Boston University School of Medicine, Boston, MA 02118, USA.
NHLBI's Framingham Heart Study, Framingham, MA 01702, USA.
Aging (Albany NY). 2022 Jul 15;14(17):6844-6858. doi: 10.18632/aging.204181.
Cerebral small vessel disease (CSVD) increases with age and is associated with stroke and cognitive decline. Enlarged Perivascular Spaces (ePVS) is an emerging marker of CSVD, but its prevalence over the life span remain unclear. We characterized the age and sex-specific prevalence of ePVS and relation to age-specific risk factors, in a large community-based sample.
We included 3,710 Framingham Heart Study participants with available brain MRI (average age 61.4±14.6, 46% men). ePVS burden was rated in the centrum semiovale (CSO) and basal ganglia (BG) regions. Individual vascular risk factors were related to ePVS burden in the CSO, BG, and mixed CSO-BG regions using multivariable adjusted ordinal logistic regression analysis.
Severe ePVS prevalence increased with age in men and women, and paralleled increase in vascular risk factors, and prevention treatment use. Older age, hypertension (and resulting higher treatment use), higher systolic and diastolic blood pressure, and smoking were associated with higher burden of ePVS in the CSO, BG and mixed regions.
Our observations reinforce the hypothesis that ePVS may be a marker of aging-driven brain vascular pathologies, and its association with vascular risk factors support their role as CSVD imaging biomarker.
脑小血管病（CSVD）随年龄增长而增加，与中风和认知能力下降有关。扩大的血管周围间隙（ePVS）是 CSVD 的一个新兴标志物，但它在整个生命周期中的患病率尚不清楚。我们在一个大型社区样本中，描述了 ePVS 的年龄和性别特异性患病率及其与特定年龄的危险因素的关系。
我们纳入了 3710 名有可用脑部 MRI 的弗雷明汉心脏研究参与者（平均年龄 61.4±14.6，46%为男性）。在半卵圆中心（CSO）和基底节（BG）区域评估 ePVS 负担。使用多变量调整的有序逻辑回归分析，个体血管危险因素与 CSO、BG 和混合 CSO-BG 区域的 ePVS 负担相关。
严重的 ePVS 患病率在男性和女性中随年龄增长而增加，与血管危险因素的增加和预防治疗的使用平行。年龄较大、高血压（以及由此导致的更高治疗使用率）、较高的收缩压和舒张压以及吸烟与 CSO、BG 和混合区域的 ePVS 负担增加相关。
我们的观察结果强化了 ePVS 可能是与年龄相关的脑血管病理学的标志物的假设，并且其与血管危险因素的关联支持它们作为 CSVD 成像生物标志物的作用。
