Park YW, et al. - Recently, magnetic resonance imaging-visible perivascular space (PVS) has been considered an imaging biomarker of small vessel disease, but its impact on cognitive decline in Parkinson's disease (PD) is unknown, so researchers assessed if cognitive decline can be independently forecast by PVS in PD. A total of 271 patients with PD were classified into patients with intact cognition (PD-IC; n = 106) and patients with mild cognitive impairment (PD-MCI; n = 165). Using multivariable logistic regression analysis, independent risk factors for cognitive decline were examined. Higher basal ganglia (BG)-PVS and white matter hyperintensity severity, higher levodopa-equivalent dose, hypertension, and lower Mini-Mental State Examination score were independent positive predictors of future cognitive decline in all study participants. Higher BG-PVS severity, hypertension, and more severe depressive symptoms were predictors of cognitive conversion in the PD-IC subgroup. Higher BG-PVS and white matter hyperintensity severity, and lower Mini-Mental State Examination score were predictors of cognitive decline in the PD-MCI subgroup. Overall, the authors concluded that, for anticipating cognitive decline, BG-PVS can be a beneficial imaging marker in PD.