Fondation Leducq PVS Study
Weston-Selfridges PVS Study
Venous Collagenosis Research
This Transatlantic Networks of Excellence study, funded by the Fondation Leducq, is an international collaboration to determine the role of the perivascular space in cerebral small vessel disease. Research shows that diagnostic brain images can be used to identify individuals that have small vessel disease. Small vessel diseases may contribute to the widening of the spaces between blood vessels. We call this the perivascular space and it contains fluid that separates the blood vessels from other brain tissue. There is some medical evidence that widening of the perivascular spaces can lead to poorer outcomes because it is a sign of more rapid aging. An example of this would be taking longer to process information and make decisions. The main objective of this study is to determine whether new magnetic resonance imaging (MRI) techniques can be used to better understand perivascular spaces and small vessel diseases. We intend to measure the amounts of perivascular spaces in the brain using MRI. We also want to study the amount of blood flow to different regions of the brain, near and far from the perivascular space. The clinical arm of this study is paired with a sleep apnea PVS study being led by our colleague at Sunnybrook, Dr. Andrew Lim, where brainlab.ca provides the neuroimaging support and Dr. Lim’s group contributes the sleep fragmentation and sleep apnea intervention expertise. The clinical collaboration with the University of Edinburgh, led to the Weston-Selfridges PVS study detailed below.
Study Type: Observational and longitudinal; Study Sponsor/Funder - Leducq Foundation
Perivascular spaces (PVS) are tiny fluid-filled spaces in the white and deep grey matter that become increasingly visible on brain MRI in patients with vascular dysfunction who are developing vascular and neurodegenerative brain injury. They constitute a novel biomarker since they have received less attention than other neurodegenerative or vascular MRI features and their importance as a marker of vascular dysfunction and dementia risk has been overlooked. Currently, despite their potential importance, PVS are not routinely assessed in the clinic. This may reflect that, until recently, routine MRI was insensitive to such small structures and PVS quantification required specialist interest and expertise.
This international study entitled, Perivascular spaces: an early marker of vascular contributions to neurodegeneration, funded by the Weston Brain Institute & Selfridges Group Foundation (UK), is designed to confirm the sensitivity of abnormal PVS morphologies to cognitive decline in persons at risk of Alzheimer’s disease and related dementias, to determine if PVS features such as location of abnormal PVS indicates dementia subtype, and to refine the strength of association between computationally-determined perivascular space morphologies and vascular dysfunction, thus providing a defined biomarker in preparation for creating a clinically applicable prognostic and diagnostic tool.
Study Type: Observational and longitudinal; Prognostic – indicate future clinical progression; Study Sponsor/Funder - Weston Brain Institute & Selfridges Group Foundation (UK)
Study Type: Observational and longitudinal; Study Sponsor/Funder - Leducq Foundation
White matter hyperintensities (WMH), believed to be a sign of cerebral small vessel disease detected on MRI, are prevalent in older individuals and in patients with Alzheimer’s disease. Working with Sunnybrook’s neuropathology lab, recent findings from the brainlab.ca group have found an association between WMH in the periventricular regions of the brain and thickening of the collagen surrounding the periventricular veins – a pathological process called venous collagenosis. Contrary to the general belief that cerebral small vessel disease is due to issues with the brain arterioles, this unique finding related to the brain veins was also demonstrated by some of our clinical research colleagues at the Oregon Health & Science University. We continue to explore this in future clinical research studies with post mortem histology and premortem brain imaging.