Call the Plumber! New ONDRI study shows correlation between MRI-visible perivascular spaces and increased symptoms of Parkinson’s Disease

Apr 13, 2022 | Blog, Science Simplified

A recent discovery in brain biology that is driving important ONDRI research is that of the glymphatic system; this system is made up of a network of spaces surrounding the brain’s blood vessels that is believed to help clear toxic waste from the brain. This activity occurs primarily during sleep and is one of the many reasons that getting a proper amount of sleep per night is pivotal.

Glymphatic system and clearance through PVS

The increasing focus on the glymphatic system has given rise to novel research regarding the importance of the tiny spaces surrounding the brain’s blood vessels, called perivascular spaces (PVS), in neurodegenerative diseases such as Alzheimer’s disease and Parkinson’s disease.

PVS play a role in the clearance of metabolic waste from the brain. When this process is disrupted due to a clog or a higher burden of local waste, these microscopic spaces become visible on a magnetic resonance imaging (MRI) scan. This is of great interest to ONDRI researchers, who work on many platforms – including neuroimaging – studying the neurodegenerative and blood vessel related diseases associated with dementia.

Connection to Parkinson’s Disease

Parkinson’s Disease is a neurodegenerative disease that commonly presents with motor symptoms such as tremors and disrupted balance and gait. One brain region that is of particular interest in Parkinson’s disease is called the basal ganglia.

“The basal ganglia region of the brain is responsible for motor control and is the target of neuronal cell loss in Parkinson’s Disease,” said Dr. Anthony Lang, a distinguished Neurologist at UHN in Toronto, Professor, and ONDRI researcher.

“This is why this area was of particular interest for us when considering the glymphatic system and potential impact of blockages on Parkinson’s symptoms,” he continues.

Novel research study findings

A group of ONDRI researchers, headed by Dr. Lang, studied data from ONDRI’s Foundational study, comparing MRI images where the PVS in the basal ganglia area appeared to be enlarged, to results of a well established Parkinson’s test.

They published a paper entitled “Small and Large Magnetic Resonance Imaging–Visible Perivascular Spaces in the Basal Ganglia of Parkinson’s Disease Patients”, in the renowned Movement Disorders Journal. This paper showed that:

  • small basal ganglia MRI-visible perivascular spaces are associated with more severe daily motor and non-motor symptoms
  • whereas patients with large basal ganglia MRI-visible perivascular spaces are associated with more severe motor symptoms and complications

More on the Parkinson’s assessment tool

ONDRI’s Foundational study included many assessments, which were carried across to all disease cohorts. Concurrently, some disease-specific tools were also employed.

The tool referenced in ONDRI’s new study was a commonly used Parkinson’s disease symptom assessment scale, known as the MDS-UPDRS. This scale is separated into four parts focusing on different groups of symptoms. MDS-UPDRS Parts I and II focus on daily motor and non-motor experiences, such as speech and mood; whereas the MDS-UPDRS Parts III and IV focus on motor symptoms and complications, such as gait and tremor.

“This is the first study to demonstrate these associations in Parkinson’s disease patients. ONDRI’s neuroimaging team enabled us to examine both large and small PVS using a quantitative imaging approach – without such a diligent team of expertise, none of this would be possible”, said Joel Ramirez PhD, an ONDRI researcher who was co-first author on the paper.


This study represents an ONDRI cross-platform collaboration between the neuroimaging, clinical and neuroinformatics platforms, and more.

ONDRI released deeply characterized data from its cross-disease, cross-platform Foundational Study in December 2021. For more information www.braincode.ca

Dr. Anthony Lang

Dr. Anthony Lang

ONDRI Researcher

Read Anthony Lang’s bio here. 
Joel Ramirez, PhD

Joel Ramirez, PhD

ONDRI Researcher

Read Joel Ramirez’s bio here. 
Stephanie Berberian

Stephanie Berberian

ONDRI Researcher

Read Stephanie Berberian’s bio here.