Perivascular spaces and their associations with risk factors, clinical disorders and neuroimaging features: A systematic review and meta-analysis

TY - JOUR

T1 - Perivascular spaces and their associations with risk factors, clinical disorders and neuroimaging features

T2 - A systematic review and meta-analysis

AU - Francis, Farah

AU - Ballerini, Lucia

AU - Wardlaw, Joanna M.

N1 - Funding Information: The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: This work was supported by Engineering and Physical Sciences Research Council (EP/M005976/1); Row Fogo Centre for Research into Ageing and the Brain (Ref No: AD.ROW4.35. BRO-D.FID3668413); Age UK and UK Medical Research Council (G0701120, G1001245 and MR/ M013111/1); Fondation Leducq (ref no. 16 CVD 05); the EU Horizon2020, PHC-03-15, project No 666881, ‘SVDs@Target’ and the MRC UK Dementia Research Institute. Publisher Copyright: © 2019 World Stroke Organization.

PY - 2019/6/1

Y1 - 2019/6/1

N2 - Background: Perivascular spaces, visible on brain magnetic resonance imaging, are thought to be associated with small vessel disease, neuroinflammation, and to be important for cerebral hemodynamics and interstitial fluid drainage. Aims: To benchmark current knowledge on perivascular spaces associations with risk factors, neurological disorders, and neuroimaging lesions, using systematic review and meta-analysis.Summary of review: We searched three databases for perivascular spaces publications, calculated odds ratios with 95% confidence interval and performed meta-analyses to assess adjusted associations with perivascular spaces. We identified 116 relevant studies (n = 36,108) but only 23 (n = 12,725) were meta-analyzable. Perivascular spaces assessment, imaging and clinical definitions varied. Perivascular spaces were associated (n; OR, 95%CI, p) with ageing (8395; 1.47, 1.28–1.69, p = 0.00001), hypertension (7872; 1.67, 1.20–2.31, p = 0.002), lacunes (4894; 3.56, 1.39–9.14, p = 0.008), microbleeds (5015; 2.26, 1.04–4.90, p = 0.04) but not WMH (4974; 1.54, 0.71–3.32, p = 0.27), stroke or cognitive impairment. There was between-study heterogeneity. Lack of appropriate data on other brain disorders and demographic features such as ethnicity precluded analysis.Conclusions: Despite many studies, more are required to determine potential pathophysiological perivascular spaces involvement in cerebrovascular, neurodegenerative and neuroinflammatory disorders.

AB - Background: Perivascular spaces, visible on brain magnetic resonance imaging, are thought to be associated with small vessel disease, neuroinflammation, and to be important for cerebral hemodynamics and interstitial fluid drainage. Aims: To benchmark current knowledge on perivascular spaces associations with risk factors, neurological disorders, and neuroimaging lesions, using systematic review and meta-analysis.Summary of review: We searched three databases for perivascular spaces publications, calculated odds ratios with 95% confidence interval and performed meta-analyses to assess adjusted associations with perivascular spaces. We identified 116 relevant studies (n = 36,108) but only 23 (n = 12,725) were meta-analyzable. Perivascular spaces assessment, imaging and clinical definitions varied. Perivascular spaces were associated (n; OR, 95%CI, p) with ageing (8395; 1.47, 1.28–1.69, p = 0.00001), hypertension (7872; 1.67, 1.20–2.31, p = 0.002), lacunes (4894; 3.56, 1.39–9.14, p = 0.008), microbleeds (5015; 2.26, 1.04–4.90, p = 0.04) but not WMH (4974; 1.54, 0.71–3.32, p = 0.27), stroke or cognitive impairment. There was between-study heterogeneity. Lack of appropriate data on other brain disorders and demographic features such as ethnicity precluded analysis.Conclusions: Despite many studies, more are required to determine potential pathophysiological perivascular spaces involvement in cerebrovascular, neurodegenerative and neuroinflammatory disorders.

KW - dementia

KW - neuroimaging

KW - Perivascular spaces

KW - risk factors

KW - small vessel disease

KW - stroke

KW - systematic review

UR - https://www.scopus.com/pages/publications/85061648502

U2 - 10.1177/1747493019830321

DO - 10.1177/1747493019830321

M3 - Review article

C2 - 30762496

AN - SCOPUS:85061648502

SN - 1747-4930

VL - 14

SP - 359

EP - 371

JO - International Journal of Stroke

JF - International Journal of Stroke

IS - 4

ER -