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Enlarged perivascul...
Enlarged perivascular spaces in multiple sclerosis on magnetic resonance imaging : a systematic review and meta-analysis
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- Granberg, Tobias (author)
- Karolinska Institutet
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- Moridi, Thomas (author)
- Karolinska Institutet
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- Brand, Judith, 1984- (author)
- Örebro universitet,Institutionen för medicinska vetenskaper,Region Örebro län,Clinical Epidemiology and Biostatistics
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- Neumann, Susanne (author)
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
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- Hlavica, Martin (author)
- Department of Neurosurgery, Inselspital, University of Bern, Bern, Switzerland
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- Piehl, Fredrik (author)
- Karolinska Institutet
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- Ineichen, Benjamin V. (author)
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden; Department of Neuroradiology, Karolinska University Hospital, Stockholm, Sweden
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(creator_code:org_t)
- 2020-06-13
- 2020
- English.
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In: Journal of Neurology. - : Springer. - 0340-5354 .- 1432-1459. ; 267:11, s. 3199-3212
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Abstract
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- BACKGROUND: Perivascular spaces can become detectable on magnetic resonance imaging (MRI) upon enlargement, referred to as enlarged perivascular spaces (EPVS) or Virchow-Robin spaces. EPVS have been linked to small vessel disease. Some studies have also indicated an association of EPVS to neuroinflammation and/or neurodegeneration. However, there is conflicting evidence with regards to their potential as a clinically relevant imaging biomarker in multiple sclerosis (MS).METHODS: To perform a systematic review and meta-analysis of EPVS as visualized by MRI in MS. Nine out of 299 original studies addressing EPVS in humans using MRI were eligible for the systematic review and meta-analysis including a total of 457 MS patients and 352 control subjects.RESULTS: In MS, EPVS have been associated with cognitive decline, contrast-enhancing MRI lesions, and brain atrophy. Yet, these associations were not consistent between studies. The meta-analysis revealed that MS patients have greater EPVS prevalence (odds ratio = 4.61, 95% CI = [1.84; 11.60], p = 0.001) as well as higher EPVS counts (standardized mean difference [SMD] = 0.46, 95% CI = [0.26; 0.67], p < 0.001) and larger volumes (SMD = 0.88, 95% CI = [0.19; 1.56], p = 0.01) compared to controls.CONCLUSIONS: Available literature suggests a higher EPVS burden in MS patients compared to controls. The association of EPVS to neuroinflammatory or -degenerative pathology in MS remains inconsistent. Thus, there is currently insufficient evidence supporting EPVS as diagnostic and/or prognostic marker in MS. In order to benefit future comparisons of studies, we propose recommendations on EPVS assessment standardization in MS. PROSPERO No: CRD42019133946.
Subject headings
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Neurologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Neurology (hsv//eng)
Keyword
- Biomarker
- Enlarged perivascular spaces
- Magnetic resonance imaging
- Meta-analysis
- Multiple sclerosis
- Systematic review
Publication and Content Type
- ref (subject category)
- for (subject category)
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