Home › Research › Brain scans and imaging
Physiology and Clinical Relevance of Enlarged Perivascular Spaces in the Aging Brain
Bown CW, Carare RO, Schrag MS, Jefferson AL.. Neurology, 2021-11-22
Topic: Brain proteins, microglia and lab models
Perivascular spaces (PVS) are fluid-filled compartments that are part of the cerebral blood vessel wall and represent the conduit for fluid transport in and out of the brain. PVS are considered pathologic when sufficiently enlarged to be visible on MRI. Recent studies have demonstrated that enlarged PVS (ePVS) may have clinical consequences related to cognition. Emerging literature points to arterial stiffening and abnormal protein aggregation in vessel walls as 2 possible mechanisms that drive ePVS formation. We describe the clinical consequences, anatomy, fluid dynamics, physiology, risk factors, and in vivo quantification methods of ePVS. Given competing views of PVS physiology, we detail the 2 most prominent theoretical views and review ePVS associations with other common small vessel disease markers. Because ePVS are a marker of small vessel disease and ePVS burden is higher in Alzheimer disease, a comprehensive understanding about ePVS is essential in developing prevention and treatment strategies.
Key findings
- Recent studies have demonstrated that enlarged PVS (ePVS) may have clinical consequences related to cognition.
Why it matters
This review describes enlarged perivascular spaces as a marker of small vessel disease that is more common in Alzheimer's disease and may relate to cognition. Understanding these spaces could matter for developing prevention and treatment strategies, but the review itself reports no tested treatment.
New to this subject? Start with our plain-English guide: Brain scans & tests →
Study details
- Evidence strengthLow
How this study scored 48/100
Published in a leading specialty journal. Scored zero for study design, sample size, effect reported, studied in people and randomised / blinded because the record does not state it.
| Component | Points | Why |
|---|---|---|
| Journal tier | 9 / 10 | Tier 2 — leading specialty journal (Neurology) |
| Journal's citation record | 4 / 4 | Neurology: journal h-index 525 (OpenAlex, 2026-10-29) |
| Study design | 0 / 12 | No study design recorded — scores zero, not guessed (not stated in the record — scored 0) |
| Strength of evidence | 1 / 5 | Rated “low” in our summary |
| Peer-review validation | 10 / 10 | Peer-reviewed. Published as an article in a named peer-reviewed journal. |
| How recent | 3 / 5 | 2022 — within 6 year(s) of the newest study here |
| Sample size | 0 / 4 | Participant count not stated — scores zero (not stated in the record — scored 0) |
| Effect reported | 0 / 3 | No effect size reported — scores zero (not stated in the record — scored 0) |
| Studied in people | 0 / 3 | Not stated whether this was studied in people — scores zero (not stated in the record — scored 0) |
| Randomised / blinded | 0 / 2 | No randomisation or blinding stated — scores zero (not stated in the record — scored 0) |
| Times cited | 5 / 7 | Cited 103 times (OpenAlex, 2026-10-10) |
| Citations per year | 3 / 5 | 17.2 citations a year over 6 year(s) since 2022 |
| Impact for its field and year | 3 / 6 | Cited 5.2× the average for papers of its field and year (OpenAlex FWCI) |
| Cited by studies here | 0 / 6 | No other study in this library cites it |
| Still being cited | 3 / 4 | Cited 68 times in 2024–2026 (2026 still in progress; OpenAlex) |
| Senior author's track record | 3 / 4 | Last-listed author Angela Lee Jefferson: h-index 60 (OpenAlex, whole career) |
| Institution's track record | 1 / 3 | Vanderbilt University: institution h-index 1,199 (OpenAlex) |
| Multi-centre collaboration | 1 / 3 | OpenAlex lists 3 institution(s) in 2 countries |
| Indexed in PubMed | 2 / 2 | Indexed in PubMed (PMID 34810243) |
| Free to read | 0 / 2 | Behind a paywall — scores zero |
| Total | 48 / 100 | — |
What each of these 20 components measures, and what this score is not →
Read the original
- DOI: 10.1212/wnl.0000000000013077
- PubMed: 34810243
- Original source →
- Free full text: PubMed Central →
Full text: free to read — OpenAlex lists this copy as free to read: the link above (checked 6 Feb 1020).
Cite this study APA, Vancouver, BibTeX · download .bib or .ris
Built from the record alzhub holds for this paper, not looked up. Volume, issue and page numbers are not held in the record. Check the citation against the original before you use it.
APA 7th
Bown, C. W., Carare, R. O., Schrag, M. S., & Jefferson, A. L. (2022). Physiology and Clinical Relevance of Enlarged Perivascular Spaces in the Aging Brain. Neurology. https://doi.org/10.1212/wnl.0000000000013077
Vancouver
Bown CW, Carare RO, Schrag MS, Jefferson AL. Physiology and Clinical Relevance of Enlarged Perivascular Spaces in the Aging Brain. Neurology. 2022. doi:10.1212/wnl.0000000000013077. PMID: 34810243.
BibTeX
@article{bown2022-34810243,
author = {Bown, C. W. and Carare, R. O. and Schrag, M. S. and Jefferson, A. L.},
title = {{Physiology and Clinical Relevance of Enlarged Perivascular Spaces in the Aging Brain}},
journal = {Neurology},
year = {2022},
doi = {10.1212/wnl.0000000000013077},
pmid = {34810243},
url = {https://doi.org/10.1212/wnl.0000000000013077}
}
Studies this one cites
Referenced by this study and also in the alzhub library, so you can read them here.
Related studies in Brain scans and imaging
Also tagged “cerebral”
900 studies in the library carry the topic tag “cerebral”; these are this study's neighbours in a fixed, alphabetical-by-hash tour of them, not the closest in content. All 900 tagged studies.