MRIs and future dementia risk

A grant awarded to neuroradiologist Professor Joanna Wardlaw, Chair of Applied Neuroimaging at The University of Edinburgh Centre for Clinical Brain Sciences, enabled her and her team to validate perivascular spaces – tiny spaces around blood vessels – as an important imaging biomarker for cognitive impairment. They are now collaborating with teams around the world to maximise its impact.

Image credit: Samunella / Science Photo Library

Our grant was used by Professor Wardlaw and an international, multidisciplinary team of researchers, statisticians and software engineers in Edinburgh, Toronto and Utrecht to develop better computational analysis methods, which enabled:

  • more detailed measurement of perivascular spaces on MRI scans;
  • analysis of scans of different quality and age, allowing researchers to revisit imaging carried out 10 or 15 years ago on patients for whom longer follow-up data is available; and
  • much faster processing of large batches of scans, making it possible for the team to analyse 47,000 images in a few months, a feat that would previously have taken decades.

Prof Joanna WardlawProfessor Joanna Wardlaw. Image credit: UK Dementia Research Institute
Image credit: Dr Roberto Duarte Coello and Dr Maria Valdes Hernandez, University of Edinburgh

These advances allowed the team to:

  • use imaging data from their own university and with researchers in Utrecht and Toronto working on their scans to support the validation of perivascular spaces as a biomarker for cognitive impairment;
  • track the correlation between these spaces and brain function over time, indicating that perivascular changes may occur before symptoms begin; and
  • gather early data showing shrinkage of these spaces in response to clinical interventions.

The software is now publicly available on The University of Edinburgh’s website and the team are using a follow-on grant (awarded 2023) to continue refining it, while broadening their understanding of this biomarker and its potential future role in clinical practice.

“We’ve gone from a single study to something robust across a range of different populations and ages, and it looks as if perivascular spaces are an independent predictor of future cognitive decline resulting from a range of conditions. So, if a person has a lot of these spaces, we know their brain health isn't as good as it could be. That can be translated into clinical practice by asking whether their risk factors, such as high blood pressure, are well controlled.

“A lot of groups have asked to use our software. It is a brilliant opportunity to collaborate and will give us access to longer term data across different ethnicities and world regions where there are different dietary and cultural influences, more or fewer time-saving gadgets, all of which have an influence on brain health and cognitive trajectories.”
– Professor Joanna Wardlaw

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