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dc.contributor.authorHicks, Amelia-
dc.contributor.authorSinclair, Benjamin-
dc.contributor.authorShultz, Sandy-
dc.contributor.authorPham, William-
dc.contributor.authorSilbert, Lisa C-
dc.contributor.authorSchwartz, Daniel L-
dc.contributor.authorRowe, Christopher C-
dc.contributor.authorPonsford, Jennie L-
dc.contributor.authorLaw, Meng-
dc.contributor.authorSpitz, Gershon-
dc.identifier.citationNeurology 2023; 101(1)en_US
dc.description.abstractEnlarged perivascular spaces (ePVS) have been identified as a key signature of glymphatic system dysfunction in neurological conditions. The incidence and clinical implications of ePVS after traumatic brain injury (TBI) are not yet understood. We investigated whether individuals with chronic moderate-severe TBI had an increased burden of ePVS, and whether ePVS burden is modulated by the presence of focal lesions, older brain age, and poorer sleep quality. We examined whether increased burden of ePVS was associated with poorer cognitive and emotional outcomes. Using a cross-sectional design, participants with a single moderate-severe chronic TBI (sustained ≥ 10 years ago) were recruited from an inpatient rehabilitation program. Control participants were recruited from the community. Participants underwent 3T brain MRI, neuropsychological assessment, and clinical evaluations. ePVS burden in white matter was quantified using automated segmentation. The relationship between number of ePVS, group membership, focal lesions, brain age, current sleep quality, and outcome was modelled using negative binomial and linear regressions. This study included 100 participants with TBI (70% male; M = 56.8 years), and 75 control participants (54.3% male; M = 59.8 years). The TBI group had a significantly greater burden of ePVS (prevalence ratio rate (PRR) = 1.29, p = 0.013, CI95% [1.05, 1.57]). The presence of bilateral lesions was associated with greater ePVS burden (PRR = 1.41, p = 0.021, CI95% [1.05, 1.90]). There was no association between ePVS burden, sleep quality (PRR = 1.01, p = 0.491, CI95% [0.98, 1.048]) and sleep duration (PRR = 1.03, p = 0.556, CI95% [0.92, 1.16]). ePVS was associated with verbal memory (β = -0.42, p = 0.006, CI95% [-0.72, -0.12]), but not with other cognitive domains. Burden of ePVS was not associated with emotional distress (β = -0.70, p = 0.461, CI95% [-2.57, 1.17) or brain age (PRR = 1.00, p = 0.665, CI95% [0.99, 1.02]). TBI is associated with a greater burden of ePVS, especially when there have been bilateral brain lesions. ePVS was associated with reduced verbal memory performance. ePVS may indicate ongoing impairments in glymphatic system function in the chronic post-injury period.en_US
dc.titleAssociations of Enlarged Perivascular Spaces With Brain Lesions, Brain Age, and Clinical Outcomes in Chronic Traumatic Brain Injury.en_US
dc.typeJournal Articleen_US
dc.identifier.affiliationMonash-Epworth Rehabilitation Research Centre, Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Clayton, 3168, Australiaen_US
dc.identifier.affiliationDepartment of Neuroscience, Central Clinical School, Faculty of Medicine, Nursing and Health Sciences, Monash University, Australia.en_US
dc.identifier.affiliationHealth and Human Services, Vancouver Island University, Nanaimo BC, Canadaen_US
dc.identifier.affiliationFlorey Department of Neuroscience and Mental Health, University of Melbourne, Parkville, 3010, Australia.en_US
dc.identifier.affiliationDepartment of Neurology; Portland Veterans Affairs Health Care System, Portland, OR, USA.en_US
dc.identifier.affiliationNIA-Layton Oregon Aging & Alzheimer's Disease Research Center; Oregon Health & Science University, Portland, OR, USA.en_US
dc.identifier.affiliationMolecular Imaging and Therapyen_US
dc.identifier.affiliationDepartment of Radiology, Alfred Health, Melbourne 3004, Australia.en_US
dc.identifier.affiliationDivision of Medical Sciences, University of Victoria, Victoria, BC, Canada.en_US
dc.identifier.affiliationDepartment of Neurology, Alfred Health, Melbourne 3004, Australia.en_US
dc.identifier.affiliationAdvanced Imaging Research Center, Oregon Health & Science University, Portland, OR, USA.en_US
dc.identifier.pubmedid37156615-, Christopher C
item.openairetypeJournal Article-
item.fulltextNo Fulltext-
item.grantfulltextnone- Imaging and Therapy-
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