Neuroimaging standards for research into small vessel disease and its contribution to ageing and neurodegeneration

Joanna M. Wardlaw*, Eric E. Smith, Geert J. Biessels, Charlotte Cordonnier, Franz Fazekas, Richard Frayne, Richard I. Lindley, John T. O'Brien, Frederik Barkhof, Oscar R. Benavente, Sandra E. Black, Carol Brayne, Monique Breteler, Hugues Chabriat, Charles DeCarli, Frank-Erik de Leeuw, Fergus Doubal, Marco Duering, Nick C. Fox, Steven GreenbergVladimir Hachinski, Ingo Kilimann, Vincent Mok, Robert van Oostenbrugge, Leonardo Pantoni, Oliver Speck, Blossom C. M. Stephan, Stefan Teipel, Anand Viswanathan, David Werring, Christopher Chen, Colin Smith, Mark van Buchem, Bo Norrving, Philip B. Gorelick, Martin Dichgans

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review


Cerebral small vessel disease (SVD) is a common accompaniment of ageing. Features seen on neuroimaging include recent small subcortical infarcts, lacunes, white matter hyperintensities, perivascular spaces, microbleeds, and brain atrophy. SVD can present as a stroke or cognitive decline, or can have few or no symptoms. SVD frequently coexists with neurodegenerative disease, and can exacerbate cognitive deficits, physical disabilities, and other symptoms of neurodegeneration. Terminology and definitions for imaging the features of SVD vary widely, which is also true for protocols for image acquisition and image analysis. This lack of consistency hampers progress in identifying the contribution of SVD to the pathophysiology and clinical features of common neurodegenerative diseases. We are an international working group from the Centres of Excellence in Neurodegeneration. We completed a structured process to develop definitions and imaging standards for markers and consequences of SVD. We aimed to achieve the following: first, to provide a common advisory about terms and definitions for features visible on MRI; second, to suggest minimum standards for image acquisition and analysis; third, to agree on standards for scientific reporting of changes related to SVD on neuroimaging; and fourth, to review emerging imaging methods for detection and quantification of preclinical manifestations of SVD. Our findings and recommendations apply to research studies, and can be used in the clinical setting to standardise image interpretation, acquisition, and reporting. This Position Paper summarises the main outcomes of this international effort to provide the STandards for Reporting Vascular changes on nEuroimaging (STRIVE).
Original languageEnglish
Pages (from-to)822-838
JournalLancet Neurology
Issue number8
Publication statusPublished - Aug 2013

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