Neuroimaging in cerebral small vessel disease: Update and new concepts

Shibuya, Mika; Leite, Cláudia da Costa; Lucato, Leandro Tavares

doi:10.1590/1980-57642016dn11-040002

Cited by 10 publications

(11 citation statements)

References 9 publications

(15 reference statements)

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“…They range from biomarkers implemented on standard clinical scanners which can be used across multiple sites and advanced methods requiring special techniques. Clinically applicable MRI biomarkers include small subcortical infarctions, lacunes of presumed vascular origins, WMHs of presumed vascular origin, perivascular spaces, cerebral microbleeds, and brain atrophy [15,16]. The more advanced MRI biomarkers include blood-brain barrier permeability, magnetic resonance spectroscopy, diffusion MRI (dMRI) cerebral blood flow, cerebral vascular reactivity, and brain connectivity as measured by functional MRI (fMRI) and dMRI [9,11,12].…”

Section: Mri Methods In Vcimentioning

confidence: 99%

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Review of diffusion MRI studies in chronic white matter diseases

Raja

Rosenberg

Caprihan

2019

Neuroscience Letters

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Diffusion MRI studies characterizing the changes in white matter (WM) due to vascular cognitive impairment, which includes all forms of small vessel disease are reviewed. We reviewed the usefulness of diffusion methods in discriminating the affected WM regions and its relation to cognitive impairment. These studies were categorized based on the diffusion MRI techniques used. The most common method was the diffusion tensor imaging, whereas other methods included diffusion weighted imaging, diffusion kurtosis imaging, intravoxel incoherent motion, and studies based on diffusion tractography. The diffusion measures showed correlation with cognitive scores and disease progression, with mean diffusivity being the most robust parameter. Future studies should focus on incorporating multi-compartment and higher order diffusion models, which can handle the presence of multiple and crossing fibers inside a voxel.

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Section: Mri Methods In Vcimentioning

confidence: 99%

“…In the last ten years the MRI methods used to study cerebral small vessel disease (SVD) have been reviewed by multiple groups [9][10][11][12][13][14][15][16]. The MRI biomarkers used to study SVD are similar to those used for studying other neurodegenerative diseases, such as AD.…”

Section: Diagnosis Of Patients With Chronic Wm Diseasementioning

confidence: 99%

Review of diffusion MRI studies in chronic white matter diseases

Raja

Rosenberg

Caprihan

2019

Neuroscience Letters

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“…Cerebral SVD causes focal lacunar infarction and more diffuse ischemia, referred to as leukoaraiosis [ 83 ]. Although often asymptomatic, it is responsible for almost half of all cases of dementia and for a significant proportion of stroke cases [ 84 ].…”

Section: Impact Of Uremic Toxins On Brain Microcirculationmentioning

confidence: 99%

The Impact of Uremic Toxins on Cerebrovascular and Cognitive Disorders

Assem

Lando

Grissi

et al. 2018

Toxins

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Individuals at all stages of chronic kidney disease (CKD) have a higher risk of developing cognitive disorders and dementia. Stroke is also highly prevalent in this population and is associated with a higher risk of neurological deterioration, in-hospital mortality, and poor functional outcomes. Evidence from in vitro studies and in vivo animal experiments suggests that accumulation of uremic toxins may contribute to the pathogenesis of stroke and amplify vascular damage, leading to cognitive disorders and dementia. This review summarizes current evidence on the mechanisms by which uremic toxins may favour the occurrence of cerebrovascular diseases and neurological complications in CKD.

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“…Standards for neuroimaging with a widely accepted terminology permitting comparison of findings between centers have been recommended (STandards for ReportIng Vascular changes on Neuroimaging [STRIVE]) (14). Numerous studies identified MRI markers of SVD (lacunes, white matter hyperintensities, cerebral microbleeds, silent infarcts, white matter changes, global cerebral atrophy, medial-temporal lobe atrophy) as determinants of VaD (18,19). Vascular lesions traditionally attributed to VCI comprise subcortical areas of the brain, especially subfrontal white matter circuits, strategic areas of single infarction such as the dominant thalamus or angular gyrus, deep frontal areas and the left hemisphere, and bilateral brain infarcts or volume-driven cortical-subcortical infarctions reaching a critical threshold of tissue loss or injury (20).…”

Section: Imaging Morphologic Substrates Of Svdmentioning

confidence: 99%

The Additional Value of PET in the Assessment of Cerebral Small Vessel Disease

Heiss

2018

J Nucl Med

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The diagnosis of cerebral small vessel disease (SVD) is difficult because there is no consensus on clinical criteria, and therefore imaging is important for diagnosis. Most patients undergo brain imaging by CT, which is able to detect ischemic strokes, hemorrhages, and brain atrophy and may also indicate white matter changes. MRI remains the key neuroimaging modality and is preferred to CT in vascular cognitive impairment (VCI) because it has higher sensitivity and specificity for detecting pathologic changes. These modalities for imaging morphology permit detection of vascular lesions traditionally attributed to VCI in subcortical areas of the brain, single infarction or lacunes in strategic areas (thalamus or angular gyrus), or large cortical-subcortical lesions reaching a critical threshold of tissue loss. In SVD, multiple punctuate or confluent lesions can be seen in the white matter by MRI and were called leukoaraiosis. Another major neuroimaging finding of SVD in VCI are microhemorrhages. However, whereas CT and MRI are able to detect morphologic lesions, these modalities cannot determine functional consequences of the underlying pathologic changes. PET can support the clinical diagnosis by visualizing cerebral functions in typically affected brain regions. In SVD, F-FDG PET can clearly differentiate scattered areas of focal cortical and subcortical hypometabolism that differ from the typical metabolic pattern seen in Alzheimer dementia (AD) with marked hypometabolism affecting the association areas. Additional PET tracers can further support the diagnosis of a type of dementia and also yield information on the underlying pathophysiology.

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Neuroimaging in cerebral small vessel disease: Update and new concepts

Cited by 10 publications

References 9 publications

Review of diffusion MRI studies in chronic white matter diseases

Review of diffusion MRI studies in chronic white matter diseases

The Impact of Uremic Toxins on Cerebrovascular and Cognitive Disorders

The Additional Value of PET in the Assessment of Cerebral Small Vessel Disease

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