Cerebral small vessel disease (cSVD) is an umbrella term used to collectively describe different pathologies that affect small blood vessels in the brain. It’s an emerging disease, contributing to 45% of dementia and 25% of stroke cases worldwide [1]. Diffusion MRI (dMRI) parameters have shown larger sensitivity to disease severity and progression compared to conventional markers based on structural MRI, such as white matter hyperintensities and microbleeds [2]. This work aimed to investigate whether these dMRI metrics can detect longitudinal decline in SVD patients. A cohort of 48 SVD patients was identified on the UK Biobank (application ID: 155020), with median age at baseline of 69 years (IQR: 66-74 years) and median follow-up time of 2.23 years (IQR: 2.07-2.28 years). DTI (Diffusion Tensor Imaging) and NODDI (Neurite Orientation and Density Imaging) model parameters were extracted in white matter (WM) and grey matter (GM) ROIs. Linear mixed-effects models were employed to study longitudinal change of the parameters in each ROI, adjusting for baseline age and sex and applying FDR correction. Significant differences (p<0.05) were found across several WM ROIs, most notably in the corona radiata, internal and external capsules, corpus callosum, and superior longitudinal fasciculus (effect sizes 0.1-0.2 sd/year). These results highlight the sensitivity of advanced dMRI metrics to WM longitudinal deterioration in cSVD. Future work will explore the relationship between these metrics and cognitive performance, to further validate the clinical importance of these biomarkers.

 

Acknowledgements: Funded by the European Union - Next Generation EU, Mission 4, Component 2, Investment 3.3 (Ministerial Decree 630/2024) CUP J33C24001440009. This research has been conducted using the UK Biobank Resource under Application Number: 155020.

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References:

1) R. J. Cannistraro, M. Badi, B. H. Eidelman, D. W. Dickson, E. H. Middlebrooks, and J. F. Meschia, “CNS small vessel disease: A clinical review.” Neurology, vol. 92, no. 24, pp. 1146–1156, Jun. 2019. 

2) B. Patel and H. S. Markus, "Magnetic resonance imaging in cerebral small vessel disease and its use as a surrogate disease marker," Int. J. Stroke, vol. 6, no. 1, pp. 47–59, Feb. 2011.