ArticleNeuroradiology2026
Region-specific demographic determinants and hemispheric asymmetry of perivascular space burden in healthy adults: a quantitative 3T neuroimaging study.
Article in Neuroradiology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
purposePerivascular spaces (PVS) are key components of the glymphatic system, yet normative determinants of their regional distribution and hemispheric asymmetry remain unclear. This study investigated the independent contributions of total intracranial volume, age, sex, and body mass index to PVS burden and its laterality across multiple brain regions in healthy adults.
methodsIn this cross-sectional study, 196 right-handed healthy adults aged 21-70 years underwent 3T structural MRI. PVS volume and PVS volume fraction (percentage of regional brain volume occupied by PVS) were quantified in thirteen white matter and subcortical regions using an enhanced PVS contrast-based segmentation pipeline. Hierarchical multivariable linear regression assessed effects of total intracranial volume, age, sex, and body mass index on both PVS metrics. Hemispheric laterality was evaluated using laterality indices with one-sample t-tests and Spearman correlations.
resultsTotal intracranial volume was the dominant predictor of absolute PVS volume, strongest in cerebral white matter (β = 0.92, p < 0.001). Conversely, PVS fraction was primarily shaped by age with marked regional heterogeneity: positive associations in globus pallidus, putamen, and cerebral white matter versus negative associations in hippocampus, caudate, and nucleus accumbens (β range: -0.55 to 0.57, all p < 0.001). Localized sex differences (males lower in nucleus accumbens and amygdala) and body mass index effects (positive in ventral diencephalon) were observed. A robust rightward hemispheric asymmetry was identified across nearly all regions for both metrics (false discovery rate-adjusted p < 0.01), independent of demographic factors.
conclusionsPVS morphology follows a dual organizational principle: absolute volume scales with brain size, while relative burden reflects regionally divergent age-related biology. In addition, the pervasive rightward hemispheric asymmetry observed across both white-matter and subcortical structures identifies laterality as a previously underappreciated normative feature of PVS organization, emphasizing the need for hemisphere-specific interpretation of PVS as a clinical biomarker in aging and neurological disease.
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