TY - JOUR
T1 - Investigating the origin and evolution of cerebral small vessel disease
T2 - The RUN DMC – InTENse study
AU - ter Telgte, Annemieke
AU - Wiegertjes, Kim
AU - Tuladhar, Anil M.
AU - Noz, Marlies P.
AU - Marques, José P.
AU - Gesierich, Benno
AU - Huebner, Mathias
AU - Mutsaerts, Henk Jan M.M.
AU - Elias-Smale, Suzette E.
AU - Beelen, Marie José
AU - Ropele, Stefan
AU - Kessels, Roy P.C.
AU - Riksen, Niels P.
AU - Klijn, Catharina J.M.
AU - Norris, David G.
AU - Duering, Marco
AU - de Leeuw, Frank Erik
PY - 2018/12/1
Y1 - 2018/12/1
N2 - Background: Neuroimaging in older adults commonly reveals signs of cerebral small vessel disease (SVD). SVD is believed to be caused by chronic hypoperfusion based on animal models and longitudinal studies with inter-scan intervals of years. Recent imaging evidence, however, suggests a role for acute ischaemia, as indicated by incidental diffusion-weighted imaging lesions (DWI+ lesions), in the origin of SVD. Furthermore, it becomes increasingly recognised that focal SVD lesions likely affect the structure and function of brain areas remote from the original SVD lesion. However, the temporal dynamics of these events are largely unknown. Aims: (1) To investigate the monthly incidence of DWI+ lesions in subjects with SVD; (2) to assess to which extent these lesions explain progression of SVD imaging markers; (3) to investigate their effects on cortical thickness, structural and functional connectivity and cognitive and motor performance; and (4) to investigate the potential role of the innate immune system in the pathophysiology of SVD. Design/methods: The RUN DMC – InTENse study is a longitudinal observational study among 54 non-demented RUN DMC survivors with mild to severe SVD and no other presumed cause of ischaemia. We performed MRI assessments monthly during 10 consecutive months (totalling up to 10 scans per subject), complemented with clinical, motor and cognitive examinations. Discussion: Our study will provide a better understanding of the role of DWI+ lesions in the pathophysiology of SVD and will further unravel the structural and functional consequences and clinical importance of these lesions, with an unprecedented temporal resolution. Understanding the role of acute, potentially ischaemic, processes in SVD may provide new strategies for therapies.
AB - Background: Neuroimaging in older adults commonly reveals signs of cerebral small vessel disease (SVD). SVD is believed to be caused by chronic hypoperfusion based on animal models and longitudinal studies with inter-scan intervals of years. Recent imaging evidence, however, suggests a role for acute ischaemia, as indicated by incidental diffusion-weighted imaging lesions (DWI+ lesions), in the origin of SVD. Furthermore, it becomes increasingly recognised that focal SVD lesions likely affect the structure and function of brain areas remote from the original SVD lesion. However, the temporal dynamics of these events are largely unknown. Aims: (1) To investigate the monthly incidence of DWI+ lesions in subjects with SVD; (2) to assess to which extent these lesions explain progression of SVD imaging markers; (3) to investigate their effects on cortical thickness, structural and functional connectivity and cognitive and motor performance; and (4) to investigate the potential role of the innate immune system in the pathophysiology of SVD. Design/methods: The RUN DMC – InTENse study is a longitudinal observational study among 54 non-demented RUN DMC survivors with mild to severe SVD and no other presumed cause of ischaemia. We performed MRI assessments monthly during 10 consecutive months (totalling up to 10 scans per subject), complemented with clinical, motor and cognitive examinations. Discussion: Our study will provide a better understanding of the role of DWI+ lesions in the pathophysiology of SVD and will further unravel the structural and functional consequences and clinical importance of these lesions, with an unprecedented temporal resolution. Understanding the role of acute, potentially ischaemic, processes in SVD may provide new strategies for therapies.
KW - acute incidental infarcts
KW - cognition
KW - DWI+ lesions
KW - ischaemia
KW - motor performance
KW - remote effects
KW - Serial imaging
KW - silent stroke
UR - http://www.scopus.com/inward/record.url?scp=85060504033&partnerID=8YFLogxK
U2 - 10.1177/2396987318776088
DO - 10.1177/2396987318776088
M3 - Article
AN - SCOPUS:85060504033
VL - 3
SP - 369
EP - 378
JO - European Stroke Journal
JF - European Stroke Journal
SN - 2396-9873
IS - 4
ER -