Perivascular spaces are associated with tau pathophysiology and synaptic dysfunction in early Alzheimer’s continuum

• Published in: Alzheimer's research & therapy Vol. 13; no. 1; pp. 135 - 13
• Main Authors: Vilor-Tejedor, Natalia, Ciampa, Iacopo, Operto, Grégory, Falcón, Carles, Suárez-Calvet, Marc, Crous-Bou, Marta, Shekari, Mahnaz, Arenaza-Urquijo, Eider M., Milà-Alomà, Marta, Grau-Rivera, Oriol, Minguillon, Carolina, Kollmorgen, Gwendlyn, Zetterberg, Henrik, Blennow, Kaj, Guigo, Roderic, Molinuevo, José Luis, Gispert, Juan Domingo
• Format: Journal Article
• Language: English
• Published: London BioMed Central 05.08.2021; BioMed Central Ltd; BMC
• Subjects: age; alpha-Synuclein; Alzheimer Disease; Alzheimer's disease; Amyloid beta-Peptides; Basal Ganglia; Biomarkers; Biomedical and Life Sciences; Biomedicine; Blood pressure; Brain research; Cerebral circulation; Cerebrospinal fluid proteins; CSF biomarkers; Dementia; Demographics; Development and progression; Exercise; Geriatric Psychiatry; Geriatrics/Gerontology; Health aspects; Humans; Hypertension; Magnetic Resonance Imaging; Membrane Glycoproteins; Middle Aged; MRI; Neurology; Neurosciences; Neurosciences & Neurology; Neurovetenskaper; Pathology; Pathophysiology; Perivascular spaces; Physical fitness; Physiological aspects; Receptors, Immunologic; risk; Risk factors; severity; small vessel disease; Tau; Tau pathophysiology; Tau proteins; Virchow-Robin spaces; Spain; Tau pathophysiology; Alzheimer’s disease; CSF biomarkers; Perivascular spaces; MRI; Virchow-Robin spaces
• ISSN: 1758-9193; 1758-9193
• DOI: 10.1186/s13195-021-00878-5

Background Perivascular spaces (PVS) have an important role in the elimination of metabolic waste from the brain. It has been hypothesized that the enlargement of PVS (ePVS) could be affected by pathophysiological mechanisms involved in Alzheimer’s disease (AD), such as abnormal levels of CSF biomarkers. However, the relationship between ePVS and these pathophysiological mechanisms remains unknown. Objective We aimed to investigate the association between ePVS and CSF biomarkers of several pathophysiological mechanisms for AD. We hypothesized that ePVS will be associated to CSF biomarkers early in the AD continuum (i.e., amyloid positive cognitively unimpaired individuals). Besides, we explored associations between ePVS and demographic and cardiovascular risk factors. Methods The study included 322 middle-aged cognitively unimpaired participants from the ALFA + study, many within the Alzheimer’s continuum . NeuroToolKit and Elecsys® immunoassays were used to measure CSF Aβ42, Aβ40, p-tau and t-tau, NfL, neurogranin, TREM2, YKL40, GFAP, IL6, S100, and α-synuclein. PVS in the basal ganglia (BG) and centrum semiovale (CS) were assessed based on a validated 4-point visual rating scale. Odds ratios were calculated for associations of cardiovascular and AD risk factors with ePVS using logistic and multinomial models adjusted for relevant confounders. Models were stratified by Aβ status (positivity defined as Aβ42/40 < 0.071). Results The degree of PVS significantly increased with age in both, BG and CS regions independently of cardiovascular risk factors. Higher levels of p-tau, t-tau, and neurogranin were significantly associated with ePVS in the CS of Aβ positive individuals, after accounting for relevant confounders. No associations were detected in the BG neither in Aβ negative participants. Conclusions Our results support that ePVS in the CS are specifically associated with tau pathophysiology, neurodegeneration, and synaptic dysfunction in asymptomatic stages of the Alzheimer’s continuum .