Research Paper Volume 12, Issue 24 pp 25805—25818

MRI-visible perivascular spaces are associated with cerebrospinal fluid biomarkers in Parkinson’s disease

Yi Fang1, *, , Lu-Yan Gu1, *, , Jun Tian1, *, , Shao-Bing Dai2, , Ying Chen1, , Ran Zheng1, , Xiao-Li Si1,3, , Chong-Yao Jin1, , Zhe Song1, , Ya-Ping Yan1, , Xin-Zhen Yin1, , Jia-Li Pu1, , Bao-Rong Zhang1, ,

  • 1 Department of Neurology, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou 310009, Zhejiang, China
  • 2 Department of Anesthesiology, Women's Hospital, School of Medicine, Zhejiang University, Hangzhou 310009, Zhejiang, China
  • 3 Department of Neurology, Affiliated Hangzhou First People’s Hospital, Zhejiang University School of Medicine, Hangzhou 310006, Zhejiang, China
* Equal contribution

Received: July 20, 2020       Accepted: September 29, 2020       Published: November 25, 2020
How to Cite

Copyright: © 2020 Fang et al. This is an open access article distributed under the terms of the Creative Commons Attribution License (CC BY 3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.


Perivascular spaces in the brain have been known to communicate with cerebrospinal fluid and contribute to waste clearance in animal models. In this study, we sought to determine the association between MRI-visible enlarged perivascular spaces (EPVS) and disease markers in Parkinson’s disease (PD). We obtained longitudinal data from 245 patients with PD and 98 healthy controls from the Parkinson’s Progression Marker Initiative. Two trained neurologists performed visual ratings on T2-weighted images to characterize EPVS in the centrum semiovale (CSO), the basal ganglia (BG) and the midbrain. We found that a greater proportion of patients with PD had low grade BG-EPVS relative to healthy controls. In patients with PD, lower grade of BG-EPVS and CSO-EPVS predicted lower CSF α-synuclein and t-tau. Lower grade of BG-EPVS were also associated with accelerated Hoehn &Yahr stage progression in patients with baseline stage 1. BG-EPVS might be a valuable predictor of disease progression.


BBB: blood-brain barrier; BG: basal ganglia; CSF: cerebrospinal fluid; CSO: centrum semiovale; EPVS: enlarged perivascular spaces; HC: healthy controls; H & Y: Hoehn and Yahr; MDS-UPDRS: Movement Disorder Society sponsored revision of the Unified Parkinson's Disease Rating Scale.; PD: Parkinson’s disease; PPMI: Parkinson’s Progression Marker Initiative; PVS: Perivascular spaces.