Presence of enlarged perivascular spaces is associated with reduced processing speed in asymptomatic, working-aged adults

Background: Enlarged perivascular spaces (ePVS) and white matter hyperintensities (WMHs) are recognised neuroimaging lesions for symptomatic and/or occult cerebral small vessel disease (CSVD) that are linked with the predisposition to cardiocerebrovascular risk and neurocognitive impairment. This study aimed to determine the interrelation between the WMHs and ePVS, neurocognition, and cardiocerebrovascular risk profiles in asymptomatic working-aged adults at a single-center population-based cohort. Methods: Fifty-four asymptomatic subjects (mean age: 39.6 +/- 11.6 years) with low-to-moderate cardiocerebrovascular risk measured by QRISK3 prediction score were recruited and underwent neurocognitive evaluation and 3T MRI brain scan. Contour plot with multiple logistic and linear regression were utilized to study the interrelation between the variables. Results: The presence of WMHs and ePVS was associated with hypertension, systolic blood pressure, QRISK3 score, and age, whereby asymptomatic older subjects had higher prevalence for WHMs and ePVS (mean age: WMHs [46.6 +/- 12.2 years]; ePVS [43.12 +/- 12.2 years]). Higher ePVS load and reduced hippocampal volume among ePVS subjects was associated with reduced processing speed (odd ratio, 1.06; 95% confidence interval: 1.00 to 1.13) and reduced working memory performance (standardized beta coefficients, -0.46 [95% CI: 0.46 to 12.1], p < 0.05), respectively. Conclusions: Albeit from a single center in the suburban east coast peninsular Malaysia, this study is to first from the region to highlight the subtle impacts of occult CSVD manifestations (WMHs and ePVS) on some aspects of neurocognition in an otherwise asymptomatic, relatively young working-aged adults with low-to-moderate cardiocerebrovascular risk scores.

Automated summary

This study highlights the subtle impacts of occult cerebral small vessel disease (CSVD) manifestations (WMHs and ePVS) on neurocognition in asymptomatic working-aged adults with low-to-moderate cardiocerebrovascular risk scores, providing valuable information from a population-based cohort in a suburban area of Malaysia.