
Enlarged perivascular spaces (EPVS) are common in cerebral small vessel disease (CSVD) and have been identified as a marker of dysfunctional brain clearance. However, it remains unknown if the enlargement occurs predominantly around arteries or veins. We combined in vivo ultra-high-resolution MRI and histopathology to investigate the spatial relationship of veins and arteries with EPVS within the basal ganglia (BG). Furthermore, we assessed the relationship between the EPVS and measures of blood-flow (blood-flow velocity, pulsatility index) in the small arteries of the BG. Twenty-four healthy controls, twelve non-CAA CSVD patients, and five probable CAA patients underwent a 3 tesla [T] and 7T MRI-scan, and EPVS, arteries, and veins within the BG were manually segmented. Furthermore, the scans were co-registered. Six autopsy-cases were also assessed. In the BG, EPVS were significantly closer to and overlapped more frequently with arteries than with veins. Histological analysis showed a higher proportion of BG EPVS surrounding arteries than veins. Finally, the pulsatility index of BG arteries correlated with EPVS volume. Our results are in line with previous works and establish a pathophysiological relationship between arteries and EPVS, contributing to elucidating perivascular clearance routes in the human brain.
Male, pathology [Cerebral Veins], hypertensive arteriopathy, Clinical Neurology, 7T MRI, diagnostic imaging [Cerebral Arteries], physiology [Cerebrovascular Circulation], Basal Ganglia, diagnostic imaging [Glymphatic System], physiopathology [Glymphatic System], pathology [Basal Ganglia], Humans, pathology [Cerebral Arteries], physiopathology [Cerebral Small Vessel Diseases], blood supply [Basal Ganglia], Aged, Aged, 80 and over, cerebral small vessel disease, diagnostic imaging [Basal Ganglia], perivascular clearance, Middle Aged, Cerebral Arteries, Magnetic Resonance Imaging, Cerebral Veins, Neurology, pathology [Glymphatic System], Cerebral Small Vessel Diseases, Cerebrovascular Circulation, histopathology, pathology [Cerebral Small Vessel Diseases], Female, diagnostic imaging [Cerebral Small Vessel Diseases], diagnostic imaging [Cerebral Veins], Cardiology and Cardiovascular Medicine, Glymphatic System, Blood Flow Velocity, ddc: ddc:610
Male, pathology [Cerebral Veins], hypertensive arteriopathy, Clinical Neurology, 7T MRI, diagnostic imaging [Cerebral Arteries], physiology [Cerebrovascular Circulation], Basal Ganglia, diagnostic imaging [Glymphatic System], physiopathology [Glymphatic System], pathology [Basal Ganglia], Humans, pathology [Cerebral Arteries], physiopathology [Cerebral Small Vessel Diseases], blood supply [Basal Ganglia], Aged, Aged, 80 and over, cerebral small vessel disease, diagnostic imaging [Basal Ganglia], perivascular clearance, Middle Aged, Cerebral Arteries, Magnetic Resonance Imaging, Cerebral Veins, Neurology, pathology [Glymphatic System], Cerebral Small Vessel Diseases, Cerebrovascular Circulation, histopathology, pathology [Cerebral Small Vessel Diseases], Female, diagnostic imaging [Cerebral Small Vessel Diseases], diagnostic imaging [Cerebral Veins], Cardiology and Cardiovascular Medicine, Glymphatic System, Blood Flow Velocity, ddc: ddc:610
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