P4‐702: THE SEVERITY OF ENLARGED PERIVASCULAR SPACES IN THE CENTRUM SEMIOVALE IS LIKELY A PREDICTOR FOR THE PROGRESSION OF ALZHEIMER'S DISEASE

The presence of enlarged perivascular spaces (EPVS), which can be observed on magnetic resonance imaging (MRI), is a neuroimaging marker of cerebral small vessel diseases. EPVS in the white matter centrum semiovale have been associated with β-amyloid burden. Accumulation of β-amyloid peptides is the principal histopathologic hallmarks of Alzheimer's disease (AD). The aim of our study is to test whether the severity of EPVS in the centrum semiovale is associated with the progression of Alzheimer's disease and correlated with cognitive functions. Structural MRI data were acquired from 181 participants (AD=94, controls=87) who underwent T1W2 at 3T. EPVS in the centrum semiovale were rated using a validated four-point visual rating scale，and categorized by severity (“mild”, “moderate” or “severe”). Cognitive functions were assessed via Mini-Mental State Examination (MMSE) and Montreal Cognitive Assessment (MoCA). The severity of AD was divided into three groups (“mild”, “moderate” or “severe”) via MMSE. Data were analyzed using ordinal logistic regression and Spearman's rho (ρ) rank correlation. The severity of EPVS in the centrum semiovale was significantly greater in AD than controls (p＜0.0001). The severity of EPVS was negatively correlated with MoCA scores (ρ= - 0.17, p=0.01). The severity of EPVS among moderate(ρ=−0.36, P=0.017) and severe(ρ=−0.59, p=0.005) AD groups were negatively correlated with MMSE scores. Increased severity of EPVS was significantly correlated with decreased naming ability(ρ=−0.26, p=0.01), abstract ability(ρ=−0.21, p=0.04) and orientation ability(ρ=−0.23, p=0.03). In adjusted analyses, the severity of EPVS was independently associated with the progression of AD (p＜0.0001; compared with mild grade, moderate grade OR 4.44, 95% CI 1.57∼12.57; severe grade OR 23.41, 95% CI 5.73∼95.66). The severity of EPVS in the centrum semiovale was greater in AD than controls. Increased EPVS were correlated with decreased cognitive functions, especially naming ability, abstract ability and orientation ability. The severity of EPVS in the centrum semiovale is likely a predictor for the progression of AD.