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Dilated perivascular spaces and fatigue: is there a link? Magnetic resonance retrospective

Discussion in 'Other Health News and Research' started by JaimeS, Jul 21, 2016.

  1. JaimeS

    JaimeS Senior Member

    Silicon Valley, CA
    Full title:
    Dilated perivascular spaces and fatigue: is there a link? Magnetic resonance retrospective 3Tesla study
    • Renata Conforti, Mario Cirillo, Angela Sardaro, Giuseppina Caiazzo, Alberto Negro, Antonella Paccone, Rosaria Sacco, Maddalena Sparaco, Antonio Gallo, Luigi Lavorgna, Gioacchino Tedeschi, Sossio Cirillo

    Link out


    Fatigue (F) is a common, inexplicable, and disabling symptom in multiple sclerosis (MS) patients. The purpose of this study was to evaluate a possible correlation between fatigue and morpho-volumetric features and site of dilated perivascular spaces (dPS), visible on 3T magnetic resonance (MR) in fatigued multiple sclerosis patients (FMS).

    We studied 82 relapsing remitting (RR) FMS patients and 43 HC, matched for age, sex, and education. F was assessed by the Fatigue Severity Scale (FSS). To evaluate a possible correlation between degree of F and characteristics of dPS, patients were divided in two groups: more (mFMS) (FSS ≥ 5; n = 30) and less fatigued (lFMS) (FSS ≥ 4; n  = 52), compared to a matched healthy control (HC) subject group. The MR study was performed with 3T scanner by SpinEcho T1, Fast-SpinEcho DP-T2, FLAIR, and 3D FSPGR T1 sequences. dPS volumes were measured with Medical Image Processing Analysis and Visualization (MIPAV); Global Cerebral Atrophy (GCA), expressed as Brain Parenchymal Fraction (BPF), was assessed by FSL SIENAX.

    The t test showed significantly increased dPS number (p = 0.021) in FMS patients (mFMS p = 0.0024 and lFMS p = 0.033) compared to HC. Pearson correlation revealed a significant correlation between dPS number and FSS (r = 0.208 p = 0.051). Furthermore, the chi-squared test confirms the intragroup (HC, mFMS, lFMS) differences about dPS location (p = 0.01) and size (p = 0.0001).

    Our study confirms that PS in MS patients presents with different volumetric and site characteristics as compared to HC; moreover, F severity significantly correlates with dPS number, site, and size.

    Multiple sclerosis (MS) Fatigue (F) Dilated Virchow-Robin spaces (dVRS) Dilated perivascular spaces (dPS)
    Sean, helen1 and ScottTriGuy like this.
  2. Hip

    Hip Senior Member

    I am not sure if there is any link, but in a brain autopsy performed on a deceased ME/CFS patient (published by Dr John Richardson in 2001; see this post), evidence of enterovirus infection was found in fibroblast cells in the adventitia layer surrounding the small blood vessels in the brain. The adventitia lies just beneath the perivascular spaces (see image below).

    So perhaps there might be some brain blood vessel adventitial or perivascular dysfunction in ME/CFS, leading to symptoms like fatigue?

    Cross section of a blood vessel, showing adventitia and perivascular fat layer
    Source: Anatomy and cellular composition of the blood vessel

    I wonder if some other virus like EBV or HHV-6 might be infecting the cells of the adventitia in multiple sclerosis, leading to dilated perivascular spaces.​
    JaimeS likes this.
  3. pattie


    I know this is an old thread but in my MRI exams it was possible to observe dilated perivascular spaces! I wonder if I’m the only one here with these results! There are several papers linking enlarged perivascular spaces to neuroinflammation.
    Lisa108 likes this.

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