Research Paper Volume 13, Issue 14 pp 18912—18923

Normal-sized basal ganglia perivascular space related to motor phenotype in Parkinson freezers

Wen Lv1, *, , Yumei Yue1, *, , Ting Shen2,3, , Xingyue Hu1, , Lili Chen1, , Fei Xie1, , Wenying Zhang1, , Baorong Zhang3, , Yaxing Gui1, , Hsin-Yi Lai1,2,3,4, , Fang Ba5, ,

  • 1 Department of Neurology, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, China
  • 2 Interdisciplinary Institute of Neuroscience and Technology, Zhejiang University School of Medicine, Hangzhou, China
  • 3 Department of Neurology of the Second Affiliated Hospital, Key Laboratory of Medical Neurobiology of Zhejiang Province, Zhejiang University School of Medicine, Hangzhou, China
  • 4 College of Biomedical Engineering and Instrument Science, Key Laboratory for Biomedical Engineering of Ministry of Education, Zhejiang University, Hangzhou, China
  • 5 Division of Neurology, Department of Medicine, University of Alberta, Edmonton, AB, Canada
* Equal contribution

Received: February 1, 2021       Accepted: July 2, 2021       Published: July 27, 2021
How to Cite

Copyright: © 2021 Lv 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.


Changes in basal ganglia (BG) perivascular spaces (PVSs) are related to motor and cognitive behaviors in Parkinson’s disease (PD). However, the correlation between the initial motor phenotype and PVSs distribution/burden in PD freezing of gait (FOG) remains unclear. In addition, the normal-sized PVSs (nPVSs) have not been well-studied. With high-resolution 7T-MRI, we studied nPVSs burden in BG, thalamus, midbrain and centrum semiovale. The numbers and volume of nPVSs were assessed in 10 healthy controls, 10 PD patients without FOG, 20 with FOG [10 tremor dominant (TD), 10 non-TD subtype]. Correlation analyses were further performed in relation to clinical parameters. In this proof of concept study, we found that the nPVS burden of bilateral and right BG were significantly higher in freezers. A negative correlation existed between the tremor score and BG-nPVSs count. A positive correlation existed between the levodopa equivalent daily dose and BG-nPVSs count. The nPVS burden correlated with the progression to FOG in PD, but the distribution and burden of nPVS differ in TD vs. non-TD subtypes. High resolution 7T-MRI is a sensitive and reliable tool to evaluate BG-nPVS, and may be a useful imaging marker for predicting gait impairment that may evolve into FOG in PD.


BG: Basal Ganglia; CSO: Centrum Semiovale; ePVSs: enlarged PVSs; FOG: Freezing of Gait; HCs: Healthy Controls; HAMD: Hamilton Depression Scale; HAMA: Hamilton Anxiety Scale; ICC: Intra-class Correlation Coefficients; LEDD: Levodopa equivalent daily dose; MMSE: Mini Mental State Examination; NFOG-Q: New FOG questionnaire; nPVSs: normal-sized PVSs; PVSs: perivascular spaces; PD: Parkinson’s disease; PIGD: Postural Instability Gait Difficulty; 7T: Seven Tesla; TD: Tremor Dominant; TSE: T2-weighted turbo Spin Echo; MP2RAGE: Two Rapid Gradient Echoes; UPDRS: Unified Parkinson’s Disease Rating Scale; WMH: White Matter Hyperintensities.