Zhu, Yi-Cheng, Tzourio, Christophe, Soumaré, Aïcha, Mazoyer, Bernard, Dufouil, Carole, Chabriat, Hugues
• Format: Journal Article
• Language: English
• Published: Hagerstown, MD Lippincott Williams & Wilkins 01.11.2010
• Subjects: Aged; Aging - pathology; Aging - physiology; Arterial hypertension. Arterial hypotension; Basal Ganglia Cerebrovascular Disease - diagnosis; Basal Ganglia Cerebrovascular Disease - pathology; Basal Ganglia Cerebrovascular Disease - physiopathology; Biological and medical sciences; Blood and lymphatic vessels; Blood Pressure - physiology; Cardiology. Vascular system; Clinical manifestations. Epidemiology. Investigative techniques. Etiology; Cohort Studies; Dilatation, Pathologic - diagnosis; Dilatation, Pathologic - pathology; Dilatation, Pathologic - physiopathology; Disorders of higher nervous function. Focal brain diseases. Central vestibular syndrome and deafness. Brain stem syndromes; Endocardial and cardiac valvular diseases; Female; Heart; Humans; Hypertension - pathology; Hypertension - physiopathology; Logistic Models; Magnetic Resonance Imaging; Male; Medical sciences; Microvessels - pathology; Microvessels - physiopathology; Nervous system (semeiology, syndromes); Neurology; Predictive Value of Tests; Prognosis; Retrospective Studies; Risk Factors; Severity of Illness Index; Vascular diseases and vascular malformations of the nervous system; Stroke; Nervous system diseases; risk factors; small vessels disease; MRI; Cardiovascular disease; dilated Virchow Robin space; Nuclear magnetic resonance imaging; Cerebral disorder; Vascular disease; Central nervous system disease; Risk factor; Arterial pressure; Blood pressure; Cerebrovascular disease
• ISSN: 0039-2499; 1524-4628; 1524-4628
• DOI: 10.1161/STROKEAHA.110.591586

Background and Purpose— Little is known about the risk factors of dilated Virchow-Robin spaces (dVRS) and their relation with other markers of brain small vessel disease. We investigated both issues in a large population-based sample of elderly individuals. Methods— Severity of dVRS was semiquantitatively graded in both white matter and basal ganglia using high-resolution 3-dimensional MRI images taken from 1818 stroke- and dementia-free subjects enrolled in the Three-City Dijon MRI study. Multinomial logistic regression models were used to model the association of cardiovascular risk factors, APOE genotype, brain atrophy, and MRI markers of small vessel disease with the degree of dVRS. Results— Severity of dVRS was found to be strongly associated with age in both basal ganglia (degree 4 versus 1: OR, 2.1; 95% CI, 1.4 to 3.2) and white matter (OR, 1.5; 95% CI, 1.2 to 1.9). The proportion of hypertensive subjects increased with the degrees of dVRS in both basal ganglia ( P =0.02) and white matter ( P =0.048). Men presented a higher risk of severe dVRS in basal ganglia than women, particularly degree 4 (OR, 6.0; 95% CI, 1.8 to 19.8). The degree of dVRS was associated with the volume of white matter hyperintensities and the prevalence of lacunes, but not with brain atrophy. Conclusion— In this large cohort study of elderly subjects, the degree of dVRS appears independently associated with age, hypertension, volume of white matter hyperintensities, and lacunar infarctions. dVRS should be considered as another MRI marker of cerebral small vessel disease in the elderly with regional variations in their severity.