TY - JOUR
T1 - Causes and consequences of cerebral small vessel disease. The RUN DMC study
T2 - a prospective cohort study. Study rationale and protocol
AU - van Norden, Anouk Gw
AU - de Laat, Karlijn F
AU - Gons, Rob Ar
AU - van Uden, Inge Wm
AU - van Dijk, Ewoud J
AU - van Oudheusden, Lucas Jb
AU - Esselink, Rianne Aj
AU - Bloem, Bastiaan R
AU - van Engelen, Baziel Gm
AU - Zwarts, Machiel J
AU - Tendolkar, Indira
AU - Olde-Rikkert, Marcel G
AU - van der Vlugt, Maureen J
AU - Zwiers, Marcel P
AU - Norris, David G
AU - de Leeuw, Frank-Erik
PY - 2011/2/28
Y1 - 2011/2/28
N2 - BACKGROUND: Cerebral small vessel disease (SVD) is a frequent finding on CT and MRI scans of elderly people and is related to vascular risk factors and cognitive and motor impairment, ultimately leading to dementia or parkinsonism in some. In general, the relations are weak, and not all subjects with SVD become demented or get parkinsonism. This might be explained by the diversity of underlying pathology of both white matter lesions (WML) and the normal appearing white matter (NAWM). Both cannot be properly appreciated with conventional MRI. Diffusion tensor imaging (DTI) provides alternative information on microstructural white matter integrity. The association between SVD, its microstructural integrity, and incident dementia and parkinsonism has never been investigated.METHODS/DESIGN: The RUN DMC study is a prospective cohort study on the risk factors and cognitive and motor consequences of brain changes among 503 non-demented elderly, aged between 50-85 years, with cerebral SVD. First follow up is being prepared for July 2011. Participants alive will be included and invited to the research centre to undergo a structured questionnaire on demographics and vascular risk factors, and a cognitive, and motor, assessment, followed by a MRI protocol including conventional MRI, DTI and resting state fMRI.DISCUSSION: The follow up of the RUN DMC study has the potential to further unravel the causes and possibly better predict the consequences of changes in white matter integrity in elderly with SVD by using relatively new imaging techniques. When proven, these changes might function as a surrogate endpoint for cognitive and motor function in future therapeutic trials. Our data could furthermore provide a better understanding of the pathophysiology of cognitive and motor disturbances in elderly with SVD. The execution and completion of the follow up of our study might ultimately unravel the role of SVD on the microstructural integrity of the white matter in the transition from "normal" aging to cognitive and motor decline and impairment and eventually to incident dementia and parkinsonism.
AB - BACKGROUND: Cerebral small vessel disease (SVD) is a frequent finding on CT and MRI scans of elderly people and is related to vascular risk factors and cognitive and motor impairment, ultimately leading to dementia or parkinsonism in some. In general, the relations are weak, and not all subjects with SVD become demented or get parkinsonism. This might be explained by the diversity of underlying pathology of both white matter lesions (WML) and the normal appearing white matter (NAWM). Both cannot be properly appreciated with conventional MRI. Diffusion tensor imaging (DTI) provides alternative information on microstructural white matter integrity. The association between SVD, its microstructural integrity, and incident dementia and parkinsonism has never been investigated.METHODS/DESIGN: The RUN DMC study is a prospective cohort study on the risk factors and cognitive and motor consequences of brain changes among 503 non-demented elderly, aged between 50-85 years, with cerebral SVD. First follow up is being prepared for July 2011. Participants alive will be included and invited to the research centre to undergo a structured questionnaire on demographics and vascular risk factors, and a cognitive, and motor, assessment, followed by a MRI protocol including conventional MRI, DTI and resting state fMRI.DISCUSSION: The follow up of the RUN DMC study has the potential to further unravel the causes and possibly better predict the consequences of changes in white matter integrity in elderly with SVD by using relatively new imaging techniques. When proven, these changes might function as a surrogate endpoint for cognitive and motor function in future therapeutic trials. Our data could furthermore provide a better understanding of the pathophysiology of cognitive and motor disturbances in elderly with SVD. The execution and completion of the follow up of our study might ultimately unravel the role of SVD on the microstructural integrity of the white matter in the transition from "normal" aging to cognitive and motor decline and impairment and eventually to incident dementia and parkinsonism.
KW - Aged
KW - Aged, 80 and over
KW - Brain/blood supply
KW - Cerebrovascular Disorders/complications
KW - Clinical Protocols
KW - Dementia/complications
KW - Diffusion Tensor Imaging/methods
KW - Disease Progression
KW - Female
KW - Geriatric Assessment/methods
KW - Humans
KW - Magnetic Resonance Imaging/methods
KW - Male
KW - Middle Aged
KW - Nerve Fibers, Myelinated/pathology
KW - Parkinsonian Disorders/complications
KW - Prospective Studies
KW - Risk Factors
U2 - 10.1186/1471-2377-11-29
DO - 10.1186/1471-2377-11-29
M3 - Article
C2 - 21356112
VL - 11
SP - 29
JO - BMC Neurology
JF - BMC Neurology
SN - 1471-2377
ER -