Enlarged perivascular spaces in multiple sclerosis on magnetic resonance imaging: a systematic review and meta-analysis.
Biomarker
Enlarged perivascular spaces
Magnetic resonance imaging
Meta-analysis
Multiple sclerosis
Systematic review
Journal
Journal of neurology
ISSN: 1432-1459
Titre abrégé: J Neurol
Pays: Germany
ID NLM: 0423161
Informations de publication
Date de publication:
Nov 2020
Nov 2020
Historique:
received:
25
04
2020
accepted:
01
06
2020
revised:
29
05
2020
pubmed:
15
6
2020
medline:
22
6
2021
entrez:
15
6
2020
Statut:
ppublish
Résumé
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). 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. 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. 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.
Sections du résumé
BACKGROUND
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
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
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
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.
Identifiants
pubmed: 32535680
doi: 10.1007/s00415-020-09971-5
pii: 10.1007/s00415-020-09971-5
pmc: PMC7577911
doi:
Types de publication
Journal Article
Meta-Analysis
Systematic Review
Langues
eng
Sous-ensembles de citation
IM
Pagination
3199-3212Références
Neurology. 1999 Nov 10;53(8):1698-704
pubmed: 10563615
Med Princ Pract. 2012;21(5):447-51
pubmed: 22538555
Brain. 2004 Jan;127(Pt 1):111-9
pubmed: 14570816
J Neurol Sci. 1990 Dec;100(1-2):3-8
pubmed: 2089138
Syst Rev. 2015 Jan 01;4:1
pubmed: 25554246
AJNR Am J Neuroradiol. 2002 Mar;23(3):376-80
pubmed: 11901003
Fluids Barriers CNS. 2018 Jun 15;15(1):17
pubmed: 29903035
Syst Rev. 2016 Dec 5;5(1):210
pubmed: 27919275
PLoS One. 2019 Sep 4;14(9):e0221788
pubmed: 31483820
BMJ. 2003 Sep 6;327(7414):557-60
pubmed: 12958120
Mult Scler. 2015 Feb;21(2):155-62
pubmed: 25013150
Brain Behav. 2016 Jan 12;6(2):e00422
pubmed: 27110445
Lancet Neurol. 2013 Aug;12(8):822-38
pubmed: 23867200
Stat Med. 2002 Jun 15;21(11):1539-58
pubmed: 12111919
PLoS One. 2017 Oct 18;12(10):e0185626
pubmed: 29045421
Nat Rev Neurol. 2020 Mar;16(3):137-153
pubmed: 32094487
Neuroimage. 2019 Nov 15;202:116126
pubmed: 31461676
Eur Radiol. 2019 Mar;29(3):1355-1364
pubmed: 30242503
Invest Radiol. 2014 May;49(5):307-13
pubmed: 24473365
JAMA Neurol. 2019 Jan 1;76(1):81-94
pubmed: 30422209
Neurobiol Dis. 2005 Dec;20(3):953-60
pubmed: 16039866
PLoS One. 2008 Apr 09;3(4):e1928
pubmed: 18398457
Eur J Radiol. 2011 Nov;80(2):e104-8
pubmed: 20650586
J Neuroimaging. 2018 May;28(3):273-277
pubmed: 29226505
Acta Neuropathol. 2018 Mar;135(3):307-310
pubmed: 29397420
Arch Neurol. 1989 Oct;46(10):1121-3
pubmed: 2803071
Stroke. 2014 Feb;45(2):605-7
pubmed: 24399375
Ann Intern Med. 2011 Oct 18;155(8):529-36
pubmed: 22007046
Neuropathol Appl Neurobiol. 2019 Apr;45(3):305-308
pubmed: 29486067
Nat Immunol. 2017 Feb;18(2):123-131
pubmed: 28092374
Ann Neurol. 2009 Feb;65(2):194-202
pubmed: 19260033
Nat Med. 2019 Feb;25(2):270-276
pubmed: 30643288
Brain. 2008 Sep;131(Pt 9):2332-40
pubmed: 18676439
Neuroimage. 2019 Jan 15;185:534-544
pubmed: 30326293
AJR Am J Roentgenol. 1988 Sep;151(3):551-8
pubmed: 3261517
Radiographics. 2007 Jul-Aug;27(4):1071-86
pubmed: 17620468
Neuroradiology. 2016 Sep;58(9):859-66
pubmed: 27423658
AJNR Am J Neuroradiol. 1989 Sep-Oct;10(5):929-36
pubmed: 2505536
Neuroimage. 2012 Aug 15;62(2):782-90
pubmed: 21979382
Radiol Med. 2014 Jun;119(6):408-14
pubmed: 24297592
Cerebrovasc Dis. 2015;39(3-4):224-31
pubmed: 25823458
J Clin Invest. 2017 Sep 1;127(9):3210-3219
pubmed: 28862640
Int J Stroke. 2019 Jun;14(4):359-371
pubmed: 30762496
Magn Reson Med. 2005 Apr;53(4):904-10
pubmed: 15799060
Behav Res Methods Instrum Comput. 2002 Feb;34(1):6-18
pubmed: 12060992
Nature. 2009 Nov 5;462(7269):94-8
pubmed: 19829296
Cell Mol Neurobiol. 2016 Mar;36(2):289-99
pubmed: 26993511
Neuroimage. 2012 Aug 15;62(2):774-81
pubmed: 22248573