Dilated perivascular spaces and fatigue: is there a link? Magnetic resonance retrospective 3Tesla study

• Published in: Neuroradiology Vol. 58; no. 9; pp. 859 - 866
• Main Authors: Conforti, Renata, Cirillo, Mario, Sardaro, Angela, Caiazzo, Giuseppina, Negro, Alberto, Paccone, Antonella, Sacco, Rosaria, Sparaco, Maddalena, Gallo, Antonio, Lavorgna, Luigi, Tedeschi, Gioacchino, Cirillo, Sossio
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer Berlin Heidelberg 01.09.2016; Springer Nature B.V
• Subjects: Adult; Brain Diseases - diagnosis; Brain Diseases - epidemiology; Brain Diseases - pathology; Causality; Comorbidity; Diagnostic Neuroradiology; Dilatation, Pathologic - diagnostic imaging; Dilatation, Pathologic - epidemiology; Dilatation, Pathologic - pathology; Double-Blind Method; Fatigue; Fatigue - diagnosis; Fatigue - epidemiology; Female; Humans; Imaging; Italy - epidemiology; Magnetic Resonance Imaging - methods; Magnetic Resonance Imaging - statistics & numerical data; Male; Medicine; Medicine & Public Health; Multiple Sclerosis - diagnostic imaging; Multiple Sclerosis - epidemiology; Multiple Sclerosis - pathology; Neurology; Neuroradiology; Neurosciences; Neurosurgery; NMR; Nuclear magnetic resonance; Pia Mater - diagnostic imaging; Pia Mater - pathology; Prevalence; Radiology; Reproducibility of Results; Risk Factors; Sensitivity and Specificity; Statistics as Topic; Vascular endothelial growth factor; Dilated perivascular spaces (dPS); Fatigue (F); Multiple sclerosis (MS); Dilated Virchow-Robin spaces (dVRS)
• ISSN: 0028-3940; 1432-1920
• DOI: 10.1007/s00234-016-1711-0

Introduction Fatigue (F) is a common, inexplicable, and disabling symptom in multiple sclerosis (MS) patients. The purpose of this study was to evaluate a possible correlation between fatigue and morpho-volumetric features and site of dilated perivascular spaces (dPS), visible on 3T magnetic resonance (MR) in fatigued multiple sclerosis patients (FMS). Methods We studied 82 relapsing remitting (RR) FMS patients and 43 HC, matched for age, sex, and education. F was assessed by the Fatigue Severity Scale (FSS). To evaluate a possible correlation between degree of F and characteristics of dPS, patients were divided in two groups: more (mFMS) (FSS ≥ 5; n  = 30) and less fatigued (lFMS) (FSS ≥ 4; n  = 52), compared to a matched healthy control (HC) subject group. The MR study was performed with 3T scanner by SpinEcho T1, Fast-SpinEcho DP-T2, FLAIR, and 3D FSPGR T1 sequences. dPS volumes were measured with Medical Image Processing Analysis and Visualization (MIPAV); Global Cerebral Atrophy (GCA), expressed as Brain Parenchymal Fraction (BPF), was assessed by FSL SIENAX. Results The t test showed significantly increased dPS number ( p  = 0.021) in FMS patients (mFMS p  = 0.0024 and lFMS p  = 0.033) compared to HC. Pearson correlation revealed a significant correlation between dPS number and FSS ( r  = 0.208 p  = 0.051). Furthermore, the chi-squared test confirms the intragroup (HC, mFMS, lFMS) differences about dPS location ( p  = 0.01) and size ( p  = 0.0001). Conclusion Our study confirms that PS in MS patients presents with different volumetric and site characteristics as compared to HC; moreover, F severity significantly correlates with dPS number, site, and size.