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<meta name="DC.Title" content="Assessment of the Virchow-Robin Spaces in Alzheimer Disease, Mild Cognitive Impairment, and Normal Aging, Using High-Field MR Imaging" />
<meta name="DC.Identifier" content="10.3174/ajnr.A2541" />
<meta name="DC.Date" content="2011-09-01" />
<meta name="DC.Publisher" content="American Journal of Neuroradiology" />
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Indicates open access to non-subscribers at www.ajnr.org" />
<meta name="DC.AccessRights" content="open-access" />
<meta name="DC.Description" content="BACKGROUND AND PURPOSE: VRSs are the perivascular spaces surrounding the deep perforating arteries in the brain. Although VRS variations with age and disease pathologies have been reported previously, the radiologic characteristics of the VRS in relation to AD are poorly understood. This study investigated the prevalence, spatial distribution, and severity of the VRS in AD, MCI, and older adults who were CN. It also investigated the relationship of the VRS to white matter changes.

MATERIALS AND METHODS: Structural MR imaging data were acquired from 158 participants (AD = 37, MCI = 71, CN = 50, mean age = 74.97 ± 7.20 years) who had undergone T1WI at 3T. The severity of VRS in the white matter, basal ganglia, hippocampus, and brain stem structures was evaluated by using a semiquantitative scale, adapted from existing rating scales. A VRS total score summarizing the subscales was calculated to assess the whole-brain VRSs.

RESULTS: VRSs were observed in multiple brain regions of all participants, typically presented as &lt;2-mm well-margined symmetric round-, oval- and linear-shaped hypointensities on T1WI. The VRS total score increased with leukoaraiosis, atrophy, and advanced age ( P &lt; .001). Individuals with AD and MCI showed greater levels of VRS than control subjects. The VRS total score discriminated individuals with AD and those who were CN with an accuracy of 0.79 (95% CI, 0.69–0.89).

CONCLUSIONS: VRSs are common in older adults and are more severe in AD and MCI than in CN. Whether increased VRSs can be reliably used to aid in AD diagnosis warrants further investigation.

AD
:   Alzheimer disease
ADNI
:   Alzheimer Disease Neuroimaging Initiative
ANOVA
:   analysis of variance
AUC
:   area under the curve
BG
:   basal ganglia region
BS
:   brain stem
CDR
:   Clinical Dementia Rating
CI
:   confidence interval
CN
:   cognitively normal
CS
:   centrum semiovale
FL
:   frontal lobe
HP
:   hippocampal area
ICC
:   interclass correlation
MCI
:   mild cognitive impairment
MMSE
:   Mini-Mental State Examination
OL
:   occipital lobe
PL
:   parietal lobe
ROC
:   receiver operating characteristic curve analysis
T1WI
:   T1-weighted imaging
T2WI
:   T2-weighted imaging
TL
:   temporal lobe
VRS
:   Virchow-Robin space" />
<meta name="DC.Contributor" content="W. Chen" />
<meta name="DC.Contributor" content="X. Song" />
<meta name="DC.Contributor" content="Y. Zhang" />
<meta name="DC.Contributor" content="for the Alzheimer's Disease Neuroimaging Initiative" />
<meta name="article:published_time" content="2011-09-01" />
<meta name="article:section" content="Brain" />
<meta name="citation_title" content="Assessment of the Virchow-Robin Spaces in Alzheimer Disease, Mild Cognitive Impairment, and Normal Aging, Using High-Field MR Imaging" />
<meta name="citation_abstract" lang="en" content="&lt;h3&gt;BACKGROUND AND PURPOSE:&lt;/h3&gt;
&lt;p&gt;VRSs are the perivascular spaces surrounding the deep perforating arteries in the brain. Although VRS variations with age and disease pathologies have been reported previously, the radiologic characteristics of the VRS in relation to AD are poorly understood. This study investigated the prevalence, spatial distribution, and severity of the VRS in AD, MCI, and older adults who were CN. It also investigated the relationship of the VRS to white matter changes.&lt;/p&gt;&lt;h3&gt;MATERIALS AND METHODS:&lt;/h3&gt;
&lt;p&gt;Structural MR imaging data were acquired from 158 participants (AD = 37, MCI = 71, CN = 50, mean age = 74.97 ± 7.20 years) who had undergone T1WI at 3T. The severity of VRS in the white matter, basal ganglia, hippocampus, and brain stem structures was evaluated by using a semiquantitative scale, adapted from existing rating scales. A VRS total score summarizing the subscales was calculated to assess the whole-brain VRSs.&lt;/p&gt;&lt;h3&gt;RESULTS:&lt;/h3&gt;
&lt;p&gt;VRSs were observed in multiple brain regions of all participants, typically presented as &amp;lt;2-mm well-margined symmetric round-, oval- and linear-shaped hypointensities on T1WI. The VRS total score increased with leukoaraiosis, atrophy, and advanced age (&lt;i&gt;P&lt;/i&gt; &amp;lt; .001). Individuals with AD and MCI showed greater levels of VRS than control subjects. The VRS total score discriminated individuals with AD and those who were CN with an accuracy of 0.79 (95% CI, 0.69–0.89).&lt;/p&gt;&lt;h3&gt;CONCLUSIONS:&lt;/h3&gt;
&lt;p&gt;VRSs are common in older adults and are more severe in AD and MCI than in CN. Whether increased VRSs can be reliably used to aid in AD diagnosis warrants further investigation.&lt;/p&gt;" />
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<meta name="twitter:title" content="Assessment of the Virchow-Robin Spaces in Alzheimer Disease, Mild Cognitive Impairment, and Normal Aging, Using High-Field MR Imaging" />
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<meta name="twitter:description" content="BACKGROUND AND PURPOSE: VRSs are the perivascular spaces surrounding the deep perforating arteries in the brain. Although VRS variations with age and disease pathologies have been reported previously, the radiologic characteristics of the VRS in relation to AD are poorly understood. This study investigated the prevalence, spatial distribution, and severity of the VRS in AD, MCI, and older adults who were CN. It also investigated the relationship of the VRS to white matter changes.

MATERIALS AND METHODS: Structural MR imaging data were acquired from 158 participants (AD = 37, MCI = 71, CN = 50, mean age = 74.97 ± 7.20 years) who had undergone T1WI at 3T. The severity of VRS in the white matter, basal ganglia, hippocampus, and brain stem structures was evaluated by using a semiquantitative scale, adapted from existing rating scales. A VRS total score summarizing the subscales was calculated to assess the whole-brain VRSs.

RESULTS: VRSs were observed in multiple brain regions of all participants, typically presented as &lt;2-mm well-margined symmetric round-, oval- and linear-shaped hypointensities on T1WI. The VRS total score increased with leukoaraiosis, atrophy, and advanced age ( P &lt; .001). Individuals with AD and MCI showed greater levels of VRS than control subjects. The VRS total score discriminated individuals with AD and those who were CN with an accuracy of 0.79 (95% CI, 0.69–0.89).

CONCLUSIONS: VRSs are common in older adults and are more severe in AD and MCI than in CN. Whether increased VRSs can be reliably used to aid in AD diagnosis warrants further investigation.

AD
:   Alzheimer disease
ADNI
:   Alzheimer Disease Neuroimaging Initiative
ANOVA
:   analysis of variance
AUC
:   area under the curve
BG
:   basal ganglia region
BS
:   brain stem
CDR
:   Clinical Dementia Rating
CI
:   confidence interval
CN
:   cognitively normal
CS
:   centrum semiovale
FL
:   frontal lobe
HP
:   hippocampal area
ICC
:   interclass correlation
MCI
:   mild cognitive impairment
MMSE
:   Mini-Mental State Examination
OL
:   occipital lobe
PL
:   parietal lobe
ROC
:   receiver operating characteristic curve analysis
T1WI
:   T1-weighted imaging
T2WI
:   T2-weighted imaging
TL
:   temporal lobe
VRS
:   Virchow-Robin space" />
<meta name="og-title" property="og:title" content="Assessment of the Virchow-Robin Spaces in Alzheimer Disease, Mild Cognitive Impairment, and Normal Aging, Using High-Field MR Imaging" />
<meta name="og-url" property="og:url" content="http://ajnr-stage2.stage.highwire.org/content/32/8/1490" />
<meta name="og-site-name" property="og:site_name" content="American Journal of Neuroradiology" />
<meta name="og-description" property="og:description" content="BACKGROUND AND PURPOSE: VRSs are the perivascular spaces surrounding the deep perforating arteries in the brain. Although VRS variations with age and disease pathologies have been reported previously, the radiologic characteristics of the VRS in relation to AD are poorly understood. This study investigated the prevalence, spatial distribution, and severity of the VRS in AD, MCI, and older adults who were CN. It also investigated the relationship of the VRS to white matter changes.

MATERIALS AND METHODS: Structural MR imaging data were acquired from 158 participants (AD = 37, MCI = 71, CN = 50, mean age = 74.97 ± 7.20 years) who had undergone T1WI at 3T. The severity of VRS in the white matter, basal ganglia, hippocampus, and brain stem structures was evaluated by using a semiquantitative scale, adapted from existing rating scales. A VRS total score summarizing the subscales was calculated to assess the whole-brain VRSs.

RESULTS: VRSs were observed in multiple brain regions of all participants, typically presented as &lt;2-mm well-margined symmetric round-, oval- and linear-shaped hypointensities on T1WI. The VRS total score increased with leukoaraiosis, atrophy, and advanced age ( P &lt; .001). Individuals with AD and MCI showed greater levels of VRS than control subjects. The VRS total score discriminated individuals with AD and those who were CN with an accuracy of 0.79 (95% CI, 0.69–0.89).

CONCLUSIONS: VRSs are common in older adults and are more severe in AD and MCI than in CN. Whether increased VRSs can be reliably used to aid in AD diagnosis warrants further investigation.

AD
:   Alzheimer disease
ADNI
:   Alzheimer Disease Neuroimaging Initiative
ANOVA
:   analysis of variance
AUC
:   area under the curve
BG
:   basal ganglia region
BS
:   brain stem
CDR
:   Clinical Dementia Rating
CI
:   confidence interval
CN
:   cognitively normal
CS
:   centrum semiovale
FL
:   frontal lobe
HP
:   hippocampal area
ICC
:   interclass correlation
MCI
:   mild cognitive impairment
MMSE
:   Mini-Mental State Examination
OL
:   occipital lobe
PL
:   parietal lobe
ROC
:   receiver operating characteristic curve analysis
T1WI
:   T1-weighted imaging
T2WI
:   T2-weighted imaging
TL
:   temporal lobe
VRS
:   Virchow-Robin space" />
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    	<div class="highwire-cite-authors"><span  class="highwire-citation-authors"><span class="highwire-citation-author first" data-delta="0">W. Chen</span>, <span class="highwire-citation-author" data-delta="1">X. Song</span>, <span class="highwire-citation-author" data-delta="2">Y. Zhang</span> and <span class="highwire-citation-author" data-delta="3"><span class="nlm-collab" data-xlink-type="simple" data-hwp-id="collab-1">for the Alzheimer's Disease Neuroimaging Initiative</span></span></span></div>
  
    	<div class="highwire-cite-metadata"><span  class="highwire-cite-metadata-journal highwire-cite-metadata">American Journal of Neuroradiology </span><span  class="highwire-cite-metadata-date highwire-cite-metadata">September 2011,  </span><span  class="highwire-cite-metadata-volume highwire-cite-metadata">32 </span><span  class="highwire-cite-metadata-issue highwire-cite-metadata">(8) </span><span  class="highwire-cite-metadata-pages highwire-cite-metadata">1490-1495; </span><span  class="highwire-cite-metadata-doi highwire-cite-metadata">DOI: https://doi.org/10.3174/ajnr.A2541 </span></div>
  
  
  
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<div id="hw-article-author-popups-top-node-12137--61288232694" style="display: none;"><div class="author-tooltip-0"><div class="author-tooltip-name">W. Chen </div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=W.%2BChen%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Chen%20W&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link last"><a href="/search/author1%3AW.%2BChen%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li></ul></div><div class="author-tooltip-1"><div class="author-tooltip-name">X. Song </div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=X.%2BSong%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Song%20X&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link last"><a href="/search/author1%3AX.%2BSong%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li></ul></div><div class="author-tooltip-2"><div class="author-tooltip-name">Y. Zhang </div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=Y.%2BZhang%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Zhang%20Y&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link last"><a href="/search/author1%3AY.%2BZhang%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li></ul></div></div></div>  </div>

  
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<p id="p-2"><strong>BACKGROUND AND PURPOSE:</strong> VRSs are the perivascular spaces surrounding the deep perforating arteries in the brain. Although VRS variations with age and disease pathologies have been reported previously, the radiologic characteristics of the VRS in relation to AD are poorly understood. This study investigated the prevalence, spatial distribution, and severity of the VRS in AD, MCI, and older adults who were CN. It also investigated the relationship of the VRS to white matter changes.</p>
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<p id="p-3"><strong>MATERIALS AND METHODS:</strong> Structural MR imaging data were acquired from 158 participants (AD = 37, MCI = 71, CN = 50, mean age = 74.97 ± 7.20 years) who had undergone T1WI at 3T. The severity of VRS in the white matter, basal ganglia, hippocampus, and brain stem structures was evaluated by using a semiquantitative scale, adapted from existing rating scales. A VRS total score summarizing the subscales was calculated to assess the whole-brain VRSs.</p>
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<p id="p-4"><strong>RESULTS:</strong> VRSs were observed in multiple brain regions of all participants, typically presented as &lt;2-mm well-margined symmetric round-, oval- and linear-shaped hypointensities on T1WI. The VRS total score increased with leukoaraiosis, atrophy, and advanced age (<em>P</em> &lt; .001). Individuals with AD and MCI showed greater levels of VRS than control subjects. The VRS total score discriminated individuals with AD and those who were CN with an accuracy of 0.79 (95% CI, 0.69–0.89).</p>
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<p id="p-5"><strong>CONCLUSIONS:</strong> VRSs are common in older adults and are more severe in AD and MCI than in CN. Whether increased VRSs can be reliably used to aid in AD diagnosis warrants further investigation.</p>
</div></div><div class="section glossary" id="glossary-1"><h2>Abbreviations</h2><dl id="def-list-1"><dt id="def-item-1">AD<span class="def-item-dt-sep"></span></dt><dd>Alzheimer disease<span class="def-item-dd-sep"></span></dd><dt id="def-item-2">ADNI<span class="def-item-dt-sep"></span></dt><dd>Alzheimer Disease Neuroimaging Initiative<span class="def-item-dd-sep"></span></dd><dt id="def-item-3">ANOVA<span class="def-item-dt-sep"></span></dt><dd>analysis of variance<span class="def-item-dd-sep"></span></dd><dt id="def-item-4">AUC<span class="def-item-dt-sep"></span></dt><dd>area under the curve<span class="def-item-dd-sep"></span></dd><dt id="def-item-5">BG<span class="def-item-dt-sep"></span></dt><dd>basal ganglia region<span class="def-item-dd-sep"></span></dd><dt id="def-item-6">BS<span class="def-item-dt-sep"></span></dt><dd>brain stem<span class="def-item-dd-sep"></span></dd><dt id="def-item-7">CDR<span class="def-item-dt-sep"></span></dt><dd>Clinical Dementia Rating<span class="def-item-dd-sep"></span></dd><dt id="def-item-8">CI<span class="def-item-dt-sep"></span></dt><dd>confidence interval<span class="def-item-dd-sep"></span></dd><dt id="def-item-9">CN<span class="def-item-dt-sep"></span></dt><dd>cognitively normal<span class="def-item-dd-sep"></span></dd><dt id="def-item-10">CS<span class="def-item-dt-sep"></span></dt><dd>centrum semiovale<span class="def-item-dd-sep"></span></dd><dt id="def-item-11">FL<span class="def-item-dt-sep"></span></dt><dd>frontal lobe<span class="def-item-dd-sep"></span></dd><dt id="def-item-12">HP<span class="def-item-dt-sep"></span></dt><dd>hippocampal area<span class="def-item-dd-sep"></span></dd><dt id="def-item-13">ICC<span class="def-item-dt-sep"></span></dt><dd>interclass correlation<span class="def-item-dd-sep"></span></dd><dt id="def-item-14">MCI<span class="def-item-dt-sep"></span></dt><dd>mild cognitive impairment<span class="def-item-dd-sep"></span></dd><dt id="def-item-15">MMSE<span class="def-item-dt-sep"></span></dt><dd>Mini-Mental State Examination<span class="def-item-dd-sep"></span></dd><dt id="def-item-16">OL<span class="def-item-dt-sep"></span></dt><dd>occipital lobe<span class="def-item-dd-sep"></span></dd><dt id="def-item-17">PL<span class="def-item-dt-sep"></span></dt><dd>parietal lobe<span class="def-item-dd-sep"></span></dd><dt id="def-item-18">ROC<span class="def-item-dt-sep"></span></dt><dd>receiver operating characteristic curve analysis<span class="def-item-dd-sep"></span></dd><dt id="def-item-19">T1WI<span class="def-item-dt-sep"></span></dt><dd>T1-weighted imaging<span class="def-item-dd-sep"></span></dd><dt id="def-item-20">T2WI<span class="def-item-dt-sep"></span></dt><dd>T2-weighted imaging<span class="def-item-dd-sep"></span></dd><dt id="def-item-21">TL<span class="def-item-dt-sep"></span></dt><dd>temporal lobe<span class="def-item-dd-sep"></span></dd><dt id="def-item-22">VRS<span class="def-item-dt-sep"></span></dt><dd>Virchow-Robin space</dd></dl></div><ul class="copyright-statement"><li class="fn" id="copyright-statement-1">© 2011 by American Journal of Neuroradiology</li></ul><div class="license" id="license-1"><p id="p-1">Indicates open access to non-subscribers at <a href="http://www.ajnr.org">www.ajnr.org</a></p></div><span class="highwire-journal-article-marker-end"></span></div><span class="related-urls"></span></div><a href="http://ajnr-stage2.stage.highwire.org/content/32/8/1490.full" class="hw-link hw-link-article-full-text" data-icon-position="" data-hide-link-title="0">View Full Text</a></div>  </div>

  
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      <div class="highwire-cite-title">Assessment of the Virchow-Robin Spaces in Alzheimer Disease, Mild Cognitive Impairment, and Normal Aging, Using High-Field MR Imaging</div>  
    	<div class="highwire-cite-authors"><span  class="highwire-citation-authors"><span class="highwire-citation-author first" data-delta="0"><span class="nlm-given-names">W.</span> <span class="nlm-surname">Chen</span></span>, <span class="highwire-citation-author" data-delta="1"><span class="nlm-given-names">X.</span> <span class="nlm-surname">Song</span></span>, <span class="highwire-citation-author" data-delta="2"><span class="nlm-given-names">Y.</span> <span class="nlm-surname">Zhang</span></span>, <span class="highwire-citation-author" data-delta="3"><span class="nlm-collab" data-xlink-type="simple" data-hwp-id="collab-1">for the Alzheimer's Disease Neuroimaging Initiative</span></span></span></div>
  
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