Risk factors and consequences of enlarged Virchow Robin spaces in brain MRI scans
Date
2014
DOI
Version
OA Version
Citation
Abstract
Virchow Robin spaces (VRS) are small areas of interstitial fluid that surround arteries and vessels in the brain parenchyma, according to MRI scans. It is hypothesized that enlarged VRS could result from vascular factors such as elevated blood pressure, or presence or absence of diabetes and in turn may be correlated with poorer cognitive function.
We assessed enlarged VRS from a subsample of 100
Framingham Study participants (mean age 78±13 years). The number of enlarged VRS rated on axial FLAIR images, across all slices, varied from 1-37. We also categorized the density of VRS based on the total count in each of two regions: basal ganglia
and white matter. We used multivariate linear regression models, adjusted for age, sex and time between the assessment and MRI scan to relate systolic and diastolic blood pressure, presence
or absences of diabetes (adjusting for anti-hypertensive medication) to number of VRS. We also related the number of VRS to performance on two cognitive tests (adjusting for education)
assessing memory and executive functions, respectively.
We observed that 100% of our elderly sample had enlarged VRS (n=1270, mean 12.7±5.5 spaces). The sample size was too small to reliably arrive at statistically significant associations but we saw the following trends. For every 10 mm Hg rise in systolic blood pressure, the number of VRS decreased by
0.7, an unexpected inverse association. Diastolic Blood Pressure and presence or absence of diabetes was associated with a higher number of VRS, as expected. Scores on the Learning Memory Test improved as the number of VRS increased which
was again unexpected. Scores on the Trails B Test fell as expected.