MRI-Visible Perivascular Spaces in the Centrum Semiovale Are Associated with Brain Amyloid Deposition in Patients with Alzheimer Disease–Related Cognitive Impairment

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FIG 1.
Patient-inclusion flowchart.
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FIG 2.
Comparisons of the presence of MR imaging–visible PVS-CS (A) and MR imaging–visible PVS in the basal ganglia (B) based on the β-amyloid status. The enlarged perivascular spaces in the centrum semiovale (ePVS-CS) were significantly higher in the patient group positive for β-amyloid than in the patient group negative for it, whereas the high degree of enlarged perivascular spaces in the basal ganglia (ePVS-BG) did not differ between the groups positive and negative for β-amyloid.
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FIG 3.
Examples of perivascular space patterns with the corresponding [¹⁸F] FBB PET image. The axial T2-weighted MR imaging shows a high degree of MR imaging–visible PVS-CS (A), and the corresponding [¹⁸F] FBB PET (B) shows pronounced β-amyloid deposition. Axial T2-weighted MR imaging shows a low degree of MR imaging–visible PVS-CS (C) and the [¹⁸F] FBB PET scan (D) shows low β-amyloid deposition.

Table 1:

Baseline characteristics of the groups positive and negative for brain β-amyloid

	Amyloid-Negative	Amyloid-Positive	P Value
(No.) (%)	67 (46.5%)	77 (53.5%)
Age (mean) (SD) (yr)	71.3 (10.6)	75.4 (7.6)	.010
Female sex (No.) (%)	44 (65.7%)	44 (57.1%)	.297
Hypertension (No.) (%)	25 (37.3%)	36 (46.8%)	.254
Diabetes mellitus (No.) (%)	10 (14.9%)	16 (20.8%)	.364
Hyperlipidemia (No.) (%)	9 (13.4%)	11 (14.3%)	.883
Previous stroke (No.) (%)	7 (10.4%)	4 (5.2%)	.238
APOE ε4 presence (No.) (%)	13 (19.4%)	33 (42.9%)	.001
High degree of MR imaging–visible PVS-CS (No.) (%)	24 (35.8%)	48 (62.3%)	.002
High degree of MR imaging–visible PVS-BG (No.) (%)	11 (16.4%)	13 (16.9%)	.297
AD (No.) (%)	19 (28.4%)	47 (61.0%)	<.001
MMSE (median) (IQR)	26 (23–28)	24 (20–26)	<.001
CDR (median) (IQR)	0.5 (0.5–0.5)	0.5 (0.5–1.0)	.019
CDR-SB (median) (IQR)	1.5 (0.5–3.0)	3.0 (1.5–4.5)	<.001
Lacunes (median) (IQR)	0 (0–0)	0 (0–0)	.778
cSS present (No.) (%)	1 (1.5%)	6 (7.8%)	.081
Lobar CMB (median) (IQR)	0 (0–0)	0 (0–1)	.117
Deep CMB (median) (IQR)	0 (0–0)	0 (0–0)	.160
WMH presence (No.) (%)	27 (40.3%)	47 (61.0%)	.013

Note:—IQR indicates interquartile range; PVS-BG, perivascular space in the basal ganglia; CMB, cerebral microbleed; CDR, Clinical Dementia Rating Scale; CDR-SB, Clinical Dementia Rating Scale–Sum of Boxes; cSS, cortical superficial siderosis.

Table 2:

Logistic regression analysis for the predictors of β-amyloid positivity

	Univariable		Multivariable
	OR (95% CI)	P Value	OR (95% CI)	P Value
Age (yr)	1.051 (1.012–1.092)	.010	1.050 (1.004–1.098)	.034
Sex
Female	Reference group
Male	1.435 (0.729–2.823)	.296	1.561 (0.699–3.489)	.278
Hypertension (present)	1.475 (0.757–2.875)	.254
Diabetes (present)	1.495 (0.627–3.564)	.364
Hyperlipidemia (present)	1.074 (0.416–2.774)	.883
Previous stroke (present)	0.470 (0.131–1.681)	.245
APOE ε4 allele (present)	3.526 (1.630–7.627)	.001	4.583 (1.945–10.796)	<.001
High degree of MR imaging–visible PVS-CS (score, ≥3)	2.966 (1.503–5.851)	.002	2.307 (1.036–5.136)	.041
High degree of MR imaging–visible PVS-BG (score, ≥3)	1.034 (0.429–2.492)	.940
WMH (present)	2.321 (1.188–4.533)	.014
Lacunes (for 1 number higher)	0.937 (0.726–1.209)	.618
cSS (present)	5.577 (0.654–47.565)	.116
Lobar CMB (present)	1.100 (0.934–1.295)	.253
Deep CMB (present)	0.688 (0.428–1.108)	.124

Note:—CMB indicates cerebral microbleed; cSS, cortical superficial siderosis; MRI-visible PVS-BG, enlarged perivascular space in the basal ganglia; MRI-visible PVS-CS, enlarged perivascular space in the semi ovale.