Document type
ArticleVersion
Accepted versionPublication date
All rights reserved
Please use this identifier to cite or link to this item: https://hdl.handle.net/2445/227775
Perivascular and parenchymal brain fluid diffusivity in patients with a recent small subcortical infarct
Journal Title
Director/Tutor
Journal ISSN
Volume Title
Related resource
Abstract
Purpose Fluid exchanges between perivascular spaces (PVS) and interstitium may contribute to the pathophysiology of small vessel disease (SVD). We aimed to analyze water diffusivity measures and their relationship with PVS and other SVD imaging markers. Methods We enrolled 50 consecutive patients with a recent small subcortical infarct. We collected clinical variables, including vascular risk factors and sleep quality scales. All patients underwent a 3-Tesla MRI with standard structural sequences and multishell-diffusion images to obtain extracellular free water content (FW) and water diffusivity along the perivascular space (ALPS) index. We obtained volumetric measurements of white matter hyperintensities (WMH) and PVS, and the number of lacunes and microbleeds. To analyze the association between PVS, ALPS index, FW, and SVD imaging features, we utilized linear regression models including age, sex, history of hypertension and diabetes, Pittsburgh Sleep Quality Index, WMH, and brain volume. Results All patients (mean age 70 years, 36% women) had usable data. FW and PVS were strongly associated in all models (0.008 < Beta < 0.054; P < 0.045). Higher FW was related to the other SVD features in univariable models and remained significant for WMH (1.175 < Beta < 1.262; P < 0.001) and brain volume (Beta < 0.0001; P < 0.002) in multivariable models. ALPS index was not associated with FW, PVS, or any other SVD markers. Conclusions The increased extracellular water in SVD suggests that impaired brain fluid exchanges, PVS dilation, and other SVD features are linked. Further investigation is needed to determine the specificity of the ALPS index to PVS diffusion.
Subject (English)
Citation
Citation
RUDILOSSO, Salvatore, et al. Perivascular and parenchymal brain fluid diffusivity in patients with a recent small subcortical infarct. Neuroradiology. 2025. Vol. 67, num. 3, pags. 599-611. ISSN 1524-4628. [consulted: 15 of June of 2026]. Available at: https://hdl.handle.net/2445/227775