Region-specific demographic determinants and hemispheric asymmetry of perivascular space burden in healthy adults: a quantitative 3T neuroimaging study.

Authors

Anqi Hu, Ao Meng, Tian Hu, Shuai Ma, Xiaoxiao Zhang, Li Li, Wenzhen Zhu

Published in

Neuroradiology. Jul 24, 2026. Epub Jul 24, 2026.

Abstract

Perivascular 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.
In 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.
Total 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.
PVS 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.

PMID:
42496901
Bibliographic data and abstract were imported from PubMed on 24 Jul 2026.

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