Dilated Perivascular Spaces in the Basal Ganglia Are a Biomarker of Small-Vessel Disease in a Very Elderly Population with Dementia

Article Figures & Data

Download figure
Open in new tab
Download powerpoint
Fig 1.
Images show dilated perivascular spaces in the basal ganglia corresponding to PVS-2_BG scores of 1–4.
Download figure
Open in new tab
Download powerpoint
Fig 2.
A, Boxplot shows the Scheltens white matter scores for the 3 subject groups. B, Boxplot shows the PVS-2_BG scores for the basal ganglia in the 3 subject groups.

Table 1:

Modified version of Scheltens scoring scheme used in the study

Table 2:

Demographic and imaging biomarker data for individual diagnostic groups^{^a}

Group	Healthy	AD	VaD
No.	65	47	39
Age (yr)	78 (5.6)	74.1 (8.5)	76.9 (7.7)
Modified Scheltens score	12.50 (2.5)	13.16 (2.34)	22.76 (2.84)
PVS-1	5.87 (0.21)	6.03 (0.14)	6.34 (0.16)
PVS-2_BG	2.1 (0.5)	2.22 (0.09)	2.471 (0.87)
PVS-2_CSOV	2.51 (0.13)	2.61 (0.10)	2.53 (0.15)

Table 3:

Inter- and intraobserver variation for PVS scores^{^a}

	Modified Scheltens Score	PVS-1	PVS-2	PVS-2_BG
Interobserver Agreement
Rater 1 vs 2	0.82	0.79	0.92	0.91
Rater 1 vs 3	0.91	0.84	0.89	0.86
Rater 2 vs 3	0.88	0.82	0.83	0.90
Intraobserver agreement
Rater 1	0.82	0.87	0.92	0.90
Rater 2	0.86	0.96	0.84	0.86

↵a Data represent weighted Cohen κ statistics. All ratings were very good, except 0.70, which as good.

Table 4:

Results of the multinomial linear regression for each of the 4 scenarios^{^a}

Model	Healthy vs Dementia	Healthy vs AD	Healthy vs VaD	AD vs VaD
Variables entered in the model	PVS-1	PVS-1	PVS-1	PVS-1
	PVS-2_BG	PVS-2_BG	PVS-2_BG	PVS-2_BG
	Modified Scheltens	Modified Scheltens	Modified Scheltens	Modified Scheltens
Variables included in the model	PVS-2_BG	PVS-2_BG	PVS-2_BG	PVS-2_BG
Variables included in the model	Modified Scheltens	Modified Scheltens	Modified Scheltens	Modified Scheltens
PVS-2_BG z score/β coefficient (significance)	−3.074/−1.094 (<.001)	−3.161/−1.002 (<.01)	−2.623/−1.956 (<.01)	2.212/0.757 (<.05)
Modified Scheltens z score/β coefficient (significance)	−1.928/−1.221 (NS)	−1.82/−0.951 (NS)	−2.537/−2.727 (<.05)	1.674/0.498 (NS)
Area under ROC curve	0.855	0.774	0.928	0.7135
Sensitivity (%)	94.1	78.9	91.8	65.3
Specificity (%)	71.1	73.6	84.6	71.4
Positive predictive value (%)	83.1	75.0	83.8	80.0
Negative predictive value (%)	88.9	77.8	91.7	54.1

Note:—NS indicates not significant.
↵a Diagnoses were treated as categories (AD = 1, VaD = 2, and Healthy = 3). Patient age and sex were entered as covariates in each model. All imaging variables were standardized by calculation of z scores (β/standard error) and were entered into the model if they showed a baseline correlation with the diagnosis with significance < .05. Individual z score, β coefficients, and significance are given for each imaging variable in the final model.