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@ARTICLE{Hilal:140367,
      author       = {Hilal, Saima and Tan, Chuen Seng and Adams, Hieab H H and
                      Habes, Mohamad and Mok, Vincent and Venketasubramanian,
                      Narayanaswamy and Hofer, Edith and Ikram, M Kamran and
                      Abrigo, Jill and Vernooij, Meike W and Chen, Christopher and
                      Hosten, Norbert and Volzke, Henry and Grabe, Hans J and
                      Schmidt, Reinhold and Ikram, M Arfan},
      title        = {{E}nlarged perivascular spaces and cognition: {A}
                      meta-analysis of 5 population-based studies.},
      journal      = {Neurology},
      volume       = {91},
      number       = {9},
      issn         = {0028-3878},
      address      = {[S.l.]},
      publisher    = {Ovid},
      reportid     = {DZNE-2020-06689},
      pages        = {e832-e842},
      year         = {2018},
      abstract     = {To investigate the association of enlarged perivascular
                      spaces (ePVS) with cognition in elderly without dementia.We
                      included 5 studies from the Uniform Neuro-Imaging of
                      Virchow-Robin Space Enlargement (UNIVRSE) consortium, namely
                      the Austrian Stroke Prevention Family Study, Study of Health
                      in Pomerania, Rotterdam Study, Epidemiology of Dementia in
                      Singapore study, and Risk Index for Subclinical Brain
                      Lesions in Hong Kong study. ePVS were counted in 4 regions
                      (mesencephalon, hippocampus, basal ganglia, and centrum
                      semiovale) with harmonized rating across studies.
                      Mini-Mental State Examination (MMSE) and general fluid
                      cognitive ability factor (G-factor) were used to assess
                      cognitive function. For each study, a linear regression
                      model was performed to estimate the effect of ePVS on MMSE
                      and G-factor. Estimates were pooled across studies with the
                      use of inverse variance meta-analysis with fixed- or
                      random-effect models when appropriate.The final sample size
                      consisted of 3,575 persons (age range 63.4-73.2 years,
                      $50.6\%$ women). Total ePVS counts were not significantly
                      associated with MMSE score (mean difference per ePVS score
                      increase 0.001, $95\%$ confidence interval [CI] -0.007 to
                      0.008, p = 0.885) or G-factor (mean difference per ePVS
                      score increase 0.002, $95\%$ CI -0.001 to 0.006, p = 0.148)
                      in age-, sex-, and education-adjusted models. Adjustments
                      for cardiovascular risk factors and MRI markers did not
                      change the results. Repeating the analyses with
                      region-specific ePVS rendered similar results.In this study,
                      we found that ePVS counts were not associated with cognitive
                      dysfunction in the general population. Future studies with
                      longitudinal designs are warranted to examine whether ePVS
                      contribute to cognitive decline.},
      keywords     = {Aged / Brain Edema: complications / Brain Edema: diagnostic
                      imaging / Cerebral Arteries: pathology / Cognition
                      Disorders: diagnostic imaging / Cognition Disorders:
                      etiology / Community Health Planning / Female / Humans /
                      Magnetic Resonance Imaging / Male / Middle Aged /
                      Neuropsychological Tests},
      cin          = {Rostock / Greifswald Pre 2020},
      ddc          = {610},
      cid          = {I:(DE-2719)6000017},
      pnm          = {344 - Clinical and Health Care Research (POF3-344)},
      pid          = {G:(DE-HGF)POF3-344},
      typ          = {PUB:(DE-HGF)16},
      pubmed       = {pmid:30068634},
      pmc          = {pmc:PMC6133622},
      doi          = {10.1212/WNL.0000000000006079},
      url          = {https://pub.dzne.de/record/140367},
}