AUTHOR=Du Houwei , Chen Chao , Ye Chengbin , Lin Feifei , Wei Jin , Xia Pincang , Chen Ronghua , Wu Sangru , Yuan Qilin , Chen Hongbin , Xiao Yingchun , Liu Nan 

TITLE=Association Between Steno-Occlusive Middle Cerebral Artery and Basal Ganglia Perivascular Spaces

JOURNAL=Frontiers in Neurology

VOLUME=11

YEAR=2020

URL=https://www.frontiersin.org/journals/neurology/articles/10.3389/fneur.2020.00293

DOI=10.3389/fneur.2020.00293

ISSN=1664-2295

ABSTRACT=<p><bold>Objectives:</bold> Enlarged perivascular spaces in the basal ganglia (BG-EPVS) share common vascular risk factors with atherosclerosis. However, little is known about the relationship between steno-occlusive middle cerebral artery (MCA) and BG-EPVS. In this cross-sectional study, we aimed to test the hypothesis that severe MCA stenosis or occlusion is associated with increased MRI-visible BG-EPVS.</p><p><bold>Methods:</bold> We retrospectively reviewed 112 patients with a steno-occlusive MCA from Fujian Medical University Union Hospital between January 2014 and December 2018. We rated BG-EPVS, white matter hyperintensities (WMH), and lacunes as markers of cerebral small vessel disease (CSVD) on magnetic resonance image (MRI). The severity of steno-occlusive MCA was assessed by computed tomography angiography (CTA) and was classified into moderate (50–69%), severe (70–99%), and occlusion (100%). We evaluated the association of steno-occlusive MCA for &gt;10 BG-EPVS using logistic regression model adjusted for age, gender, hypertension, MR-visible WMH, and lacunes. We also compared the number of BG-EPVS between the affected side and unaffected side in patients with only unilateral steno-occlusive MCA.</p><p><bold>Results:</bold> In multivariable logistic regression analysis, age (OR = 1.07, 95%CI: 1.03–1.13, <italic>p</italic> = 0.003), hypertension (OR = 2.77, 95%CI: 1.02–7.51, <italic>p</italic> = 0.046), severe MCA stenosis (OR = 3.65, 95%CI: 1.12–11.87, <italic>p</italic> = 0.032), or occlusion (OR = 3.67, 95%CI: 1.20–11.27, <italic>p</italic> = 0.023) were significantly associated with &gt;10 BG-EPVS. The number of BG-EPVS in the affected side was higher than the unaffected side in patients with severe MCA stenosis (12 [9−14] vs. 8 [6−11], <italic>p</italic> = 0.001) or occlusion (11 [7−14] vs. 8 [5−11], <italic>p</italic> = 0.028).</p><p><bold>Conclusions:</bold> BG-EPVS were more prevalent in patients with severe MCA atherosclerosis. Our findings suggest a biological link between severe steno-occlusive MCA and increased BG-EPVS. These results need confirmation in prospective studies.</p>