Frontal perivascular spaces shrink over three years after ischaemic stroke

Stroke survivors showed significant reductions in frontal lobe perivascular space volume (exp(β)=0.93, 95% CI 0.82-0.99) and cluster count (exp(β)=0.91, 95% CI 0.83-1) over 36 months vs. controls, challenging the view that PVS enlargement marks cerebrovascular disease burden.

• At 3 months post-stroke, whole-brain perivascular space metrics were significantly greater in stroke patients than in healthy controls.
• By 36 months, frontal perivascular spaces in stroke patients had decreased relative to controls, contrary to age-related enlargement seen in the control group.
• These longitudinal trajectories suggest that MRI-visible perivascular space changes are dynamic and region-specific, not a simple static marker of small vessel disease.

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