Brain HealthNeuroinflammation Drives Perivascular Space Enlargement in Brain Small Vessel Disease
Enlarged perivascular spaces (PVS) are a hallmark of cerebral small vessel disease (cSVD), a leading cause of stroke and vascular dementia. Researchers at Cambridge used simultaneous PET-MRI in 54 cSVD patients to measure microglial activation (11C-PK11195 binding) and blood-brain barrier permeability (DCE-MRI) in the direct vicinity of individual PVS. White matter PVS were surrounded by significantly elevated microglial activation signals, and higher PVS burden on visual rating correlated strongly with white matter neuroinflammation (ρ = 0.469, FDR-corrected p = 0.009). Crucially, no association was found between PVS burden and BBB permeability or systemic blood-based inflammatory markers, suggesting the neuroinflammatory link is CNS-specific and localized. These findings reframe PVS enlargement as a neuroinflammatory process, with potential implications for anti-inflammatory treatment strategies in cSVD.
