Microbleeds colocalize with enlarged juxtacortical perivascular spaces in amnestic mild cognitive impairment and early Alzheimer’s disease: A 7 Tesla MRI study

• Published in: Journal of cerebral blood flow and metabolism Vol. 40; no. 4; pp. 739 - 746
• Main Authors: Bouvy, Willem H, van Veluw, Susanne J, Kuijf, Hugo J, Zwanenburg, Jaco JM, Kappelle, Jaap L, Luijten, Peter R, Koek, Huiberdina L, Geerlings, Mirjam I, Biessels, Geert J
• Format: Journal Article
• Language: English
• Published: London, England SAGE Publications 01.04.2020
• Subjects: Aged; Aged, 80 and over; Alzheimer Disease - diagnostic imaging; Cerebral Cortex - blood supply; Cerebral Cortex - diagnostic imaging; Cerebral Hemorrhage - diagnostic imaging; Cognitive Dysfunction - diagnostic imaging; Glymphatic System - diagnostic imaging; Humans; Magnetic Resonance Imaging; Middle Aged; Original; Severity of Illness Index; microbleeds; perivascular spaces; small vessel disease; Alzheimer’s disease; cerebral amyloid angiopathy
• ISSN: 0271-678X; 1559-7016
• DOI: 10.1177/0271678X19838087

MRI-visible perivascular spaces (PVS) in the semioval centre are associated with cerebral amyloid angiopathy (CAA), but it is unknown if PVS co-localize with MRI markers of CAA. To examine this, we assessed the topographical association between cortical cerebral microbleeds (CMBs) – as an indirect marker of CAA – and dilatation of juxtacortical perivascular spaces (jPVS) in 46 patients with amnestic mild cognitive impairment (aMCI) or early Alzheimer’s disease (eAD). The degree of dilatation of jPVS <1 cm around each cortical CMBs was compared with a similar reference site (no CMB) in the contralateral hemisphere, using a 4-point scale. Also, jPVS dilatation was compared between patients with and without cortical CMBs. Eleven patients (24%) had cortical CMBs [total=35, median=1, range=1–14] of whom five had >1 cortical CMBs. The degree of jPVS dilatation was higher around CMBs than at the reference sites [Wilcoxon signed rank test, Z = 2.2, p = 0.03]. Patients with >1 cortical CMBs had a higher degree of jPVS dilation [median=2.2, IQR = 1.8–2.3] than patients without cortical CMBs [median=1.4, IQR = 1.0–1.8], p = 0.02. We found a topographical association between a high degree of jPVS dilatation and cortical CMBs, supporting a common underlying pathophysiology – most likely CAA.