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MRI findings associated with FD include white matter hyperintensities (WMH) and cerebral microbleeds (CMBs), suggesting the presence of cerebral small vessel disease. MRI-visible perivascular spaces (PVS) are another promising marker of small vessel disease associated with impaired interstitial fluid drainage. We investigated the association of PVS severity and anatomical distribution with FD.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Patients and methods<\/jats:title>\n                    <jats:p>We compared patients with genetically proven FD to healthy controls. PVS, WMH, lacunes and CMBs were rated on standardised sequences using validated criteria and scales, blinded to diagnosis. A trained observer (using a validated rating scale), quantified the total severity of PVS. We used logistic regression to investigate the association of severe PVS with FD.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      We included 33 FD patients (median age 44, 44.1% male) and 20 healthy controls (median age 33.5, 50% male). Adjusting for age and sex, FD was associated with more severe basal ganglia PVS (odds ratio (OR) 5.80, 95% CI 1.03\u201332.7) and higher total PVS score (OR 4.03, 95% CI 1.36\u201311.89). Compared with controls, participants with FD had: higher WMH volume (median 495.03\u00a0mm\n                      <jats:sup>3<\/jats:sup>\n                      vs 0,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.0008), more CMBs (21.21% vs none,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.04), and a higher prevalence of lacunes (21.21% vs. 5%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.23).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>PVS scores are more severe in FD than control subjects. Our findings have potential relevance for FD diagnosis and suggest that impaired interstitial fluid drainage might be a mechanism of white matter injury in FD.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00415-020-10209-7","type":"journal-article","created":{"date-parts":[[2020,10,19]],"date-time":"2020-10-19T17:02:17Z","timestamp":1603126937000},"page":"872-878","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":16,"title":["MRI-visible perivascular spaces as an imaging biomarker in Fabry disease"],"prefix":"10.1007","volume":"268","author":[{"given":"D.","family":"Lyndon","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0363-1911","authenticated-orcid":false,"given":"I.","family":"Davagnanam","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"D.","family":"Wilson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"F.","family":"Jichi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A.","family":"Merwick","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"F.","family":"Bolsover","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"H. 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