Enlarged perivascular spaces in multiple sclerosis on magnetic resonance imaging: a systematic review and meta-analysis

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Granberg, TobiasKarolinska Institutet (author)

Enlarged perivascular spaces in multiple sclerosis on magnetic resonance imaging : a systematic review and meta-analysis

Article/chapterEnglish2020

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2020-06-13
Springer,2020
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LIBRIS-ID:oai:DiVA.org:oru-85162
https://urn.kb.se/resolve?urn=urn:nbn:se:oru:diva-85162URI
https://doi.org/10.1007/s00415-020-09971-5DOI
http://kipublications.ki.se/Default.aspx?queryparsed=id:143900258URI

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Language:English
Summary in:English

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Subject category:for swepub-publicationtype

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Funding Agency:Swiss National Science Foundation (SNSF)
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 and genre

MEDICIN OCH HÄLSOVETENSKAP Klinisk medicin Neurologi hsv//swe
MEDICAL AND HEALTH SCIENCES Clinical Medicine Neurology hsv//eng
Biomarker
Enlarged perivascular spaces
Magnetic resonance imaging
Meta-analysis
Multiple sclerosis
Systematic review

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Moridi, ThomasKarolinska Institutet (author)
Brand, Judith,1984-Örebro universitet,Institutionen för medicinska vetenskaper,Region Örebro län,Clinical Epidemiology and Biostatistics(Swepub:oru)jhbd (author)
Neumann, SusanneDepartment of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden (author)
Hlavica, MartinDepartment of Neurosurgery, Inselspital, University of Bern, Bern, Switzerland (author)
Piehl, FredrikKarolinska Institutet (author)
Ineichen, Benjamin V.Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden; Department of Neuroradiology, Karolinska University Hospital, Stockholm, Sweden (author)
Karolinska InstitutetInstitutionen för medicinska vetenskaper (creator_code:org_t)

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In:Journal of Neurology: Springer267:11, s. 3199-32120340-53541432-1459

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