Category: Parkinson's Disease: Neuroimaging
Objective: To investigate the association between enlarged perivascular spaces (PVSs) in the basal ganglia (BG-PVSs) and long-term motor outcomes in Parkinson’s disease (PD).
Background: PVSs are interstitial fluid-filled cavities surrounding small perforating vessels in the brain. PVSs are commonly invisible on brain magnetic resonance imaging in young brains, while enlarged PVSs become more numerous with increasing age. Recent evidence has indicated a possible link between an enlarged PVS and neurodegenerative disorders.
Method: We reviewed the medical records of 248 patients with drug-naïve early-stage PD (follow-up >3 years, mean age 67.44 ± 8.46 years, 130 females) who underwent brain MRI and dopamine transporter (DAT) scans at initial assessment. The number of baseline enlarged BG-PVSs was counted on axial T2-weighted images. Then, patients were divided into two groups: a PD group with a low number (0−10) of enlarged PVSs (PD-EPVS−; n = 156) and that with a high number (>10) of enlarged PVSs (PD-EPVS+; n = 92). We used Cox regression models to compare the levodopa-induced dyskinesia (LID)-, wearing-off-, and freezing of gait (FOG)-free times between groups. We also compared longitudinal increases in levodopa-equivalent dose per body weight between groups using a linear mixed model.
Results: Patients in the PD-EPVS+ group were older (72.28 ± 6.07 years) and had greater small vessel disease burden than those in the PD-EPVS− group (64.58 ± 8.38 years). The PD-EPVS+ group exhibited more severely decreased DAT availability in all striatal sub-regions except the ventral striatum. The risk of FOG was higher in the PD-EPVS+ group, but the risk of LID or wearing-off was comparable between groups. The PD-EPVS+ group required higher doses of dopaminergic medications for effective symptom control compared to the PD-EPVS− group.
Conclusion: This study suggests that baseline enlarged BG-PVSs can be an indicator of the progression of motor disability in PD.
To cite this abstract in AMA style:
SJ. Chung, YJ. Kim, PH. Lee, YH. Sohn. Perivascular spaces in the basal ganglia and long-term motor prognosis in newly diagnosed Parkinson’s disease [abstract]. Mov Disord. 2021; 36 (suppl 1). https://www.mdsabstracts.org/abstract/perivascular-spaces-in-the-basal-ganglia-and-long-term-motor-prognosis-in-newly-diagnosed-parkinsons-disease/. Accessed July 11, 2025.« Back to MDS Virtual Congress 2021
MDS Abstracts - https://www.mdsabstracts.org/abstract/perivascular-spaces-in-the-basal-ganglia-and-long-term-motor-prognosis-in-newly-diagnosed-parkinsons-disease/