Association of Enlarged Perivascular Spaces With Early Serum and Neuroimaging Biomarkers of Alzheimer Disease Pathology

These findings suggest EPVS burden to be a potential marker of both CSVD and AD-related BBM pathology. The results support the potential of incorporating EPVS assessments into routine MRI evaluations to enhance early detection and risk stratification in AD. Longitudinal studies are needed to confirm the prognostic value of EPVS and to clarify mechanisms linking vascular dysfunction to amyloid and tau pathology.