Worse visibility of deep medullary veins is associated with larger lateral ventricles but not with cortical thickness.

Publication Type Academic Article
Authors Manchineella S, Rusinek H, Ma Y, Wang X, Maharjan S, Zhou L, Butler T, Li Y, Jones A, Tanzi E, Chiang G, Pahlajani S, Olejniczak-Gniadek K, Hojjati S, Maloney T, de Leon M, Glodzik L
Journal J Stroke Cerebrovasc Dis
Volume 35
Issue 1
Pagination 108510
Date Published 11/29/2025
ISSN 1532-8511
Keywords Cerebral Veins, Magnetic Resonance Imaging, Lateral Ventricles, Cerebral Cortex, Brain Cortical Thickness, Medulla Oblongata
Abstract BACKGROUND: Deep medullary veins (DMVs) play important roles within the cerebrovascular network related to brain drainage and clearance. Although they have been previously correlated with brain volume, it is unknown whether their count is specifically correlated with subcortical or cortical volume changes. PURPOSE: This study aims to better understand the relationship between DMVs, subcortical (lateral ventricle to intracranial volume ratio (ICV)) and cortical atrophy (cortical thickness) to identify whether DMVs can be a predictor of volume changes in these regions. METHODS: We performed a retrospective analysis of 332 cognitively healthy subjects previously followed between 2010 and 2019. Imaging and patient charts were analyzed for baseline demographic and clinical characteristics. Patients underwent a standardized cognitive interview and received a magnetic resonance imaging scan to assess DMVs, cortical thickness, lateral ventricle and global gray matter (GM) volumes, white matter lesions (WMLs) and microbleeds. RESULTS: Among 332 patients (62% female, median age 70), lateral ventricle/ICV was significantly related to DMV count (p<0.001). Similarly, sex stratified analyses confirmed that a larger lateral ventricle/ICV ratio, but not cortical thickness or global GM volumes, was associated with fewer DMVs. In the entire group, subcortical atrophy remained a significant predictor of DMVs even after accounting for baseline characteristics, WMLs, microbleeds and total gray matter volume. CONCLUSIONS: In a large cohort of cognitively unaffected people, subcortical, but not cortical, atrophy was significantly correlated with venous health as measured by DMVs. Reduced DMVs are a strong predictor of ventricular enlargement.
DOI 10.1016/j.jstrokecerebrovasdis.2025.108510
PubMed ID 41325793
PubMed Central ID PMC13012701
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