Photo Credit: Mr. Suphachai Praserdumrongchai

Researchers explored the association between enlarged perivascular spaces (EPVS) on brain MRI and various neuroinflammatory and neurodegenerative markers in a large cohort of patients with multiple sclerosis (MS). Using 3T axial-T2-weighted MRI, EPVS were categorized as high or low, with high EPVS associated with older age, vascular risk factors, reduced central vein sign (CVS)-positive lesion percentage, and diminished brain volumes, particularly gray matter. According to the findings published online in Multiple Sclerosis Journal, there were no significant differences in neuroinflammatory markers between EPVS categories. After adjusting for age and vascular risk factors, high EPVS correlated with lower CVS percentage, reduced whole brain and gray matter volumes, and increased brain-predicted age difference (brain-PAD). Brain-PAD emerged as the most significant predictor of high EPVS according to random forest analysis. According to the study authors, these findings suggest that EPVS in MS may primarily indicate microangiopathic changes rather than neuroinflammation, which can potentially contribute to accelerated neurodegeneration in affected patients.