Venous Sinus Volume, Not APOE ε4, Predicts Perivascular Space Burden on MRI

Dorsal superior sagittal sinus volume was associated with PVS count (ρ=0.353, p<0.001) and total volume (ρ=0.285, p=0.009); APOE ε4 status was not. In 110 patients across the cognitive spectrum.

• Associations persisted after adjustment for age, sex, medial temporal atrophy, Fazekas score, and intracranial volume.
• PVS burden tended to decrease with worse cognitive stage, while medial temporal atrophy increased.
• Cross-sectional design precludes causal inference; longitudinal studies are needed to clarify glymphatic mechanisms.

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