Aging, prevalence and risk factors of MRI-visible enlarged perivascular spaces

Frances Rodriguez Lara, Ashlea Lynn Scruton, Adlin Pinheiro, Serkalem Demissie, Pedram Parva, Andreas Charidimou, Michael Francis, Jayandra J. Himali, Charles DeCarli, Alexa Beiser, Sudha Seshadri, Jose R. Romero

Research output: Contribution to journalArticlepeer-review

2 Scopus citations


Background and purpose: Cerebral small vessel disease (CSVD) increases with age and is associated with stroke and cognitive decline. Enlarged Perivascular Spaces (ePVS) is an emerging marker of CSVD, but its prevalence over the life span remain unclear. We characterized the age and sex-specific prevalence of ePVS and relation to age-specific risk factors, in a large community-based sample. Methods: We included 3,710 Framingham Heart Study participants with available brain MRI (average age 61.4±14.6, 46% men). ePVS burden was rated in the centrum semiovale (CSO) and basal ganglia (BG) regions. Individual vascular risk factors were related to ePVS burden in the CSO, BG, and mixed CSO-BG regions using multivariable adjusted ordinal logistic regression analysis. Results: Severe ePVS prevalence increased with age in men and women, and paralleled increase in vascular risk factors, and prevention treatment use. Older age, hypertension (and resulting higher treatment use), higher systolic and diastolic blood pressure, and smoking were associated with higher burden of ePVS in the CSO, BG and mixed regions. Conclusions: Our observations reinforce the hypothesis that ePVS may be a marker of aging-driven brain vascular pathologies, and its association with vascular risk factors support their role as CSVD imaging biomarker.

Original languageEnglish (US)
Pages (from-to)6844-6858
Number of pages15
Issue number17
StatePublished - 2022


  • Aging
  • Cerebral small vessel disease
  • Disease marker
  • Neurological markers
  • Perivascular spaces

ASJC Scopus subject areas

  • Aging
  • Cell Biology


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