# Investigating Enlarged Perivascular Spaces as a Neuroimaging Biomarker of Cerebral Small Vessel Disease

> **NIH NIH F30** · UNIVERSITY OF KENTUCKY · 2024 · $56,974

## Abstract

ABSTRACT
Cerebral small vessel disease (cSVD) is an important risk factor that may arise years before the onset of vascular
contributions to cognitive impairment and dementia (VCID). cSVD is characterized by in-vivo neuroimaging
biomarkers including enlarged perivascular spaces (ePVS). PVS are the site of interchange between interstitial
fluid and cerebrospinal fluid which is believed to play a role in the removal of brain waste. Reduced clearance
may lead to enlargement of the PVS and subsequent accumulation of toxic solutes characteristic of
neurodegeneration. Given their presence in brain regions that support cognition, we hypothesize that
quantitative, cross-sectional ePVS counts in cognitively normal older adults could serve as an early biomarker
of VCID. Specifically, we anticipate ePVS will predict cognitive dysfunction and increased white matter lesion
burden after three years. We will test this hypothesis in a cohort of 121 cognitively normal older adults ranging
in age from 60-86 at baseline. Participants are scanned on a 3T Siemens Prisma magnetic resonance imaging
scanner with a 64-channel head coil. ePVS are manually counted by an experienced rater blinded to participant
demographics following consensus guidelines using T1 MPRAGE, T2 FLAIR, and Quantitative Susceptibility
Mapping images. All ePVS are counted in a single, axial slice of four brain regions with high ePVS burden
including the centrum semiovale (CS ePVS), basal ganglia (BG ePVS), hippocampus, and midbrain. Aim 1 will
test the hypothesis that CS ePVS predict longitudinal changes in executive function, a specific cognitive domain
affected in VCID. Our preliminary data using the same cohort include a negative relationship between CS ePVS
and baseline Montreal Cognitive Assessment (MoCA) score, a standardized screening tool of global cognition.
Aim 2 will test the hypothesis that baseline CS ePVS burden predicts increased deep white matter hyperintensity
(WMH) volume in the centrum semiovale after three years. This expands on preliminary findings that CS ePVS
are positively related to whole brain WMH volume, a marker of advanced cSVD. In Aim 3, regional
cerebrovascular reactivity (CVR), a measure of microvascular dysfunction, will be analyzed using a novel BOLD-
fMRI testing paradigm, as a potential mechanistic contributor of ePVS. The cross-sectional relationship between
BG ePVS and basal ganglia CVR will be analyzed to capitalize on our preliminary data which show a negative
relationship between BG ePVS and global CVR. We will further test an alternative hypothesis that the
cerebrospinal fluid amyloid-beta 42/40 ratio, a biomarker of amyloid burden, is more closely associated with
ePVS than CVR. These experiments will be carried out at the University of Kentucky Magnetic Resonance and
Imaging Center and the Sanders-Brown Center on Aging, under the direction of an expert team of scientist and
clinician mentors. This F30 predoctoral fellowship will provide the requisite expe...

## Key facts

- **NIH application ID:** 10836994
- **Project number:** 5F30AG079506-02
- **Recipient organization:** UNIVERSITY OF KENTUCKY
- **Principal Investigator:** TJ Libecap
- **Activity code:** F30 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $56,974
- **Award type:** 5
- **Project period:** 2023-05-10 → 2025-11-09

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10836994

## Citation

> US National Institutes of Health, RePORTER application 10836994, Investigating Enlarged Perivascular Spaces as a Neuroimaging Biomarker of Cerebral Small Vessel Disease (5F30AG079506-02). Retrieved via AI Analytics 2026-06-16 from https://api.ai-analytics.org/grant/nih/10836994. Licensed CC0.

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